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Song DK, Hong YS, Sung YA, Lee H. The effect of menopause on cardiovascular risk factors according to body mass index in middle-aged Korean women. PLoS One 2023; 18:e0283393. [PMID: 36952503 PMCID: PMC10035845 DOI: 10.1371/journal.pone.0283393] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Menopausal status and obesity are associated with an increased risk for cardiovascular diseases. However, there are few studies on the effect of menopause on cardiovascular risk factors according to the degree of obesity during the menopausal transition. We aimed to evaluate the effect of menopause on cardiovascular risk factors according to body mass index (BMI) in middle-aged Korean women. METHODS We analyzed 361 postmenopausal women and 758 premenopausal women (age: 45-55 years) without diabetes mellitus, hypertension, or dyslipidemia, using a cohort database released by the Korean National Health and Nutrition Examination Survey 2016-2018. Subjects were divided into two groups based on BMI. Women who underwent a hysterectomy or were pregnant were excluded from this study. Differences between groups adjusted for age and BMI were assessed. RESULTS Postmenopausal women (52 ± 2 years) were older than premenopausal women (48 ± 2 years), and BMI did not differ between the two groups (22.8 ± 2.9 vs. 23.0 ± 3.1 kg/m2). After adjustment for age and BMI in total and non-obese subjects (not obese subjects), postmenopausal women exhibited higher hemoglobin A1c and total cholesterol levels than premenopausal women. Subgroup analysis for 138 postmenopausal and 138 age- and BMI-matched premenopausal women showed that postmenopausal women had higher total cholesterol levels than premenopausal women with marginal significance (201 ± 25 vs. 196 ± 27 mg/dL). CONCLUSION Menopausal status was associated with increased glucose and cholesterol levels independent of age and BMI in middle-aged Korean women. Menopausal status showed a significant relationship with increased total cholesterol levels even after adjusting for age and BMI in non-obese women but not obese women. Therefore, intensive monitoring and treating of lipid status is necessary to prevent cardiovascular events during the menopausal transition, especially in non-obese subjects.
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Affiliation(s)
- Do Kyeong Song
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Young Sun Hong
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yeon-Ah Sung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyejin Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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2
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Choi DJ, Park JJ, Yoon M, Park SJ, Jo SH, Kim EJ, Kim SJ, Lee S. Self-Monitoring of Blood Pressure and Feed-back Using APP in TReatment of UnconTrolled Hypertension (SMART-BP): A Randomized Clinical Trial. Korean Circ J 2022; 52:785-794. [PMID: 36217600 PMCID: PMC9551232 DOI: 10.4070/kcj.2022.0133] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. METHODS Self-Monitoring of blood pressure and Feed-back using APP in TReatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. CONCLUSIONS SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04470284.
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Affiliation(s)
- Dong-Ju Choi
- Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jin Joo Park
- Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Minjae Yoon
- Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung-Ji Park
- Division of Cardiology, Heart Vascular Stroke Institute, Samsung Medical Center/Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang-Ho Jo
- Division of Cardiology, Hallym University Sacred Heart Hospital/Hallym University College of Medicine, Anyang, Korea
| | - Eung Ju Kim
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Soo-Joong Kim
- Division of Cardiology, Kyung Hee University Hospital, Seoul, Korea
| | - Sungyoung Lee
- Department of Computer Science and Engineering, Kyung Hee University, Yongin, Korea
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3
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Hernández-Vásquez A, Vargas-Fernández R. Prevalence of Prehypertension and Associated Cardiovascular Risk Profiles among Adults in Peru: Findings from a Nationwide Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137867. [PMID: 35805525 PMCID: PMC9265298 DOI: 10.3390/ijerph19137867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 12/04/2022]
Abstract
