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Cho JH, Park GT, Park KT, Kim HM, Lee SY, Jeong YH, Lee WS, Kim SW, Won H. Temporal trends in adherence to lifestyle recommendations of patients with hypertension in Korea, 2007-2021. Hypertens Res 2024:10.1038/s41440-024-01838-w. [PMID: 39152255 DOI: 10.1038/s41440-024-01838-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 07/13/2024] [Accepted: 07/23/2024] [Indexed: 08/19/2024]
Abstract
Adherence to lifestyle recommendations is crucial in managing hypertension, independent of medical treatment. This study aimed to evaluate the implementation of adherence to lifestyle recommendations and analyze the trends in adherence to lifestyle recommendations among patients with hypertension in Korea from 2007 to 2021 using the Korea National Health and Nutrition Examination Survey (KNHANES). The study included adults aged ≥20 years. Factors such as regular physical activity, smoking and alcohol abstinence, weight and stress management, and adherence to a healthy diet were analyzed. In 2021, A doublefold increase was observed in the proportion of patients with hypertension who adhered to sodium restriction compared to 2007. However, 70% of patients with hypertension consume more sodium than recommended. Moreover, potassium intake has steadily decreased since 2014, with only 23.8% of patients with hypertension meeting the recommended intake. The body mass index (BMI) and waist circumference of patients with hypertension have gradually increased, with fewer patients maintaining an appropriate weight. The neglect of diet and weight control among young patients with hypertension who experience high stress levels poses challenges in modifying their lifestyles. Patients with hypertension in Korea still consume high amounts of sodium, whereas potassium intake is gradually decreasing. Additionally, obesity rates have been increasing, especially among young patients with hypertension. A multidisciplinary approach is necessary for improving the lifestyle habits of hypertensive patients.
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Affiliation(s)
- Jun Hwan Cho
- Division of Cardiology, Chung-Ang University Gwangmyeong Hospital and Department of Internal Medicine, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Gyu Tae Park
- Cardiovascular-Arrhythmia Center, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Kyung-Taek Park
- Cardiovascular-Arrhythmia Center, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Hyue Mee Kim
- Cardiovascular-Arrhythmia Center, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Sang Yeub Lee
- Division of Cardiology, Chung-Ang University Gwangmyeong Hospital and Department of Internal Medicine, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Young-Hoon Jeong
- Division of Cardiology, Chung-Ang University Gwangmyeong Hospital and Department of Internal Medicine, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Wang-Soo Lee
- Cardiovascular-Arrhythmia Center, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Sang-Wook Kim
- Division of Cardiology, Chung-Ang University Gwangmyeong Hospital and Department of Internal Medicine, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Hoyoun Won
- Cardiovascular-Arrhythmia Center, College of Medicine, Chung-Ang University Hospital, Seoul, Korea.
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Kim D, Youn JC, Lee HW, Oh J, Son JW, Cho HJ, Lee S, Shah NR, Kittleson MM, Jeon ES. Diagnostic Pitfall and Clinical Characteristics of Variant Versus Wild-Type Transthyretin Amyloid Cardiomyopathy in Asian Population: The Korean Nationwide Cohort Study. J Korean Med Sci 2024; 39:e163. [PMID: 38769922 PMCID: PMC11106562 DOI: 10.3346/jkms.2024.39.e163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/29/2023] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Transthyretin amyloidosis cardiomyopathy (ATTR-CM) is an under-recognized cause of heart failure (HF) with clinical phenotypes that vary across regions and genotypes. We sought to characterize the clinical characteristics of ATTR-CM in Asia. METHODS Data from a nationwide cohort of patients with ATTR-CM from six major tertiary centres in South Korea were analysed between 2010 and 2021. All patients underwent clinical evaluation, biochemical laboratory tests, echocardiography, and transthyretin (TTR) genotyping at the time of diagnosis. The study population comprised 105 Asian ATTR-CM patients (mean age: 69 years; male: 65.7%, wild-type ATTR-CM: 41.9%). RESULTS Among our cohort, 18% of the patients had a mean left ventricular (LV) wall thickness < 12 mm. The diagnosis of ATTR-CM increased notably during the study period (8 [7.6%] during 2010-2013 vs. 22 [21.0%] during 2014-2017 vs. 75 [71.4%] during 2018-2021). Although the duration between symptom onset and diagnosis did not differ, the proportion of patients with HF presenting mild symptoms increased during the study period (25% NYHA class I/II between 2010-2013 to 77% between 2018-2021). In contrast to other international registry data, male predominance was less prominent in wild-type ATTR-CM (68.2%). The distribution of TTR variants was also different from Western countries and from Japan. Asp38Ala was the most common mutation. CONCLUSION A nationwide cohort of ATTR-CM exhibited less male predominance, a proportion of patients without increased LV wall thickness, and distinct characteristics of genetic mutations, compared to cohorts in other parts of the world. Our results highlight the ethnic variation in ATTR-CM and may contribute to improving the screening process for ATTR-CM in the Asian population.
