Epidemiology and Health

Original Articles

Association of blood pressure measurements in sitting, supine, and standing positions with the 10-year risk of mortality in Korean adults: Inkyung Baik, Nan Hee Kim, Seong Hwan Kim, Chol Shin; Epidemiol Health. 2023;45:e2023055. Published online June 8, 2023; DOI: https://doi.org/10.4178/epih.e2023055

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Abstract

OBJECTIVES
This prospective cohort study investigated the association between blood pressure (BP) as measured in different body postures and all-cause and cardiovascular (CV) mortality risk.

METHODS

This population-based investigation included 8,901 Korean adults in 2001 and 2002. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured sequentially in the sitting, supine, and standing positions and classified into 4 categories: (1) normal, SBP <120 mmHg and DBP <80 mmHg; (2) high normal/prehypertension, SBP 120-129 mmHg and DBP <80 mmHg/SBP 130-139 mmHg or DBP 80-89 mmHg; (3) grade 1 hypertension (HTN), with SBP 140-159 mmHg or DBP 90-99 mmHg; and (4) grade 2 HTN, SBP ≥160 mmHg or DBP ≥100 mmHg. The date and cause of individual deaths were confirmed in the death record data compiled until 2013. Data were analyzed using Cox proportional hazard regression.

RESULTS

Significant associations were found between the BP categories and all-cause mortality, but only when BPs were measured in the supine position. The multivariate hazard ratios (95% confidence intervals, [CIs]) were 1.36 (95% CI, 1.06 to 1.75) and 1.59 (95% CI, 1.06 to 2.39) for grade 1 HTN and grade 2 HTN, respectively, compared with the normal category. The associations between the BP categories and CV mortality were significant regardless of body posture among participants ≥65 years, whereas they were significant for supine BP measurements only in those <65 years.

CONCLUSIONS

BP measured in the supine position predicted all-cause mortality and CV mortality better than BP measured in other postures.

Summary

Korean summary
본 역학 연구는 한국 성인 8,901명을 연구대상자로 하여 기초조사에서 세가지 자세, 즉 앉은 자세, 누운 자세, 일어선 자세에서 혈압을 측정하고, 이후 10년 동안의 사망 여부를 추적조사하여, 측정 자세에 따른 혈압과 사망 위험과의 관련성을 분석하였다. 그 결과, 누운 자세에서 측정된 고혈압(기준: 수축기 혈압이 140 mmHg 이상 혹은 이완기 혈압이 90 mmHg 이상)인 사람은 정상 혈압(기준: 수축기 혈압이 120 mmHg 미만이고 이완기 혈압이 80 mmHg 미만)인 사람에 비해 36%(1단계 고혈압) 혹은 59%(2단계 고혈압) 가량 총 사망 위험이 유의적으로 증가하는 것으로 나타났다. 이에 비해, 앉은 자세 및 일어선 자세에서 측정, 정의된 고혈압은 총 사망 위험을 증가시켰지만 유의적인 결과를 나타내지 못했다. 추후 연구에서 재확인이 필요하지만, 본 연구 결과가 시사하는 바는 앉은 자세나 일어선 자세보다 누운 자세에서 측정하는 혈압이 총 사망 위험을 더 잘 예측하므로, 고혈압 진단 외의 추가적인 활용 가능성이 있는 것으로 평가된다.

Key Message
The current epidemiological study revealed that blood pressure measured in a supine position could predict all-cause mortality and cardiovascular mortality better than blood pressure measured in a sitting or standing position. As a result, blood pressure measurements in a supine position may be useful in assessing mortality risk.

Citations

Citations to this article as recorded by

Safety of midodrine in patients with heart failure with reduced ejection fraction: a retrospective cohort study
Ming-Ju Wu, Cheng-Hsu Chen, Shang-Feng Tsai
Frontiers in Pharmacology.2024;[Epub] CrossRef

Impact of statin treatment on cardiovascular events in patients with retinal vein occlusion: a nested case-control study in Korea: Joonsang Yoo, Joo Youn Shin, Jimin Jeon, Jinkwon Kim; Epidemiol Health. 2023;45:e2023035. Published online March 15, 2023; DOI: https://doi.org/10.4178/epih.e2023035