Prehypertension is a clinical condition that increases the risk of hypertension and cardiovascular disease. In South American countries, prehypertension affects almost one-third of the population. The aim of the present study was to determine the association between prehypertension and the main cardiometabolic risk factors according to the US National Cholesterol Education Program Adult Treatment Panel III by sex in the Peruvian population. A total of 863 participants surveyed were included in the study. A total of 21.1% had prehypertension, 14.4% of whom were female, and 30.5% were male. Women belonging to the age group 50–59 years, having abdominal obesity and being a current smoker, were more likely to have prehypertension, while the likelihood of having prehypertension increased in men with abdominal obesity. Three out of 10 men and one out of 10 women in Peru have prehypertension. In women, being 50 to 59 years of age, having abdominal obesity, and being a current smoker, increased the probability of having prehypertension, whereas, in men, only abdominal obesity was found to be associated with prehypertension. Our findings will allow the development of prevention strategies focused on the appropriate diagnosis of prehypertension and cardiometabolic risk factors according to sex.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15024, Peru
- Correspondence:
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Kodoth V, Scaccia S, Aggarwal B. Adverse Changes in Body Composition During the Menopausal Transition and Relation to Cardiovascular Risk: A Contemporary Review. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:573-581. [PMID: 35814604 PMCID: PMC9258798 DOI: 10.1089/whr.2021.0119] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 05/10/2023]
Abstract
The menopausal transition period in aging women is strongly associated with weight gain. Evidence shows that weight changes during menopause increases the risk of developing cardiovascular disease (CVD) in postmenopausal women. However, the potential mechanisms that cause weight gain and adverse changes to body composition specifically during the menopausal transition period remain to be elucidated. In this contemporary review, we examined recent evidence for adverse changes in body composition at midlife during the menopausal transition and the link to increased CVD risk and described factors that may contribute to these changes, including normal chronological aging, hormonal factors (decreased estrogen, etc.), behavioral factors (changes in diet, physical activity), or other emerging factors (e.g., sleep). This review focused on identifying factors that make the menopausal transition period a critical window for prevention of CVD. Future study is needed to decipher the extent to which hormonal changes, age-related factors, and behavioral factors interact with and contribute to increased CVD risk in women undergoing menopause. Understanding the causes of weight gain during the menopausal transition may help to inform strategies to mitigate adverse CVD outcomes for women transitioning through menopause.
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Affiliation(s)
- Varna Kodoth
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Samantha Scaccia
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Brooke Aggarwal
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Institute of Human Nutrition, Columbia University Irving Medical Center, New York, New York, USA
- Address correspondence to: Brooke Aggarwal, EdD, MS, FAHA, Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA.
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5
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Tran NTT, Blizzard CL, Luong KN, Truong NLVN, Tran BQ, Otahal P, Nelson MR, Magnussen CG, Van Bui T, Srikanth V, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Gall S. Sex differences in total cholesterol of Vietnamese adults. PLoS One 2021; 16:e0256589. [PMID: 34415963 PMCID: PMC8378708 DOI: 10.1371/journal.pone.0256589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The mid-life emergence of higher levels of total cholesterol (TC) for women than for men has been observed in different Western and Asian populations. The aim of this study was to investigate whether there is evidence of this in Vietnam and, if so, whether it can be explained by ageing, by body size and fatness, or by socio-demographic characteristics and behavioural factors. METHODS Participants (n = 14706, 50.9% females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Linear regression was used to assess the independent contributions of potential explanatory factors to mean levels of TC. Data were analysed using complex survey methods. RESULTS Men and women had similar mean levels of body mass index (BMI), and men had modestly higher mean levels of waist circumference (WC), in each 5-year age category. The mean TC of women increased more or less continuously across the age range but with a step-up at age 50 years to reach higher concentrations on average than those of their male counterparts. The estimated step-up was not eliminated by adjustment for anthropometric indices including BMI or WC, or by adjustment for socio-demographic characteristics or behavioural factors. The estimated step-up was least for women with the greatest weight. CONCLUSION There is a marked step-up in TC at age 50 years for Vietnamese women that cannot be explained by their age, or by their body fatness or its distribution, or by their socio-demographic characteristics or behavioural factors, and which results in greater mean levels of TC for middle-aged women than for their male counterparts in Vietnam.