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Affiliation(s)
- Darae Kim
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Hye Won Lee
- Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Korea
| | - Jaewon Oh
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung-Woo Son
- Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun-Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seul Lee
- Medical Affairs, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea
| | - Nishant R Shah
- Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Michelle M Kittleson
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Eun-Seok Jeon
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Park J, Park S. Association of Handgrip Strength and Cardiovascular Disease Risk Among Middle-Aged Postmenopausal Women: An Analysis of the Korea National Health and Nutrition Examination Survey 2014-2019. Vasc Health Risk Manag 2024; 20:183-194. [PMID: 38628618 PMCID: PMC11020303 DOI: 10.2147/vhrm.s442277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
Purpose Handgrip strength is an indicator of overall muscle strength and has been associated with an increased risk of cardiovascular disease. Evidence suggests that menopause is a risk factor for cardiovascular disease in women, and muscle strength decreases progressively after menopause. Despite the prognostic importance of the decline in muscle strength and increased cardiovascular disease risk among postmenopausal women, evidence of their association is limited. This study aimed to investigate the relationship between handgrip strength and cardiovascular disease risk among postmenopausal, middle-aged Korean women. Patients and Methods Using pooled cohort equations, we calculated the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among postmenopausal women (N = 2019) aged 50-64 years without cardiovascular disease history from the 2014-2019 Korea National Health and Nutrition Examination Survey. Relative grip strength was defined as measured grip strength divided by body mass index. Logistic regression analysis of a complex sampling design was performed to evaluate the association between relative grip strength and a predicted 10-year ASCVD risk ≥7.5%. Results The average handgrip strength was 24.8 kg, and 5.2% of women were considered for sarcopenia (<18 kg). The quartile-stratified relative grip strength was negatively associated with 10-year ASCVD risk (p < 0.001). In the multiple logistic regression analysis, the adjusted odds ratio for the highest relative grip strength quartile was 0.53 (95% confidence interval [CI]: 0.36-0.78), and that of the group who breastfed for more than 12 months was 1.75 (95% CI: 1.36-2.25) for 10-year ASCVD risk. Conclusion Increased handgrip strength may be associated with lower cardiovascular disease risk among middle-aged postmenopausal women in Korea. Our findings provide critical evidence regarding the importance of increasing handgrip strength among postmenopausal, middle-aged women to reduce cardiovascular disease risk. Handgrip strength measurement might be a valuable screening tool for cardiovascular disease prevention.
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Affiliation(s)
- Jinkyung Park
- College of Nursing, Chonnam National University, Gwangju, 61469, Republic of Korea
| | - Sooyeon Park
- College of Nursing, Konyang University, Daejeon, 35365, Republic of Korea
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Yoon M, Kim EJ, Han SW, Park SM, Kim IC, Cho MC, Ahn HS, Shin MS, Hwang SJ, Jeong JO, Yang DH, Kim JJ, Choi JO, Cho HJ, Yoo BS, Kang SM, Choi DJ. The Third Nationwide Korean Heart Failure III Registry (KorHF III): The Study Design Paper. INTERNATIONAL JOURNAL OF HEART FAILURE 2024; 6:70-75. [PMID: 38694931 PMCID: PMC11058439 DOI: 10.36628/ijhf.2024.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/06/2024] [Accepted: 03/22/2024] [Indexed: 05/04/2024]
Abstract
With advancements in both pharmacologic and non-pharmacologic treatments, significant changes have occurred in heart failure (HF) management. The previous Korean HF registries, namely the Korea Heart Failure Registry (KorHF-registry) and Korean Acute Heart Failure Registry (KorAHF-registry), no longer accurately reflect contemporary acute heart failure (AHF) patients. Our objective is to assess contemporary AHF patients through a nationwide registry encompassing various aspects, such as clinical characteristics, management approaches, hospital course, and long-term outcomes of individuals hospitalized for AHF in Korea. This prospective observational multicenter cohort study (KorHF III) is organized by the Korean Society of Heart Failure. We aim to prospectively enroll 7,000 or more patients hospitalized for AHF at 47 tertiary hospitals in Korea starting from March 2018. Eligible patients exhibit signs and symptoms of HF and demonstrate either lung congestion or objective evidence of structural or functional cardiac abnormalities in echocardiography, or isolated right-sided HF. Patients will be followed up for up to 5 years after enrollment in the registry to evaluate long-term clinical outcomes. KorHF III represents the nationwide AHF registry that will elucidate the clinical characteristics, management strategies, and outcomes of contemporary AHF patients in Korea. Trial Registration ClinicalTrials.gov Identifier: NCT04329234.
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Affiliation(s)
- Minjae Yoon
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eung Ju Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Seong Woo Han
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong, Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - In-Cheol Kim
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Keimyung University, Dongsan Hospital, Daegu, Korea
| | - Myeong-Chan Cho
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine, Cheongju, Korea
| | - Hyo-Suk Ahn
- Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Mi-Seung Shin
- Division of Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seok Jae Hwang
- Division of Cardiology, Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jin-Ok Jeong
- Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University, Daegu, Korea
| | - Jae-Joong Kim
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Oh Choi
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun-Jai Cho
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seok-Min Kang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dong-Ju Choi
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Choi J, Sung S, Park SK, Park S, Kim H, Cho MC, Williams B, Lee HY. SCORE and SCORE2 in East Asian Population: A Performance Comparison. JACC. ASIA 2024; 4:265-274. [PMID: 38660103 PMCID: PMC11035948 DOI: 10.1016/j.jacasi.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/03/2023] [Accepted: 10/23/2023] [Indexed: 04/26/2024]
Abstract
Background Systematic COronary Risk Evaluation 2 (SCORE2) and SCORE2-Older Persons (OP) models have been proposed as new cardiovascular risk evaluation tools. Objectives This study evaluated the performance of SCORE/SCORE-OP and SCORE2/SCORE2-OP in the East Asian population by using population-based cohort data from the National Health Insurance Service (NHIS) Health Screening Cohort of Korea. Methods A total of 324,384 NHIS examinees from 2004 to 2005 were divided into 5 age groups: 40-49 years, 50-59 years, 60-69 years,70-79 years, and more than 80 years. The examinees had their predicted cardiovascular disease risks calculated by using SCORE, SCORE2, SCORE-OP, and SCORE2-OP models. The low-risk model was applied on the basis of the cohort's observed event rates. The observed and predicted cardiovascular risks were compared. Results A total of 324,384 subjects were included (mean age 51.4 ± 7.3 years; women, 37.9% for the SCORE/SCORE2 group and mean age 73.0 ± 2.8 years; women, 47.5% for the SCORE/SCORE2-OP group). Over a median follow-up of 9 years, cardiovascular events occurred in 15.0% and 28.9% in SCORE/SCORE2 and SCORE/SCORE2-OP groups, respectively. The SCORE/SCORE-OP model underestimated cardiovascular disease risk in young men (aged 40-49 years) and women (aged 40-59 years) and overestimated it in older age groups. In contrast, SCORE2/SCORE2-OP invariably overestimated the risk in all age groups and sexes. SCORE2/SCORE2-OP showed no improvement in Harrell's concordance index (C-index) compared with SCORE/SCORE-OP. Calibration plots favored SCORE2 over SCORE but not SCORE2-OP over SCORE-OP. Conclusions Both SCORE2/SCORE2-OP and SCORE/SCORE-OP overestimated cardiovascular disease risk with low performance. SCORE2/SCORE2-OP showed slight improvement over older versions, but modifications are necessary for the East Asian population.