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Retinal vein occlusion (RVO) is associated with an increased risk of future cardiovascular events. Statin therapy is a key cornerstone in prevention for patients at high cardiovascular risk. However, little is known about the role of statin therapy for patients with RVO. This study evaluated whether statin treatment in patients with RVO was associated with a lower risk of cardiovascular events.
METHODS
A population-based, nested case-control study was conducted with a cohort of newly diagnosed RVO patients without prior cardiovascular disease between 2008 and 2020 using a nationwide health claims database in Korea. From this cohort of RVO patients, we identified cases of cardiovascular events (stroke or myocardial infarction) after RVO and matched controls based on sex, age, insurance type, antiplatelet use, and underlying comorbidities using 1:2 incidence density sampling.
RESULTS
Using a cohort of 142,759 patients with newly diagnosed RVO, we selected 6,810 cases and 13,620 matched controls. A significantly lower risk of cardiovascular events (adjusted odds ratio, 0.604; 95% confidence interval, 0.557 to 0.655) was observed in RVO patients with statin treatment than in those without statin treatment. Statin treatment was associated with a reduced risk for both stroke and myocardial infarction after RVO. Longer statin treatment after RVO was associated with a lower risk for cardiovascular events.
CONCLUSIONS
Statin treatment was associated with a lower risk for future cardiovascular events in patients with newly diagnosed RVO. Further studies are warranted to clarify the potential cardiovascular preventive role of statins in patients with RVO.; Summary

Korean summary
· 망막정맥폐색 환자들은 심뇌혈관질환의 발생 위험이 높다고 알려져 있다. · 이번 연구를 통해 망막정맥폐색의 발생 이후 스타틴을 복용한 환자들에서 심근경색 및 뇌졸중 발생 위험도가 감소함을 확인하였다. · 고위험군인 망막정맥폐색 환자들에서 적극적인 스타틴의 사용이 심뇌혈관질환의 예방에 도움이 될 수 있을 것이다.

Key Message
· Statin was associated with a lower risk of cardiovascular events in RVO patients. · The reduced risk was observed in both stroke and myocardial infarction after RVO. · Statins might be a good candidate for cardiovascular prevention in RVO patients.

A hypertension risk score for adults: a population-based cross-sectional study from the Dubai Household Survey 2019: Ibrahim Mahmoud, Nabil Sulaiman, Amal Hussein, Heba Mamdouh, Wafa K. AL Nakhi, Hamid Y. Hussain, Gamal M. Ibrahim; Epidemiol Health. 2021;43:e2021064. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021064

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Abstract Summary PDF: Abstract
OBJECTIVES
The aim of this study was to develop a risk score model for predicting hypertension specific to the population of Dubai in the United Arab Emirates (UAE) to facilitate prevention and early intervention.
METHODS
A retrospective analysis of data from the Dubai Household Health Survey 2019 was conducted. Demographic and physical parameters, as well as blood glucose levels, were included in the data. The risk factors for hypertension were identified using bivariate analysis. A risk score model was developed using the enter method, where all significant predictors of hypertension in bivariate analyses were entered in a single step with the primary outcome of hypertension status (yes/no). The model was validated internally by splitting the data into Emirati and non-Emirati populations.
RESULTS
A total of 2,533 subjects were studied. The significant risk factors for hypertension identified were male sex, older age (≥40 years), education level, body mass index, diabetes mellitus, and dyslipidaemia. The model showed a high discrimination ability between individuals with and without hypertension, with an area under the curve of 0.77 (95% confidence interval [CI], 0.75 to 0.79), excellent sensitivity (81.0%; 95% CI, 71.9 to 88.2) and moderate specificity (56.0%; 95% CI, 45.7 to 65.9).
CONCLUSIONS
The model developed by this study is simple, convenient, and based on readily available demographic and medical characteristics. This risk score model could support initial hypertension screening and provide an effective tool for targeted lifestyle counselling and prevention programs.; Summary

Key Message
To prevent hypertension in Dubai's adult population, primary health care physicians can use our risk score model to recommend preventative measures, with a focus on men over 40 years old, with a low educational level, who are obese, and who have other morbidities, such as diabetes mellitus and dyslipidemia.

Exploring the associations between cardiovascular health measured with the CANHEART model and early cognitive impairment in a middle-aged population in Korea: Ye Jin Jeon, Ji Heon Lee, Hyeon Chang Kim, Sun Jae Jung; Epidemiol Health. 2021;43:e2021044. Published online July 13, 2021; DOI: https://doi.org/10.4178/epih.e2021044

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Abstract

OBJECTIVES
Both cardiovascular health (CVH) and inflammation are associated with cognition, and inflammation is also associated with CVH. However, limited information has been reported on these factors in the Korean population. The objective of our study was to investigate the influence of inflammation on the association between CVH and cognition using a cross-sectional design.

METHODS

Data were obtained from the Cardiovascular and Metabolic Diseases Etiology Research Center baseline study. Participants who completed fasting serum analysis, questionnaires, and cognitive function tests were included in the analysis, whereas those with a history of autoimmune disease were excluded. The CVH in Ambulatory Care Research Team health index metrics, including smoking, physical activity, healthy diet, obesity, history of hypertension, and diabetes, were used to assess CVH. Cognitive function was evaluated with the Korean version of the Mini-Mental State Estimation for Dementia Screening. Inflammatory status was assessed based on a high-sensitivity C-reactive protein (hs-CRP) test.