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Affiliation(s)
- Nga Thi Thu Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Ngoc Le Van Ngoc Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mark R. Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Velandai Srikanth
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Abstract
Managing dyslipidemia over a women's life, including a focus on pregnancy, contraception, and atherosclerotic cardiovascular disease risk prevention can decrease the burden of cardiovascular disease.
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7
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Jung M, Choo E, Lee S. Comprehensive Trends and Patterns of Antihypertensive Prescriptions Using a Nationwide Claims Database in Korea. Clin Epidemiol 2020; 12:963-975. [PMID: 32982461 PMCID: PMC7494009 DOI: 10.2147/clep.s265966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/11/2020] [Indexed: 01/13/2023] Open
Abstract
Purpose The number of people receiving antihypertensive prescriptions in Korea has increased more than threefold from 2002 to 2016. However, previous studies regarding the current use of these medications have been fairly limited. We aimed to examine the current trends and changes in the patterns of antihypertensive prescriptions based on a nationwide claims database. Patients and Methods Patients receiving antihypertensive medications over 30 days, without any limited therapeutic indication, were identified using the Health Insurance Review and Assessment Service (HIRA) database between 2015 and 2017. For each patient, the use of antihypertensive medication was specified as the class of drug used for the longest duration in each year. Results A total of 8,625,821 patients in 2015, 8,997,829 patients in 2016, and 9,357,751 patients in 2017 taking antihypertensives were included in this study. Angiotensin II receptor blockers (ARB) (35.9% in 2015 and 38.9% in 2017) and calcium channel blockers (CCB) (37.1% in 2015 and 35.2% in 2017) for monotherapy, ARB+CCB combinations (49.3% in 2015 and 56.3% in 2017) for dual therapy, and ARB+CCB+diuretics combinations (48.8% in 2015 and 48.9% in 2017) for more than triple therapy were the most frequently prescribed. Subjects aged ≥70 showed the highest prescription rate of antihypertensives compared with those <70; however, a decreasing trend presented from 62.3% in 2015 to 54.2% in 2017. Additionally, in subjects aged >70 years, the rate in women was higher than that in men, but this was reversed in younger patients. While changes arose in the patterns of the use of antihypertensives, these were similar each year. Conclusion The trends and changes in the patterns of the use of antihypertensive medications were affected by age, sex, and type of therapy. Our findings may contribute to a better understanding of the actual status regarding the use of antihypertensive medications in Korea.
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Affiliation(s)
- Minji Jung
- Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, Republic of Korea
| | - Eunjung Choo
- Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, Republic of Korea
| | - Sukhyang Lee
- Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, Republic of Korea
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8
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Kim HC, Ihm SH, Kim GH, Kim JH, Kim KI, Lee HY, Lee JH, Park JM, Park S, Pyun WB, Shin J, Chae SC. 2018 Korean Society of Hypertension guidelines for the management of hypertension: part I-epidemiology of hypertension. Clin Hypertens 2019; 25:16. [PMID: 31388451 PMCID: PMC6670210 DOI: 10.1186/s40885-019-0121-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 06/03/2019] [Indexed: 02/08/2023] Open
Abstract
The Korean Society of Hypertension guideline defines hypertension as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, where the effectiveness of pharmacological treatment has been established. It is confirmed that higher blood pressure levels are associated with increased risk of cardiovascular disease and mortality also in the Korean population. About one third of Korean adults aged 30 years or older are estimated to have hypertension, and the prevalence of hypertension gradually increases as the age increases. The awareness, treatment, and control rates of hypertension are generally improving in Korea, but more efforts are required to increase awareness and treatment among younger patients with hypertension and to improve lifestyle modification compliance at all ages. More studies are required to determine the magnitude and impact of white coat hypertension and masked hypertension in the Korean population.