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Affiliation(s)
- JungMin Choi
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soseul Sung
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seyong Park
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyoyeong Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Bryan Williams
- UCL Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| | - Hae-Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Park YS, Jang HM, Park JH, Kim BJ, Park HY, Kim YJ. Evaluating cardiovascular disease risk stratification using multiple-polygenic risk scores and pooled cohort equations: insights from a 17-year longitudinal Korean cohort study. Front Genet 2024; 15:1364993. [PMID: 38606355 PMCID: PMC11007088 DOI: 10.3389/fgene.2024.1364993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, caused by a complex interplay of genetic and environmental factors. This study aimed to evaluate the combined efficacy of multi-polygenic risk scores and pooled cohort equations (PCE) for predicting future CVD risks in the Korean population. In this longitudinal study, 7,612 individuals from the Ansan and Ansung cohorts were analyzed over a 17-year follow-up period. The participants were genotyped using the Korea Biobank Array, and quality-controlled genetic data were subjected to imputation analysis. The weighted sum of the PRSs (wPRSsum) was calculated using PRS-CS with summary statistics from myocardial infarction, ischemic stroke, coronary artery disease, and hypertension genome-wide association studies. The recalibrated PCE was used to assess clinical risk, and the participants were stratified into risk groups based on the wPRSsum and PCE. Associations between these risk scores and incident CVD were evaluated using Cox proportional hazards models and Kaplan-Meier analysis. The wPRSsum approach showed a significant association with incident CVD (HR = 1.15, p = 7.49 × 10-5), and the top 20% high-risk genetic group had an HR of 1.50 (p = 5.04 × 10-4). The recalibrated PCE effectively differentiated between the low and high 10-year CVD risk groups, with a marked difference in survival rates. The predictive models constructed using the wPRSsum and PCE demonstrated a slight improvement in prediction accuracy, particularly among males aged <55 years (C-index = 0.640). We demonstrated that while the integration of wPRSsum with PCE did not significantly outperform the PCE-only model (C-index: 0.703 for combined and 0.704 for PCE-only), it provided enhanced stratification of CVD risk. The highest risk group, identified through the combination of high wPRSsum and PCE scores, exhibited an HR of 4.99 for incident CVD (p = 1.45 × 10-15). These findings highlight the potential of integrating genetic risk assessments with traditional clinical tools for effective CVD risk stratification. Although the addition of wPRSsum to the PCE provided a marginal predictive improvement, it proved valuable in identifying high-risk individuals and supporting personalized treatment strategies. This study reinforces the utility of multi-PRS in conjunction with clinical risk assessment tools, paving the way for more tailored approaches for CVD prevention and management in diverse populations.
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Affiliation(s)
- Yi Seul Park
- Division of Genome Science, Department of Precision Medicine, National Institute of Health, Cheongju-si, Republic of Korea
| | - Hye-Mi Jang
- Division of Genome Science, Department of Precision Medicine, National Institute of Health, Cheongju-si, Republic of Korea
| | - Ji Hye Park
- Division of Genome Science, Department of Precision Medicine, National Institute of Health, Cheongju-si, Republic of Korea
| | - Bong-Jo Kim
- Division of Genome Science, Department of Precision Medicine, National Institute of Health, Cheongju-si, Republic of Korea
| | - Hyun-Young Park
- National Institute of Health, Cheongju-si, Republic of Korea
| | - Young Jin Kim
- Division of Genome Science, Department of Precision Medicine, National Institute of Health, Cheongju-si, Republic of Korea
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Kim HC, Lee H, Lee HH, Son D, Cho M, Shin S, Seo Y, Kim EJ. Korea Hypertension Fact Sheet 2023: analysis of nationwide population-based data with a particular focus on hypertension in special populations. Clin Hypertens 2024; 30:7. [PMID: 38424634 PMCID: PMC10905929 DOI: 10.1186/s40885-024-00262-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/10/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The Korea Hypertension Fact Sheet 2023, presented by the Korean Society of Hypertension, offers an overview of the prevalence and management of hypertension, along with recent trends. METHODS Data for the Fact Sheet were derived from the Korea National Health and Nutrition Examination Survey spanning 1998 to 2021, and the National Health Insurance Big Data from 2002 to 2021. RESULTS As of 2021, hypertension affected 28.0% of Korean adults aged 20 and older, totaling approximately 12.3 million individuals, with 5.3 million (43.5%) aged 65 or older. Among those with hypertension, awareness stood at 74.1%, treatment rates at 70.3%, and control rates at 56.0%. Over the years, the number of hypertension diagnoses increased from 3.0 million in 2002 to 11.1 million in 2021. During the same period, the utilization of antihypertensive medications rose from 2.5 million to 10.5 million, with treatment adherence also improving from 0.6 million to 7.8 million individuals. In 2021, the predominant antihypertensive drug class was angiotensin receptor blockers (75.1%), followed by calcium channel blockers (61.7%), diuretics (23.4%), and beta blockers (15.3%). Notably, 60.2% of all antihypertensive prescriptions involved combination therapy with at least two classes of antihypertensive medication. There was a positive trend towards stricter blood pressure control targets (systolic/diastolic blood pressure < 130/80 mmHg) among elderly hypertensive patients, as well as those with diabetes, obesity, and high-risk hypertension. However, this trend declined in individuals aged 80 years or older and those with chronic kidney disease in recent years. CONCLUSION In Korea, hypertension management is making strides, yet the total number of hypertensive individuals is rising. Effectively addressing the growing population of elderly hypertensive patients and the persistently low treatment rates among younger individuals with hypertension is a critical challenge. Additionally, developing more efficient and customized policies for blood pressure control and cardiovascular disease prevention is imperative.