RESULTS

Among 2,622 total participants (mean age, 57.2 years; 1,792 women), 13%, 58%, and 29% had poor, intermediate, and ideal CVH, respectively. Logistic regression analysis demonstrated that CVH was significantly associated with cognitive function only in women. A stratified analysis showed that cognitive impairment due to CVH was not associated with hs-CRP levels. When the same analyses were conducted for each CVH component, the only component affecting the association was hypertension history in men.

CONCLUSIONS

CVH is not significantly associated with cognitive decline in the middle-aged Korean population. Inflammation did not play a significant modifying role in this relationship.

Summary

Korean summary
• 본 연구는 심뇌혈관 및 대상질환원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center, CMERC) 코호트의 기반조사 데이터를 활용하여, 심혈관계건강과 인지기능 사이의 연관성을 한국 도시거주 중년인구에서 확인하고, 염증 지표인 고감도C반응단백 (high-sensitivity C-reactive protein, hs-CRP) 수준에 따른 차이를 탐색하였다. • 남성과 여성 모두에서 CANHEART health index가 낮은 집단에서 인지기능이 평균적으로 더 낮았으나, 통계적으로 유의하지는 않았다. • 염증 수준에 따른 심혈관계건강과 인지기능 사이의 연관성은 해당 연구에서는 확인할 수 없었다.

Key Message
In the Korean middle-aged population, poor cardiovascular health (CVH) assessed by CANHEART health index was associated with low cognitive function, but not statistically significant. Further investigation is suggested to develop CVH index specified in Korean populations and to estimate the association between CVH and cognitive function in larger population.

Citations

Citations to this article as recorded by

Cardiovascular disease risk models and dementia or cognitive decline: a systematic review
Ruirui Jia, Qing Wang, Hengyi Huang, Yanli Yang, Yuet Foon Chung, Tao Liang
Frontiers in Aging Neuroscience.2023;[Epub] CrossRef

Renal hyperfiltration, fatty liver index, and the hazards of all-cause and cardiovascular mortality in Finnish men: Mounir Ould Setti, Ari Voutilainen, Tomi-Pekka Tuomainen; Epidemiol Health. 2021;43:e2021001. Published online December 24, 2020; DOI: https://doi.org/10.4178/epih.e2021001

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Abstract

OBJECTIVES
Renal hyperfiltration (RHF) and fatty liver are separately associated with adverse health outcomes. In this study, we investigated the mortality hazard of coexisting RHF and fatty liver.

METHODS

Middle-aged men from the Kuopio Ischaemic Disease Risk Factor Study (n=1,552) were followed up for a median of 29 years. Associations among RHF, fatty liver index (FLI) score, age, body mass index, smoking status, alcohol consumption, and hypertension status were assessed using logistic regression. Cox proportional hazards models were used to determine the hazard ratios (HRs) for all-cause and cardiovascular disease (CVD) mortality with respect to RHF and fatty liver.

RESULTS

Of the men, 5% had RHF (n=73), whereas a majority had fatty liver (n=848). RHF was associated specifically with smoking, and fatty liver was associated specifically with overweight. The all-cause mortality hazard was highest (HR, 1.96; 95% confidence interval [CI], 1.27 to 3.01) among men with RHF and fatty liver (n=33). Among men with RHF but normal FLI (n=40), the HR of all-cause mortality was 1.67 (95% CI, 1.15 to 2.42). Among men with fatty liver but a normal estimated glomerular filtration rate (n=527), the HR of all-cause mortality was 1.35 (95% CI, 1.09 to 1.66). CVD mortality hazard was associated with RHF, but not fatty liver. We detected no interaction effect between RHF and fatty liver for all-cause (synergy index, 0.74; 95% CI, 0.21 to 2.67) or CVD (synergy index, 0.94; 95% CI, 0.34 to 2.60) mortality.

CONCLUSIONS

RHF and fatty liver are independently associated with all-cause and CVD mortality

Summary

Key Message
Both prevalent, underdiagnosed, and commonly coexisting, renal hyperfiltration and fatty liver are two notable independent risk factors of all-cause and cardiovascular disease mortality.