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Affiliation(s)
- Hyeon Chang Kim
- 1Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Ihm
- 2Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Gheun-Ho Kim
- 3Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Ju Han Kim
- 4Department of Internal Medicine, School of Medicine, Chonnam University, GwangJu, South Korea
| | - Kwang-Il Kim
- 5Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Hae-Young Lee
- 6Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Jang Hoon Lee
- 7Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu, 700-721 South Korea
| | - Jong-Moo Park
- 8Department of Neurology, Eulji General Hospital, Eulji University College of Medicine, Seoul, South Korea
| | - Sungha Park
- 9Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Wook Bum Pyun
- 10Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Jinho Shin
- 3Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Shung Chull Chae
- 7Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu, 700-721 South Korea
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9
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Premenopausal cardiovascular disease and age at natural menopause: a pooled analysis of over 170,000 women. Eur J Epidemiol 2019; 34:235-246. [DOI: 10.1007/s10654-019-00490-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/29/2019] [Indexed: 12/27/2022]
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10
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Wild R, Weedin EA, Gill EA. Women's Health Considerations for Lipid Management. Endocrinol Metab Clin North Am 2016; 45:65-85. [PMID: 26892998 DOI: 10.1016/j.ecl.2015.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Understanding opportunities to reduce dyslipidemia before, during, and after pregnancy has major implications for cardiovascular disease risk prevention for the entire population. The best time to screen for dyslipidemia is before pregnancy or in the early antenatal period. The differential diagnosis of hypertriglyceridemia in pregnancy is the same as in nonpregnant women except that clinical lipidologists need to be aware of the potential obstetric complications associated with hypertriglyceridemia. Dyslipidemia discovered during pregnancy should be treated with diet and exercise intervention, as well as glycemic control if indicated. A complete lipid profile assessment during each trimester of pregnancy is recommended.
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Affiliation(s)
- Robert Wild
- Section of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, 1100 N Lindsay Ave, Oklahoma City, OK 73104, USA.
| | - Elizabeth A Weedin
- Section of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, 1100 N Lindsay Ave, Oklahoma City, OK 73104, USA
| | - Edward A Gill
- Division of Cardiology, UW Department of Medicine, Harborview Medical Center Echocardiography, University of Washington School of Medicine, Seattle University, 325 Ninth Avenue, Box 359748, Seattle, WA 98104-2499, USA
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11
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Waist circumference compared with other obesity parameters as determinants of coronary artery disease in essential hypertension: a 6-year follow-up study. Hypertens Res 2016; 39:475-9. [PMID: 26865004 DOI: 10.1038/hr.2016.8] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 12/01/2015] [Accepted: 12/07/2015] [Indexed: 12/24/2022]
Abstract
This study aimed to assess the predictive role of body mass index (BMI), waist circumference (WC) and the waist-to-hip ratio (WHR) for the incidence of coronary artery disease (CAD) in a cohort of essential hypertensive patients. We followed up 2266 essential hypertensive individuals (mean age, 57.8 years; males, 1083; office blood pressure (BP), 143/89 mm Hg) who were free of cardiovascular disease for a mean period of 6 years. All subjects had at least one annual visit and, at baseline, underwent blood sampling and a complete echocardiographic study to determine the left ventricular (LV) mass index. CAD was defined as a history of myocardial infarction or significant coronary artery stenosis that was revealed by angiography or a coronary revascularization procedure. The incidence of CAD throughout the follow-up period was 2.33%. Hypertensive individuals who developed CAD (n=53) had a greater baseline WC (101.1±11.7 vs. 96.4±12 cm, P=0.005), WHR (0.94±0.07 vs. 0.89±0.08 cm, P<0.0001) and LV mass index (117±26.8 vs. 103.3±27 g m(-)(2), P<0.0001) compared with those without CAD at follow-up (n=2213), whereas no difference was observed compared with the baseline office BP and BMI values (P=NS for all). Using a multivariate Cox regression model, WC (hazard ratio (HR) 1.037, P=0.002) and LV mass index (HR 1.010, P=0.044) were found to be independent predictors of CAD. In essential hypertensive patients, WC could predict the future development of CAD, whereas BMI and WHR showed no independent prognostic value. These findings suggest that WC constitutes an easy clinical tool to assess risk in hypertension among individuals with obesity.