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Affiliation(s)
- Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Republic of Korea.
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Republic of Korea
| | - Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dasom Son
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Minsung Cho
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Sojung Shin
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Yeeun Seo
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Eun-Jin Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Republic of Korea
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Kim HW, Han M, Jung I, Ahn SS. New-onset atrial fibrillation in seropositive rheumatoid arthritis: association with disease-modifying anti-rheumatic drugs treatment. Rheumatology (Oxford) 2024; 63:630-638. [PMID: 37421392 DOI: 10.1093/rheumatology/kead336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 07/10/2023] Open
Abstract
OBJECTIVE Atrial fibrillation (AF) is a potentially lethal complication that leads to increased hospitalization, disability and mortality. Furthermore, the risk of cardiovascular disease is increased in RA. We evaluated whether DMARD treatment is associated with incident AF in patients with seropositive RA (SPRA). METHODS The South Korean Health Insurance Review and Assessment Service database was used to identify patients newly diagnosed with SPRA between 2010 and 2020. A nested case-control analysis was performed to match AF-affected patients to unaffected controls for age, sex, follow-up duration, and index year of SPRA diagnosis at a 1:4 ratio. Adjusted conditional logistic regression was used to identify the predictive factors for AF. RESULTS Of the 108 085 patients with SPRA, 2,629 (2.4%) developed new-onset AF, and the proportion of females was ∼67%. In the matched population, pre-existing comorbidities of hypertension, chronic kidney disease, and heart failure were associated with increased risk of AF. Meanwhile, the use of methotrexate (MTX) decreased the risk of incident AF [adjusted odds ratio (aOR), 0.89], whereas the use of leflunomide (LEF) increased AF (aOR, 1.21). In a subgroup of patients aged ≥50 years, LEF and adalimumab increased the occurrence of AF, while MTX decreased AF in males and LEF increased this risk in females. CONCLUSION Although the number of subjects developing new-onset AF was small, MTX decreased and LEF increased incident AF in patients with RA. Especially, a distinct pattern of AF risk with DMARDs usage was observed according to age and sex.
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Affiliation(s)
- Hyung Woo Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Ahn
- Division of Rheumatology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
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Cheong HS, Chang Y, Kim Y, Kwon MJ, Cho Y, Kim B, Joo EJ, Bae YH, Kim C, Ryu S. Human papillomavirus infection and cardiovascular mortality: a cohort study. Eur Heart J 2024:ehae020. [PMID: 38321359 DOI: 10.1093/eurheartj/ehae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/20/2023] [Accepted: 12/07/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND AND AIMS High-risk human papillomavirus (HR-HPV) infection-a well-established risk factor for cervical cancer-has associations with cardiovascular disease (CVD). However, its relationship with CVD mortality remains uncertain. This study examined the associations between HR-HPV infection and CVD mortality. METHODS As part of a health examination, 163 250 CVD-free Korean women (mean age: 40.2 years) underwent HR-HPV screening and were tracked for up to 17 years (median: 8.6 years). National death records identified the CVD mortality cases. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD mortality were estimated using Cox proportional hazard regression analyses. RESULTS During 1 380 953 person-years of follow-up, 134 CVD deaths occurred, with a mortality rate of 9.1 per 105 person-years for HR-HPV(-) women and 14.9 per 105 person-years for HR-HPV(+) women. After adjustment for traditional CVD risk factors and confounders, the HRs (95% CI) for atherosclerotic CVD (ASCVD), ischaemic heart disease (IHD), and stroke mortality in women with HR-HPV infection compared with those without infection were 3.91 (1.85-8.26), 3.74 (1.53-9.14), and 5.86 (0.86-40.11), respectively. The association between HR-HPV infection and ASCVD mortality was stronger in women with obesity than in those without (P for interaction = .006), with corresponding HRs (95% CI) of 4.81 (1.55-14.93) for obese women and 2.86 (1.04-7.88) for non-obese women. CONCLUSIONS In this cohort study of young and middle-aged Korean women, at low risks for CVD mortality, those with HR-HPV infection had higher death rates from CVD, specifically ASCVD and IHD, with a more pronounced trend in obese individuals.