Citations

Citations to this article as recorded by

Impact of gout on cardiovascular disease mortality: a meta-analysis
Jielin Yuan, Zhitao Xie, Bo Pan, Jingchang Zhang
Zeitschrift für Rheumatologie.2024;[Epub] CrossRef
Sex-specific association of body mass index and fatty liver index with prevalence of renal hyperfiltration: a cross sectional study using Japanese health check-up data
Atsushi Kitazawa, Yoshiharu Fukuda
BMC Nephrology.2023;[Epub] CrossRef
Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population
Andrea Dalbeni, Marta Garbin, Mirko Zoncapè, Sara Romeo, Filippo Cattazzo, Anna Mantovani, Annalisa Cespiati, Anna Ludovica Fracanzani, Emmanouil Tsochatzis, David Sacerdoti, Alessandro Mantovani, Rosa Lombardi
International Journal of Molecular Sciences.2023; 24(21): 15837. CrossRef
Fatty Liver Index Independently Predicts All-Cause Mortality in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis but No Substantial Liver Disease
Pil Gyu Park, Jung Yoon Pyo, Sung Soo Ahn, Hyun Joon Choi, Jason Jungsik Song, Yong-Beom Park, Ji Hye Huh, Sang-Won Lee
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef

Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran: Sohrab Iranpour, Soheila Khodakarim, Abbas Shahsavani, Ardeshir Khosravi, Koorosh Etemad; Epidemiol Health. 2020;42:e2020053. Published online July 18, 2020; DOI: https://doi.org/10.4178/epih.e2020053

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Abstract

OBJECTIVES
This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide).

METHODS

Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value.

RESULTS

We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality.

CONCLUSIONS

A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.

Summary

Citations

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Associations between ambient temperature and suicide: а systematic review
Andrej М. Grjibovski, Ivan М. Kobelev, Natalia N. Kukalevskaya, Yulia A. Popova, Alexander V. Baranov
Ekologiya cheloveka (Human Ecology).2023; 30(6): 399. CrossRef
Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States
Richard V. Remigio, Hao He, Jochen G. Raimann, Peter Kotanko, Frank W. Maddux, Amy Rebecca Sapkota, Xin-Zhong Liang, Robin Puett, Xin He, Amir Sapkota
Science of The Total Environment.2022; 812: 152481. CrossRef

Brief Communication

Testosterone levels and cause-specific mortality in the older French men without metabolic syndrome: Nasser Laouali, Sylvie Brailly-Tabard, Catherine Helmer, Marie-Laure Ancelin, Christophe Tzourio, Alexis Elbaz, Anne Guiochon-Mantel, Marianne Canonico; Epidemiol Health. 2020;42:e2020036. Published online June 1, 2020; DOI: https://doi.org/10.4178/epih.e2020036

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
Previous studies have reported controversial findings regarding the association of testosterone with mortality in older men. This heterogeneity might be partially explained by comorbidities and the presence of metabolic syndrome, as well as differential associations according to causes of death.

METHODS

We used data from a random subsample of the Three-City study, in which hormone levels were measured in 338 men ≥65 years without metabolic syndrome who were followed-up for 12 years. Vital status was determined for all participants from different sources. We used inverse-probability-weighted Cox regression to estimate the hazard ratios (HRs) of cause-specific mortality and 95% confidence intervals (CIs).

RESULTS

Over the follow-up period, 130 men died (30 from cardiovascular disease, 45 from cancer, 55 from other causes). The association of testosterone with mortality showed significant heterogeneity across causes of death (p=0.027 and p=0.022 for total and bioavailable testosterone, respectively). Higher testosterone levels were associated with increased cardiovascular mortality (HR for 1-standard deviation increase, 1.86; 95% CI, 1.28 to 2.71 and 1.50; 95% CI, 1.04 to 2.17 for total and bioavailable testosterone, respectively). By contrast, there were no significant associations of testosterone with mortality from cancer and other causes.

CONCLUSIONS

Our data suggest that the association of testosterone with mortality in men without metabolic syndrome might be differential according to the cause of death. These findings may partially explain the heterogeneity across studies on the relationship between testosterone levels and mortality.

Summary

Citations

Citations to this article as recorded by

Testosterone, atherosclerosis and cardiovascular risks
Anastasia V. Makarova, Sergey B. Shustov, Yuri S. Khalimov, Sergey V. Gaiduk, Viktor P. Kitsyshin, Dmitry S. Frolov
Bulletin of the Russian Military Medical Academy.2023; 25(3): 481. CrossRef

Original Articles

Factors affecting awareness of myocardial infarction symptoms among the general public in Korea: Kyong Sil Park; Epidemiol Health. 2020;42:e2020032. Published online May 18, 2020; DOI: https://doi.org/10.4178/epih.e2020032

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Abstract

OBJECTIVES
We aimed to determine the level of awareness of myocardial infarction (MI) symptoms among the general public in Korea and identify factors affecting awareness of MI symptoms using data from the 2017 Korea Community Health Survey (KCHS).

METHODS

This is a cross-sectional study using KCHS data. Based on five questions about MI symptoms, participants were divided into an awareness group (replied ‘yes’ to all five questions) and an unawareness group (replied ‘no’ or ‘not sure’ to at least one of five questions) for analysis.