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12
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Abstract
Understanding opportunities to reduce dyslipidemia before, during, and after pregnancy has major implications for cardiovascular disease risk prevention for the entire population. The best time to screen for dyslipidemia is before pregnancy or in the early antenatal period. The differential diagnosis of hypertriglyceridemia in pregnancy is the same as in nonpregnant women except that clinical lipidologists need to be aware of the potential obstetric complications associated with hypertriglyceridemia. Dyslipidemia discovered during pregnancy should be treated with diet and exercise intervention, as well as glycemic control if indicated. A complete lipid profile assessment during each trimester of pregnancy is recommended.
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13
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Shin JH, Lee HT, Lim YH, Park HC, Shin J, Kim KS, Park JK. Defining Vitamin D Deficiency and Its Relationship to Hypertension in Postmenopausal Korean Women. J Womens Health (Larchmt) 2015; 24:1021-9. [PMID: 26540562 DOI: 10.1089/jwh.2015.5358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Inconsistent results regarding the association between low vitamin D level and hypertension (HTN) have led to uncertainty in clinical practice as to the use of vitamin D cutoff value. The aims of this study were to investigate the association between vitamin D deficiency and HTN in postmenopausal women and to determine the clinically significant cutoff value for vitamin D deficiency. METHODS We analyzed data from the Korean National Health and Nutrition Examination Survey 5 database (4107 postmenopausal women, aged 50-79 years). The cutoff value for vitamin D deficiency was based on the changes in parathyroid hormone (PTH) level according to serum 25(OH)D value. RESULTS PTH levels were significantly higher in groups with serum 25(OH)D <15 ng/mL (p < 0.001). When a serum 25(OH)D value of 15 ng/mL was used as a cutoff value, 35.2% of the subjects were found to be vitamin D deficient. Although the association between 25(OH)D level <15 ng/mL and systolic blood pressure did not remain significant after adjusting for season (p = 0.30), multiple logistic regression analysis revealed that 25(OH)D level <15 ng/mL was an independent risk factor for HTN (adjusted odds ratio [OR] 1.285, 95% confidence interval [CI] 1.024-1.614, p = 0.031). CONCLUSIONS Using serum PTH level, we defined vitamin D deficiency as 25(OH)D <15 ng/mL in postmenopausal women. Vitamin D deficiency [25(OH)D <15 ng/mL] was a significant risk factor for HTN in postmenopausal women.
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Affiliation(s)
- Jeong-Hun Shin
- 1 Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Guri Hospital , Guri, Korea
| | - Hyung Tak Lee
- 2 Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Medical Center , Seoul, Korea
| | - Young-Hyo Lim
- 2 Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Medical Center , Seoul, Korea
| | - Hwan-Cheol Park
- 1 Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Guri Hospital , Guri, Korea
| | - Jinho Shin
- 2 Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Medical Center , Seoul, Korea
| | - Kyung-Soo Kim
- 2 Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Medical Center , Seoul, Korea
| | - Jin-Kyu Park
- 2 Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Medical Center , Seoul, Korea
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Jacobson TA, Maki KC, Orringer CE, Jones PH, Kris-Etherton P, Sikand G, La Forge R, Daniels SR, Wilson DP, Morris PB, Wild RA, Grundy SM, Daviglus M, Ferdinand KC, Vijayaraghavan K, Deedwania PC, Aberg JA, Liao KP, McKenney JM, Ross JL, Braun LT, Ito MK, Bays HE, Brown WV. National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. J Clin Lipidol 2015; 9:S1-122.e1. [DOI: 10.1016/j.jacl.2015.09.002] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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15
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Guidelines for dietary management of menopausal women with simple obesity. MENOPAUSE REVIEW 2015; 14:48-52. [PMID: 26327888 PMCID: PMC4440197 DOI: 10.5114/pm.2015.48678] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 09/22/2014] [Accepted: 11/18/2014] [Indexed: 11/19/2022]
Abstract
The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman's life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient's needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska). For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.