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Affiliation(s)
- Hae Suk Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250 Taepyung-ro 2ga, Jung-gu, Seoul 04514, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250 Taepyung-ro 2ga, Jung-gu, Seoul 04514, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115, Irwon-ro, Gangnam-gu, Seoul 06355, Republic of Korea
| | - Yejin Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250 Taepyung-ro 2ga, Jung-gu, Seoul 04514, Republic of Korea
| | - Min-Jung Kwon
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Yoosun Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250 Taepyung-ro 2ga, Jung-gu, Seoul 04514, Republic of Korea
| | - Bomi Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Eun-Jeong Joo
- Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Young Ho Bae
- Department of Statistics, Sungkyunkwan University, Seoul 03063, Republic of Korea
| | - Chanmin Kim
- Department of Statistics, Sungkyunkwan University, Seoul 03063, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250 Taepyung-ro 2ga, Jung-gu, Seoul 04514, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250 Taepyung-ro 2ga, Jung-gu, Seoul 04514, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115, Irwon-ro, Gangnam-gu, Seoul 06355, Republic of Korea
- Healthcare Data Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
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10
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Kim TJ, Lee HS, Kim SE, Park J, Kim JY, Lee J, Song JE, Hong JH, Lee J, Chung JH, Kim HC, Shin DH, Lee HY, Kim BJ, Seo WK, Park JM, Lee SJ, Jung KH, Kwon SU, Hong YC, Kim HS, Kang HJ, Lee J, Bae HJ. Developing a national surveillance system for stroke and acute myocardial infarction using claims data in the Republic of Korea: a retrospective study. Osong Public Health Res Perspect 2024; 15:18-32. [PMID: 38481047 PMCID: PMC10982659 DOI: 10.24171/j.phrp.2023.0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Limited information is available concerning the epidemiology of stroke and acute myocardial infarction (AMI) in the Republic of Korea. This study aimed to develop a national surveillance system to monitor the incidence of stroke and AMI using national claims data. METHODS We developed and validated identification algorithms for stroke and AMI using claims data. This validation involved a 2-stage stratified sampling method with a review of medical records for sampled cases. The weighted positive predictive value (PPV) and negative predictive value (NPV) were calculated based on the sampling structure and the corresponding sampling rates. Incident cases and the incidence rates of stroke and AMI in the Republic of Korea were estimated by applying the algorithms and weighted PPV and NPV to the 2018 National Health Insurance Service claims data. RESULTS In total, 2,200 cases (1,086 stroke cases and 1,114 AMI cases) were sampled from the 2018 claims database. The sensitivity and specificity of the algorithms were 94.3% and 88.6% for stroke and 97.9% and 90.1% for AMI, respectively. The estimated number of cases, including recurrent events, was 150,837 for stroke and 40,529 for AMI in 2018. The age- and sex-standardized incidence rate for stroke and AMI was 180.2 and 46.1 cases per 100,000 person-years, respectively, in 2018. CONCLUSION This study demonstrates the feasibility of developing a national surveillance system based on claims data and identification algorithms for stroke and AMI to monitor their incidence rates.
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Affiliation(s)
- Tae Jung Kim
- Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Seong-Eun Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jinju Park
- Central Division of Cardio-cerebrovascular Disease Management, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun Yup Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jiyoon Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Eun Song
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin-Hyuk Hong
- Central Division of Cardio-cerebrovascular Disease Management, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joong-Hwa Chung
- Department of Cardiology, Chosun University Hospital, Gwangju, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Ho Shin
- Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae-Young Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo-Keun Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong-Moo Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Soo Joo Lee
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun U. Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun-Jae Kang
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
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11
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Kim IC, Kim SH, Youn JC, Kim D, Lee S, Kim H, Kim JJ, Jung MH, Rossano JW, Cherikh WS, Kobashigawa JA, Stehlik J. Temporal Trends, Risk Factors, and Clinical Outcomes of De Novo Lymphoproliferative Disorders After Heart Transplantation. JACC. HEART FAILURE 2024; 12:395-405. [PMID: 38326002 DOI: 10.1016/j.jchf.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/02/2023] [Accepted: 10/17/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Post-transplant lymphoproliferative disorder (PTLD) is an important cause of morbidity and mortality in heart transplant (HTx) recipients. However, previous studies of PTLD after HTx are limited to single-center analyses or extrapolated from all solid organ transplantations. OBJECTIVES The authors analyzed the temporal trends, risk factors, and clinical outcome of de novo PTLD specifically after HTx. METHODS Using multi-institutional, multinational data from the International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, the authors evaluated the real-world data of PTLD after HTx, transplanted between January 2000 and June 2015. Multivariable analysis was done to identify risk factors for PTLD development after HTx. RESULTS Among 28,136 HTx recipients, 1,069 (3.8%) developed PTLD within 10 years of transplantation. PTLD showed a bimodal age pattern with peak incidence in patients of pediatric age and late adulthood at transplantation. The early transplant era (2000-2007 vs 2008-2015), male recipient, and EBV donor-positive-recipient-negative match were independent risk factors of PTLD development within 3 years of transplantation, whereas maintenance therapy with cyclosporine vs tacrolimus at initial discharge was associated with a lower incidence. PTLD development within 3 years of transplantation was significantly associated with mortality (HR: 2.42 [95% CI: 2.01-2.91]; P < 0.001). Survival after PTLD diagnosis was higher in the recent transplant era. CONCLUSIONS PTLD is relatively rare, but potentially fatal, post-transplant malignancy. PTLD incidence and mortality after HTx have decreased in the recent era. Strategies to minimize the risk of PTLD, and ensure early diagnosis and effective treatment are likely to improve outcomes in HTx.
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Affiliation(s)
- In-Cheol Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Sang Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Darae Kim
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seonhwa Lee
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Hyungseop Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Jin-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi-Hyang Jung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joseph W Rossano
- The Cardiac Center, The Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Wida S Cherikh
- United Network for Organ Sharing, Richmond, Virginia, USA; ISHLT Transplant Registry, Dallas, Texas, USA
| | - Jon A Kobashigawa
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Josef Stehlik
- Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
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12
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Goo SY, Lee MK, Lee DH, Park DH, Lee TH, Lee CJ, Lee JY, Jeon JY. Comparing domain- and intensity-specific physical activity in coronary heart disease and non-CHD individuals. Sci Rep 2024; 14:2622. [PMID: 38297008 PMCID: PMC10831062 DOI: 10.1038/s41598-024-52764-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/23/2024] [Indexed: 02/02/2024] Open
Abstract
Although increase in physical activity is important to improve prognosis of cardiac patients in addition to hospital-based exercise cardiac rehabilitation, their physical activity levels are not properly understood. This study aimed to examine domain- and intensity-specific physical activity in individuals with coronary heart disease (CHD) and compare them with non-CHD individuals. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2019 were analyzed, including 1083 CHD patients and 38,532 non-CHD individuals. The inclusion criteria were age 19 years or older and data not missing for CHD information. Before and after propensity score matching (PSM) for age, sex, body mass index, education, household income, alcohol intake, and smoking status, domain (leisure, work, transportation)-and intensity (moderate, vigorous) -specific physical activity participation levels were compared between individuals with and without CHD. Before PSM, CHD individuals were older, less educated, more sedentary, and participated less in PAs compared to non-CHD individuals. After PSM, CHD individuals had similar levels of domain-specific PAs. However, they had higher work-related PA levels (29.7 ± 209.6 vs. 42.1 ± 291.3 min/week p = 0.022) and more sedentary time (487.2 ± 224.2 vs. 514.1 ± 228.7. p = 0.003) than those without CHD. Subgroup analysis revealed lower leisure-related PA in men with CHD (63.5 ± 165.5 vs. 47.3 ± 140.2, p < 0.05) and higher work-related PA in women with CHD (18.9 ± 159.7 vs. 57.1 ± 397.5, p < 0.01). Among those < 65 years of age, individuals with CHD spent more time sedentary than individuals without CHD. CHD individuals are not physically inactive compared with non-CHD individuals who are similar in sociodemographic status and lifestyle. CHD patients' PA levels may have been underestimated.