RESULTS

Of a total of 228,281 participants, 42.4% were aware of MI symptoms. There was a high level of awareness of chest pain and shortness of breath, but a low level of awareness of gastrointestinal symptoms and pain in the arm, shoulder, jaw, neck, and back. While women had a higher level of overall awareness relative to men, they showed a lower level of awareness regarding chest pain and discomfort. The factors affecting awareness of MI symptoms were gender, age, education level, occupation, smoking, drinking, physical inactivity, and cardiovascular disease risk factors.

CONCLUSIONS

In order to enhance awareness of MI symptoms among the general population, appropriate education and promotion efforts must be implemented based on gender, age, education level, and occupation. Moreover, active efforts by the government, educational institutions, and medical institutions are necessary to improve awareness of both typical and atypical MI symptoms. Furthermore, health policies to promote reduced smoking and drinking and increased physical activity, as well as continuous monitoring and management of individuals with cardiovascular disease risk factors, are required.

Summary

Korean summary
2017년 지역사회건강조사 자료를 분석한 결과, 한국의 심근경색증 증상의 인지율은 42%로 낮은 인식을 보였다. 한국의 지역사회 내 일반인들의 심근경색증 증상의 인지율을 제고하기 위해 성별, 연령, 교육수준, 직업을 고려하여 교육 및 홍보를 실시해야 한다. 그리고, 전형적인 심근경색증 증상뿐만 아니라 비전형적인 심근경색증 증상에 대한 인식에 대한 정부, 교육기관, 의료기관 등의 적극적인 노력이 필요하다. 또한, 금연, 금주, 신체활동 증진에 대한 보건정책적 관리방안과 심혈관질환 위험요인을 가진 대상자들의 지속적인 모니터링 및 관리가 필요하다.

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Recognition of Early Cardiovascular Disease Symptoms in Hypertensive and Dyslipidemic Individuals of Icheon, Korea: Insights into Educational Levels and Health Literacy
Jeehye Lee, Dong-Hee Ryu
Healthcare.2024; 12(7): 736. CrossRef
Engaging social activities prevent stroke and myocardial infraction by raising awareness of warning symptoms: A cross-sectional survey study
Gahyeon Kim, Hyeokjoo Jang, Sebin Kwon, Bumyeol Lee, Suk-Yong Jang, Wonjeong Chae, Sung-In Jang
Frontiers in Public Health.2023;[Epub] CrossRef
“Recognition of heart attack symptoms and treatment-seeking behaviors: a multi-center survey in Tehran, Iran”
Elnaz Shahmohamadi, Mojtaba Sedaghat, Arash Rahmani, Farnoosh Larti, Babak Geraiely
BMC Public Health.2023;[Epub] CrossRef
Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries
Paul Jie Wen Tern, Amar Vaswani, Khung Keong Yeo
Korean Circulation Journal.2023; 53(9): 594. CrossRef
Awareness of Myocardial Infarction Symptoms and Risk Factors in Saudi Arabia: A Cross-Sectional Study
Saad M Alsaab, Ahmed M Almutairi, Ghadi K Alsaadi, Ziyad A Altokhais, Samar H Alabdulqader, Wafa Y Alnofal, Nourah M Alduhaim
Cureus.2023;[Epub] CrossRef
Gender and Social Inequalities in Awareness of Coronary Artery Disease in European Countries
Antonio Daponte-Codina, Emily C. Knox, Inmaculada Mateo-Rodriguez, Amanda Seims, Vera Regitz-Zagrosek, Angela H. E. M. Maas, Alan White, Floris Barnhoorn, Fernando Rosell-Ortiz
International Journal of Environmental Research and Public Health.2022; 19(3): 1388. CrossRef
Blood Pressure Awareness and Knowledge of Cardio-Cerebrovascular Diseases in South Korean Women with Hypertension
Yeo Won Jeong
Healthcare.2021; 9(3): 360. CrossRef
Global Awareness of Myocardial Infarction Symptoms in General Population: a Systematic Review and Meta-Analysis
Akash Sharma, Karavadi Vidusha, Harshini Suresh, Ajan M. J., Kavinkumar Saravanan, Madhvi Dhamania, Nisha B, Rabbanie Tariq Wani
Korean Circulation Journal.2021; 51(12): 983. CrossRef
Global Awareness of Myocardial Infarction Symptoms in General Population
Soo-Joong Kim
Korean Circulation Journal.2021; 51(12): 997. CrossRef
Disparities in Awareness of Myocardial Infarction and Stroke Symptoms and Response Among United States– and Foreign‐Born Adults in the National Health Interview Survey
Ivy Mannoh, Ruth‐Alma Turkson‐Ocran, Jasmine Mensah, Danielle Mensah, Stella S. Yi, Erin D. Michos, Yvonne Commodore‐Mensah
Journal of the American Heart Association.2021;[Epub] CrossRef