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Shin J, Park JB, Kim KI, Kim JH, Yang DH, Pyun WB, Kim YG, Kim GH, Chae SC. 2013 Korean Society of Hypertension guidelines for the management of hypertension: part I-epidemiology and diagnosis of hypertension. Clin Hypertens 2015; 21:1. [PMID: 26893915 PMCID: PMC4745140 DOI: 10.1186/s40885-014-0012-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/23/2014] [Indexed: 01/01/2023] Open
Abstract
The standardized techniques of blood pressure measurement in the clinic are emphasized and the indications for ambulatory and/or home blood pressure monitoring are specified more broadly. The epidemiologic findings specific to Korean population related to blood pressure are reviewed. Cardiovascular risk of hypertensive patients are stratified based upon the data of a Korean population cohort study.
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Affiliation(s)
- Jinho Shin
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Bae Park
- Division of Cardiology, Department of Medicine, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea
| | - Kwang-Il Kim
- Department of Internal Medicine, School of Medicine, Seoul National University, Bundang, Korea
| | - Ju Han Kim
- Department of Internal Medicine, School of Medicine, Chonnam University, GwangJu, Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Wook Bum Pyun
- Ewha Womans University School of Medicine, Seoul, Korea
| | - Young Gweon Kim
- Division of Cardiology, Department of Internal Medicine, Dongkuk University College of Medicine, Ilsan, Korea
| | - Gheun-Ho Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Shung Chull Chae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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Relationship between bone mineral density and a 10-year risk for coronary artery disease in a healthy Korean population. Coron Artery Dis 2015; 26:66-71. [DOI: 10.1097/mca.0000000000000165] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Wang SK, Ma W, Wang S, Yi XR, Jia HY, Xue F. Obesity and its relationship with hypertension among adults 50 years and older in Jinan, China. PLoS One 2014; 9:e114424. [PMID: 25517735 PMCID: PMC4269412 DOI: 10.1371/journal.pone.0114424] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/10/2014] [Indexed: 12/22/2022] Open
Abstract
Background The relationship between obesity and hypertension varies with geographical area, race and definitions of obesity. Our study aimed to investigate the prevalence of obesity using standard Chinese criteria based on the body mass index (BMI) and the waist circumference (WC) and to examine the association between obesity and hypertension among middle-aged and elderly people in Jinan city. Methods This cross-sectional study examined 1,870 subjects from the blocks randomly selected from among the 6 communities of Jinan, China in 2011–2012. The Student's t-test was used to compare numerical data, and the χ2 test was used to compare categorical data. Multivariate logistic regression analyses were performed to assess the effects of general and central obesity on hypertension after adjusting for age or for education level, smoking, alcohol consumption, and continuous age. Results The prevalence of general obesity among people age 50 years and older was 21.1% (17.0% for males and 23.1% for females), and the prevalence of central obesity was 77.8% for men and 78.7% for women. For men, compared with a normal BMI, the ORs and 95% CIs for overweight and general obesity were 1.853 (1.252, 2.744) and 3.422 (1.894, 6.182), respectively, after adjusting for age, smoking, alcohol consumption and educational level. Compared with a normal WC, the ORs and 95% CIs for central obesity were 2.334 (1.573, 3.465) and 2.318 (1.544, 3.479), respectively, for men. For women, compared with a normal BMI, the ORs and 95% CIs were 1.942 (1.473, 2.599) and 4.011 (2.817, 5.712), respectively, after adjusting for age, smoking, alcohol consumption and educational level. Compared with a normal WC, the ORs and 95% CIs for central obesity were 2.488 (1.865, 3.319) and 2.379 (1.773, 3.192), respectively, for women. Conclusions The relationship between hypertension and general obesity was stronger than the relationship between hypertension and either overweight or central obesity in both genders.
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Affiliation(s)
- Shu-Kang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Wei Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Shumei Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Xiang-Ren Yi
- The College of Physical Education of Shandong University, Jinan, China
| | - Hong-Ying Jia
- The Second Hospital of Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
- * E-mail:
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Lim YH, Cho SH. Response to Letter to the Editor Regarding “Sex-Specific Characteristics of Anthropometry in Patients With Obstructive Sleep Apnea: Neck Circumference and Waist–Hip Ratio”. Ann Otol Rhinol Laryngol 2014; 123:887-8. [DOI: 10.1177/0003489414539634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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