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Affiliation(s)
- Seon Young Goo
- Department of Sport Industry Studies and Exercise Medicine Center for Diabetes and Cancer Patients, Yonsei University, 50, Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea
| | - Mi Kyung Lee
- Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, Republic of Korea
| | - Dong Hoon Lee
- Department of Sport Industry Studies and Exercise Medicine Center for Diabetes and Cancer Patients, Yonsei University, 50, Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Dong -Hyuk Park
- Department of Sport Industry Studies and Exercise Medicine Center for Diabetes and Cancer Patients, Yonsei University, 50, Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea
| | - Tae Ho Lee
- Department of Sport Industry Studies and Exercise Medicine Center for Diabetes and Cancer Patients, Yonsei University, 50, Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea
| | - Chan Joo Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong-Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, 29, Saemunan-Ro, Jongno-Gu, Seoul, Republic of Korea.
| | - Justin Y Jeon
- Department of Sport Industry Studies and Exercise Medicine Center for Diabetes and Cancer Patients, Yonsei University, 50, Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea.
- Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, Republic of Korea.
- Cancer Prevention Center, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
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13
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Son YJ, Kim DY, Choi YG, Kim EY. Eight-year trajectories and predictors of cognitive function in community-dwelling Korean older adults with cardiovascular diseases. J Nurs Scholarsh 2024; 56:153-163. [PMID: 37548269 DOI: 10.1111/jnu.12930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/02/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE This study aims to identify longitudinal patterns and predictors of cognitive function trajectories among Korean older adults with cardiovascular diseases. DESIGN This study is a longitudinal panel analysis based on secondary data. Data from the the Korean Longitudinal Study of Ageing (KLoSA) were used for analysis. METHODS The KLoSA is a representative panel survey of older Koreans. We analyzed responses from 301 participants aged ≥65 years who completed the same survey more than three times out of five waves between 2012 and 2020. FINDINGS Latent class growth modeling identified two trajectories of cognitive function in older people with cardiovascular diseases: "low and declining" (n = 81, 26.9%) and "high and declining" (n = 220, 73.1%). Participants in "the low and declining trajectory group" were more likely to have a low educational level, weak handgrip strength, depression, and low social participation at baseline than those in "the high and declining trajectory group." CONCLUSIONS Our results indicate a need to develop community-based tailored interventions for improving handgrip strength, mental health, and social participation in delaying cognitive decline in older people with cardiovascular diseases considering their educational level. CLINICAL RELEVANCE Healthcare providers should be more concerned about older people with a weaker handgrip, depression, and low social activities as a high-risk group for cognitive decline over time in cardiovascular care. Therefore, it is necessary to evaluate them early with standardized tools and make subsequent strategies for the older population with cardiovascular diseases.
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Affiliation(s)
- Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Da-Young Kim
- Graduate School of Nursing, Chung-Ang University, Seoul, South Korea
| | - Yoon-Gyeong Choi
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Eun Young Kim
- Department of Nursing, Soonchunhyang University, Cheonan, South Korea
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14
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Cho M, Lee HH, Baek JH, Yum KS, Kim M, Bae JW, Lee SJ, Kim BK, Kim YA, Yang J, Kim DW, Kim YD, Pak H, Kim KW, Park S, You SC, Lee H, Kim HC. Identification of acute myocardial infarction and stroke events using the National Health Insurance Service database in Korea. Epidemiol Health 2023; 46:e2024001. [PMID: 38186245 PMCID: PMC10928469 DOI: 10.4178/epih.e2024001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024] Open
Abstract
OBJECTIVES The escalating burden of cardiovascular disease (CVD) is a critical public health issue worldwide. CVD, especially acute myocardial infarction (AMI) and stroke, is the leading contributor to morbidity and mortality in Korea. We aimed to develop algorithms for identifying AMI and stroke events from the National Health Insurance Service (NHIS) database and validate these algorithms through medical record review. METHODS We first established a concept and definition of "hospitalization episode," taking into account the unique features of health claims-based NHIS database. We then developed first and recurrent event identification algorithms, separately for AMI and stroke, to determine whether each hospitalization episode represents a true incident case of AMI or stroke. Finally, we assessed our algorithms' accuracy by calculating their positive predictive values (PPVs) based on medical records of algorithm- identified events. RESULTS We developed identification algorithms for both AMI and stroke. To validate them, we conducted retrospective review of medical records for 3,140 algorithm-identified events (1,399 AMI and 1,741 stroke events) across 24 hospitals throughout Korea. The overall PPVs for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively. CONCLUSIONS We successfully developed algorithms for identifying AMI and stroke events. The algorithms demonstrated high accuracy, with PPVs of approximately 90% for first events and 80% for recurrent events. These findings indicate that our algorithms hold promise as an instrumental tool for the consistent and reliable production of national CVD statistics in Korea.