The association between smoking or passive smoking and cardiovascular diseases using a Bayesian hierarchical model: based on the 2008-2013 Korea Community Health Survey: Whanhee Lee, Sung-Hee Hwang, Hayoung Choi, Ho Kim; Epidemiol Health. 2017;39:e2017026. Published online June 22, 2017; DOI: https://doi.org/10.4178/epih.e2017026

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Smoking and passive smoking have been extensively reported as risk factors of cardiovascular morbidity and mortality. Despite the biological mechanisms underlying the impact of hazardous chemical substances contained in tobacco in cardiovascular diseases (CVD), studies investigating the association between smoking and passive smoking with morbidity are at an inchoate stage in Korea. Therefore, this study aimed to estimate the risks of smoking and passive smoking on cardiovascular morbidity at the national and regional levels.

METHODS

This study calculated sex-standardized and age-standardized prevalence of CVD and smoking indices in 253 community health centers (si/gun/gu) in Korea using the 2008-2013 Korea Community Health Survey data. Furthermore, a Bayesian hierarchical model was used to estimate the association of smoking and passive smoking with the prevalence of CVD from the national and regional community health centers.

RESULTS

At the national level, smoking was significantly associated with stroke (relative risk [RR], 1.060) and hypertension (RR, 1.016) prevalence, whilst passive smoking at home and work were also significantly associated with prevalence of stroke (RR, 1.037/1.013), angina (RR, 1.016/1.006), and hypertension (RR, 1.010/1.004). Furthermore, the effects of smoking and passive smoking were greater in urban-industrial areas than in rural areas.

CONCLUSIONS

The findings of this study would provide grounds for national policies that limit smoking and passive smoking, as well as regionally serve as the basis for region-specific healthcare policies in populations with high CVD vulnerability.

Summary

Korean summary
베이지안 계층화 방법을 이용하여 흡연 및 간접 흡연과 심혈관계 질환 유병의 전국 및 시/군/구별 연관성을 추정한 결과, 흡연은 뇌졸중 (RR=1.060) 과 고혈압 (RR=1.016) 유병에 유의하게 연관되었다.

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Cohort Profile

Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort: study protocol and results of the first 3 years of enrollment: Jee-Seon Shim, Bo Mi Song, Jung Hyun Lee, Seung Won Lee, Ji Hye Park, Dong Phil Choi, Myung Ha Lee, Kyoung Hwa Ha, Dae Jung Kim, Sungha Park, Won-Woo Lee, Hyeon Chang Kim; Epidemiol Health. 2017;39:e2017016. Published online April 1, 2017; DOI: https://doi.org/10.4178/epih.e2017016

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Abstract Summary PDF

Abstract

Although the etiologies of cardiovascular disease (CVD) are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.

Summary

Korean summary
심뇌혈관 및 대사질환 원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center)에서는 심뇌혈관질환 및 대사질환의 새로운 발병 원인을 찾고 효율적인 예방 전략을 개발하고자 코호트(CMERC cohort와 CMERC-HI cohort)를 구축하였다. 지역사회에 거주하는 만 30-64세 건강한 성인을 대상으로 하는 CMERC cohort는 2013년부터 2018년 까지 총 5년 동안 8000명 등록을 목표로 기반조사를 진행 중이며(2016년 12월 현재 6000여명 등록), 이미 알려진 다양한 위험요인 이외에 사회연결망 정보와 면역노화 관련 바이오마커 등 새로운 위험 요인에 관한 광범위한 정보가 수집되고 있다. CMERC cohort는 심뇌혈관 및 대사질환 예방연구의 기초자료로 활용되어 과학적 데이터에 근거한 예방 전략 수립에 기여하게 될 것이다.

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Original Articles

The burden of infectious and cardiovascular diseases in India from 2004 to 2014: Kajori Banerjee, Laxmi Kant Dwivedi; Epidemiol Health. 2016;38:e2016057. Published online December 14, 2016; DOI: https://doi.org/10.4178/epih.e2016057

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Abstract PDF

Abstract

OBJECTIVES
In India, both communicable and non-communicable diseases have been argued to disproportionately affect certain socioeconomic strata of the population. Using the 60th (2004) and 71st (2014) rounds of the National Sample Survey, this study assessed the balance between infectious diseases and cardiovascular diseases (CVD) from 2004 to 2014, as well as changes in the disease burden in various socioeconomic and demographic subpopulations.

METHODS

Prevalence rates, hospitalization rates, case fatality rates, and share of in-patients deaths were estimated to compare the disease burdens at these time points. Logistic regression and multivariate decomposition were used to evaluate changes in disease burden across various socio-demographic and socioeconomic groups.