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Affiliation(s)
- Minsung Cho
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | - Jang-Hyun Baek
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Sun Yum
- Department of Neurology, Chungbuk National University Hospital, Cheongju, Korea
| | - Min Kim
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Jang-Whan Bae
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Seung-Jun Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byeong-Keuk Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ah Kim
- Division of Digital Health, Yonsei University Health System, Seoul, Korea
| | - JiHyun Yang
- Department of Medical Records, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Dong Wook Kim
- Department of Information and Statistics, Research Institute of Natural Science, Gyeongsang National University, Jinju, Korea
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Haeyong Pak
- Institute of Health Insurance & Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Sohee Park
- Department of Health Information & Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Seng Chan You
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
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15
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Seo Y, Moon J, Lee HH, Kim HC, Kaneko F, Shin S, Kim E, Bae JW, Kim BK, Lee SJ, Kim M, Lee H. Incidence and case fatality of acute myocardial infarction in Korea, 2011-2020. Epidemiol Health 2023; 46:e2024002. [PMID: 38186244 PMCID: PMC10928467 DOI: 10.4178/epih.e2024002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/22/2023] [Indexed: 01/09/2024] Open
Abstract
OBJECTIVES Cardiovascular diseases are a leading cause of mortality worldwide, and acute myocardial infarction (AMI) is particularly fatal condition. We evaluated the incidence and case fatality rates of AMI in Korea from 2011 to 2020. METHODS We utilized data from the National Health Insurance Services to calculate crude, age-standardized, and age-specific incidence rates, along with 30-day and 1-year case fatality rates, of AMI from 2011 to 2020. Age-standardized incidence rates were determined using direct standardization to the 2005 population. RESULTS The crude incidence rate of AMI per 100,000 person-years consistently increased from 44.7 in 2011 to 68.3 in 2019, before decreasing slightly to 66.2 in 2020. The age-standardized incidence rate of AMI displayed a 19% rise from 2011 to 2019, followed by a slight decline in 2020. The increasing trend for AMI incidence was more pronounced in males than in females. Both 30-day and 1-year case fatality rates remained stable among younger individuals but showed a decrease among older individuals. There was a minor surge in case fatality in 2020, particularly among recurrent AMI cases. CONCLUSIONS Over the past decade, the AMI incidence rate in Korea has consistently increased, with a slight downturn in 2020. The case fatality rate has remained relatively stable except for a minor increase in 2020. This study provides data for continuous surveillance, the implementation of targeted interventions, and the advancement of research aimed at AMI in Korea.
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Affiliation(s)
- Yeeun Seo
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Jenny Moon
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | - Fumie Kaneko
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Sojung Shin
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Eunji Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jang-Whan Bae
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Byeong-Keuk Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
| | - Seung Jun Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
| | - Min Kim
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
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16
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Park SJ, Lee SY, Jung HJ, Park MW, Choi HG, Kim H, Wee JH. Association between Tonsillectomy and Cardiovascular Diseases in Adults. J Pers Med 2023; 14:16. [PMID: 38276231 PMCID: PMC10817544 DOI: 10.3390/jpm14010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
This study aimed to evaluate the association between tonsillectomy and cardiovascular diseases (CVDs) in the Korean adult population. Using data from the 2002-2015 Korean National Health Insurance Service-Health Screening Cohort, a total of 1082 participants aged 40 years or older who had undergone tonsillectomy were matched with 4328 control individuals for age, sex, income, and region of residence. We evaluated the incidence of CVDs in both the tonsillectomy and control groups and calculated the hazard ratios (HRs) of stroke, ischemic heart disease (IHD), and heart failure (HF) for participants who underwent tonsillectomy using a stratified Cox proportional hazard model. The incidence rates of stroke (81.3 vs. 46.6 per 10,000 person-years) and IHD (112.3 vs. 64.9 per 10,000 person-years) were significantly higher in patients who had undergone tonsillectomy than in the control group. After adjustment, the tonsillectomy group exhibited a 1.78-fold and 1.60-fold higher occurrence of stroke (CI = 1.32-2.42, p < 0.001) and IHD (CI = 1.24-2.08, p < 0.001), respectively, compared to the control group. However, there was no significant difference in the incidence rate of tonsillectomy and control groups (11.1 vs. 6.1 per 10,000 person-years). The HR of HF did not differ significantly between the tonsillectomy and control groups in the adjusted model (p = 0.513). We identified a significant relationship between a history of tonsillectomy and occurrence of stroke/IHD in the Korean adult population.
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Affiliation(s)
- Sung Joon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong 14353, Republic of Korea;
| | - Sei Young Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea;
| | - Hahn Jin Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Republic of Korea;
| | - Min Woo Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangdong Sacred Heart Hospital, Seoul 05355, Republic of Korea;
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mdanalytics, Suseoseoulent Clinic, Seoul 06349, Republic of Korea;
| | - Heejin Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Jee Hye Wee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
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Baek HS, Kim B, Lee SH, Lim DJ, Kwon HS, Chang SA, Han K, Yun JS. Long-Term Cumulative Exposure to High γ-Glutamyl Transferase Levels and the Risk of Cardiovascular Disease: A Nationwide Population-Based Cohort Study. Endocrinol Metab (Seoul) 2023; 38:770-781. [PMID: 37926990 PMCID: PMC10764996 DOI: 10.3803/enm.2023.1726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/04/2023] [Accepted: 08/11/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGRUOUND Elevated γ-glutamyl transferase (γ-GTP) levels are associated with metabolic syndrome. We investigated the association of cumulative exposure to high γ-GTP with the risk of cardiovascular disease (CVD) in a large-scale population. METHODS Using nationally representative data from the Korean National Health Insurance system, 1,640,127 people with 4 years of consecutive γ-GTP measurements from 2009 to 2012 were included and followed up until the end of 2019. For each year of the study period, participants were grouped by the number of exposures to the highest γ-GTP quartile (0-4), and the sum of quartiles (0-12) was defined as cumulative γ-GTP exposure. The hazard ratio for CVD was evaluated using the Cox proportional hazards model. RESULTS During the 6.4 years of follow-up, there were 15,980 cases (0.97%) of myocardial infarction (MI), 14,563 (0.89%) of stroke, 29,717 (1.81%) of CVD, and 25,916 (1.58%) of death. Persistent exposure to high γ-GTP levels was associated with higher risks of MI, stroke, CVD, and death than those without such exposure. The risks of MI, stroke, CVD, and mortality increased in a dose-dependent manner according to total cumulative γ-GTP (all P for trend <0.0001). Subjects younger than 65 years, with a body mass index <25 kg/m2, and without hypertension or fatty liver showed a stronger relationship between cumulative γ-GTP and the incidence of MI, CVD, and death. CONCLUSION Cumulative γ-GTP elevation is associated with CVD. γ-GTP could be more widely used as an early marker of CVD risk, especially in individuals without traditional CVD risk factors.