RESULTS

Evidence of stagnation in the infectious disease burden and rapid increase in the CVD burden was observed. Along with the drastic increase in case fatality rate, share of in-patients deaths became more skewed towards CVD from 2004 to 2014. Logistic regression analysis demonstrated a significant shift of the chance of succumbing to CVD from the privileged class, comprising non-Scheduled Castes and Tribes, more highly educated individuals, and households with higher monthly expenditures, towards the underprivileged population. Decomposition indicated that a change in the probability of suffering from CVD among the subcategories of age, social groups, educational status, and monthly household expenditures contributed to the increase in CVD prevalence more than compositional changes of the population from 2004 to 2014.

CONCLUSIONS

This study provides evidence of the ongoing tendency of CVD to occur in older population segments, and also confirms the theory of diffusion, according to which an increased probability of suffering from CVD has trickled down the socioeconomic gradient.

Summary

Citations

Citations to this article as recorded by

Comparing the Effectiveness of Different Approaches to Raise Awareness About Antimicrobial Resistance in Farmers and Veterinarians of India
Garima Sharma, Florence Mutua, Ram Pratim Deka, Rajeshwari Shome, Samiran Bandyopadhyay, Bibek Ranjan Shome, Naresh Goyal Kumar, Delia Grace, Tushar Kumar Dey, Johanna Lindahl
Frontiers in Public Health.2022;[Epub] CrossRef
India’s Opportunities and Challenges in Establishing a Twin Registry: An Unexplored Human Resource for the World’s Second-Most Populous Nation
Ruby Dhar, Shweta Rana, Tryambak Pratap Srivastava, Arnab Nayek, Jai Bhagwan Sharma, Digjeet Kaur, Krishna R. Kalari, Harpreet Singh, Subhradip Karmakar
Twin Research and Human Genetics.2022; 25(3): 156. CrossRef
COVID-19 pandemic effects on the distribution of healthcare services in India: A systematic review
Nirav Nimavat, Mohammad Mehedi Hasan, Sundip Charmode, Gowthamm Mandala, Ghanshyam R Parmar, Ranvir Bhangu, Israr Khan, Shruti Singh, Amit Agrawal, Ashish Shah, Vishi Sachdeva
World Journal of Virology.2022; 11(4): 186. CrossRef
Temporal decomposition of life years lived with disability in India: a growing demographic concern
Kajori Banerjee, Srei Chanda, Laxmi Kant Dwivedi
BMC Public Health.2019;[Epub] CrossRef
Undernutrition and Overnutrition Burden for Diseases in Developing Countries: The Role of Oxidative Stress Biomarkers to Assess Disease Risk and Interventional Strategies
Francesca Mastorci, Cristina Vassalle, Kyriazoula Chatzianagnostou, Claudio Marabotti, Khawer Siddiqui, Ahmed Eba, Soueid Mhamed, Arun Bandopadhyay, Marco Nazzaro, Mirko Passera, Alessandro Pingitore
Antioxidants.2017; 6(2): 41. CrossRef

Comparison of Prevalence of Metabolic Syndrome Between Korean Emigrants and Host Country Residents in Japan and China-The Korean Emigrant Study: Myung-Hee Shin, Mi Kyung Kim, Zhong Min Li, Hyun-Kyung Oh, Soo Ryang Kim, Miyuki Taniguchi, Jinnv Fang; Epidemiol Health. 2010;32:e2010005. Published online May 7, 2010; DOI: https://doi.org/10.4178/epih/e2010005

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Abstract

<sec><title>OBJECTIVES</title>This study aims to compare the prevalence of metabolic syndrome between Korean emigrants (KEs) and their host country residents in Japan and China.</sec><sec><title>METHODS</title>The Korean Emigrant Study (KES) is a cohort study initiated in 2005 to elucidate the effect of genetic susceptibility and environmental change on hypertension, diabetes, and metabolic syndrome. Equal numbers of KEs and host country residents, aged 30 or over, were recruited from three regions; Kobe-Osaka in Japan (total number=965), Yanbian in China (n=1,019), and Changchun in China (n=949).</sec><sec><title>RESULTS</title>The age-adjusted prevalences of metabolic syndrome among KEs in Kobe-Osaka were significantly higher than those among Japanese (in men 24.0% vs. 15.6%, p=0.04, in women 8.4% vs. 2.7%, p=0.01), while the age-adjusted prevalences among KEs in Changchun were similar to those among Chinese (in men 11.7% vs. 16.1%, p=0.37, in women 28.3% vs. 30.1%, p=0.91). The age-adjusted prevalences were generally higher in Yanbian than other regions, and KEs had higher prevalence than Chinese in men but not in women (in men 37.9% vs. 28.3%, p=0.03, women 46.0% vs. 50.6%, p=0.44). The components with significant ethnic differences in prevalence were high blood pressure and abdominal obesity in Japan, and triglyceride in China. The most influential component in diagnosing metabolic syndrome was abdominal obesity in men and triglyceride in women.</sec><sec><title>CONCLUSION</title>The prevalence of metabolic syndrome was higher in KEs than in host country residents in Japan but not in China. Abdominal obesity and triglyceride are both discriminating and influential components in metabolic syndrome.</sec>

Summary

Citations

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New Common and Rare Variants Influencing Metabolic Syndrome and Its Individual Components in a Korean Population
Ho-Sun Lee, Yongkang Kim, Taesung Park
Scientific Reports.2018;[Epub] CrossRef
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Yeonjung Kim, Bok-Ghee Han
International Journal of Epidemiology.2017; 46(2): e20. CrossRef
Is There Disparity in Cardiovascular Health Between Migrant Workers and Native Workers?
Hyeonkyeong Lee, Sunghye Cho, Yune Kyong Kim, Jung Hee Kim
Workplace Health & Safety.2016; 64(8): 350. CrossRef
Coffee Intake and Liver Enzyme Association in Korean Immigrants and Japanese: A Comprehensive Cross-Sectional Study
Soo Ki Kim, Myung-Hee Shin, Kayo Sugimoto, Soo Ryang Kim, Susumu Imoto, Ke Ih Kim, Miyuki Taniguchi, Hyun-Kyung Oh, Yoshihiko Yano, Yoshitake Hayashi, Masatoshi Kudo
Digestive Diseases.2016; 34(6): 665. CrossRef

Intervention Study for the Effectiveness of Alcohol Restriction to Blood Pressure.: Yeon Ee Song, Kang Sook Lee; Korean J Epidemiol. 2001;23(2):25-32.

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Abstract PDF: Abstract
PURPOSE
To assess whether blood pressure is reduced by the intervention of intensive weekly counseling to lower alcohol intake for 12 weeks in heavy drinkers with elevated blood pressure, we conducted the quasi-experimental study through workplace health promotion program.
METHODS
Thirty workers with an average intake of alcohol over 180 g/week(2 bottles of Soju, Korean popular liquor) and with over 90 mm Hg in diastolic blood pressure(DBP) or over 140 mm Hg systolic blood pressure(SBP) assigned to intervention group(15 men, IG) and control group(15 men, CG) voluntarily. Mean age was 47.2 6.5 and 43.0 5.4 years old respectivel. The goal of intervention was below 45g/week(1/2 bottle of Soju).
RESULTS
Average weekly alcohol intake after 12 weeks in IG was significantly reduced(before 300.6 114.8g/week, after 24.8 24.5g/week) compared with CG(before 334.4 150.7g/week, after 311.3 150.8g/week). In IG, SBP(before 141.5 9.4mm Hg, after 128.7 13.0mm Hg) and DBP(before 95.5 6.3mm Gg, after 88.0 10.8mm Hg) was significantly decreased after 12 weeks of alcohol restriction program, but in CG there was no change.
CONCLUSION
Restriction program of alcohol intake in workplace was so effective to reduce blood pressure among hypertensives, although this study has a limitation of small subjects, short duration of follow up and no randomized controlled design.; Summary

Genetic Contribution to Cardiovascular Risk Factors in Korea: The Results from the 1998 Korean Nationwide Health and Nutrition Examination Survey.: Sun Ha Jee; Korean J Epidemiol. 2001;23(1):36-42.

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Abstract PDF: Abstract
PURPOSE
The purpose of this study was to estimate the heritability for cardiovascular disease(CVD) risk factors such as obesity, serum lipids, blood pressure and putative other risk factors.
METHODS
Familial correlations and heritability in CVD risk factors were investigated with use of data from a community-based sample of 435 families involving 2,507 persons collected in the 1998 Korean Nationwide Nutrition and Health Examination Survey over the period November to December in 1998. The risk factors considered were obesity indexes such as waist circumference(WC), hip circumference(HC), waist-to-hip ratio(WHR), body mass index(BMI), serum lipids(total cholesterol, LDL- and HDL- cholesterol and triglyceride), systolic and diastolic blood pressure(SBP and DBP) and other putative risk factors(fasting blood sugar, creatinine, platelet, blood urea nitrate).
RESULTS
First, the estimated heritabilites for obesity variables were 49.5% for WC, 46.6% for BMI, 43.2% for WHR and 39.2% for HC. Second, the estimated heritabilites for well-established CVD risk factors were 53% for LDL-cholesterol, 52% for total cholesterol, 52% for HDL-cholesterol, 24% for triglyceride, 39% for SBP and 30% for DBP. Third, the estimated heritabilites for the putative CVD risk factors were 39% for platelet, 39% for fasting blood sugar, 34% for blood urea nitrate, and 32% for creatinine level.
CONCLUSION
Future linkage studies in these families may be worthwhile to further clarify the molecular basis for biological mechanisms controlling these CVD risk factors showing high heritability.; Summary

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