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Affiliation(s)
- Han-Sang Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bongseong Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang-Ah Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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Jung H, Lee E, Ro JS, Lee JY, Bang J. Mortality After Acute Coronary Syndrome in Human Immunodeficiency Virus Infection with Optimal Adherence: A Nationwide Study. Infect Chemother 2023; 55:471-478. [PMID: 38014728 PMCID: PMC10771943 DOI: 10.3947/ic.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/17/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND There have been few studies on the outcome of acute coronary syndrome (ACS) in human immunodeficiency virus (HIV) infection in the era when antiretroviral therapy (ART) is generalized and most of them have achieved viral suppression. Using claims data, we aimed to assess the mortality after atherosclerotic cardiovascular events in people with HIV (PWH) who maintain optimal adherence to ART. MATERIALS AND METHODS We used claims data from the National Health Insurance of the Korea to confirm newly diagnosed PWH from 2009 to 2019, and measured ART adherence. ACS and mortality were confirmed in PWH who showed optimal adherence to ART. RESULTS Among 7,100 PWH with optimal adherence and during 27,387 person-year of follow-up duration, ACS was confirmed in 140 (2.0%) cases, which was 1.3 times greater than statistics of the Korean general population (511.0 vs. 383.1 per 100,000). Acquired immunodeficiency syndrome, hypertension, dyslipidemia, and diabetes mellitus were associated with the development of ACS in PWH with optimal adherence. Mortality was confirmed in 10 cases, which is 7.1% overall and 2.9% when limited to myocardial infarction. It was comparable with the mortality rate of the Korean general population after myocardial infarction (8.9%). CONCLUSION ACS prevalence was higher in PWH even when optimal adherence was maintained. However, mortality after ACS was comparable to that in the HIV-negative population.
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Affiliation(s)
- Hyemin Jung
- Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, Korea
| | - Eunyoung Lee
- Division of Infectious Diseases, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jun-Soo Ro
- Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, Korea
| | - Jin Yong Lee
- Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, Korea
- Public Healthcare Center, Seoul National University Hospital, Seoul, Korea.
| | - Jihwan Bang
- Division of Infectious Diseases, Seoul National University Boramae Medical Center, Seoul, Korea.
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Rhee SY. Potential of γ-Glutamyl Transferase as a Novel Risk Factor for Cardiovascular Disease. Endocrinol Metab (Seoul) 2023; 38:667-668. [PMID: 38164074 PMCID: PMC10764999 DOI: 10.3803/enm.2023.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Sang Youl Rhee
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
- Center for Digital Health, Kyung Hee University, Seoul, Korea
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20
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Lee J, Lee SH. Expanding the therapeutic landscape: ezetimibe as non-statin therapy for dyslipidemia. Korean J Intern Med 2023; 38:797-809. [PMID: 37866817 PMCID: PMC10636547 DOI: 10.3904/kjim.2023.243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/21/2022] [Accepted: 09/13/2023] [Indexed: 10/24/2023] Open
Abstract
Dyslipidemia is a significant risk factor for atherosclerotic cardiovascular disease (ASCVD), and statins are the primary therapeutic options for reducing low-density lipoprotein cholesterol (LDL-C) levels. However, it can be challenging to achieve optimal LDL-C goals with statin monotherapy. Ezetimibe, a cholesterol absorption inhibitor, offers a potential non-statin therapy to optimize LDL-C management. Key clinical trials, such as IMPROVE-IT and RACING, have demonstrated that the addition of ezetimibe to statin therapy leads to further decreases in LDL-C or significant decreases in major adverse cardiovascular events (MACEs), particularly in patients with high ASCVD risk. Subsequent meta-analyses and clinical trials have further supported the beneficial effect of ezetimibe, suggesting additive decreases in LDL-C and MACEs, as well as pleiotropic effects. This review provides a comprehensive analysis of the clinical implications of ezetimibe for managing dyslipidemia; it also evaluates the available evidence that supports the role of ezetimibe as an adjunct non-statin therapy for long-term use. However, the long-term pleiotropic effects of ezetimibe remain controversial because of limited clinical data. Therefore, additional research is needed to clarify its potential benefits beyond LDL-C reduction. Nonetheless, an understanding of the role of ezetimibe in dyslipidemia management will help clinicians to develop effective treatment strategies.
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Affiliation(s)
- Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul,
Korea
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21
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Kim HL, Kim MA. Sex Differences in Coronary Artery Disease: Insights From the KoRean wOmen'S chest pain rEgistry (KoROSE). Korean Circ J 2023; 53:655-676. [PMID: 37880830 PMCID: PMC10625849 DOI: 10.4070/kcj.2023.0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 10/27/2023] Open
Abstract
Interest in sex differences in coronary artery disease (CAD) has been steadily increasing. Concurrently, most of the data on these differences have primarily been Western-oriented. The KoRean wOmen'S chest pain rEgistry (KoROSE), started in 2011, has since published numerous research findings. This review aims to summarize the reported differences between men and women in CAD, integrating data from KoROSE. Cardiovascular risk in postmenopausal women escalates dramatically due to the decrease in estrogen levels, which normally offer cardiovascular protective effects. Lower estrogen levels can lead to abdominal obesity, insulin resistance, increased blood pressure, and endothelial dysfunction in older women. Upon analyzing patients with CAD, women are typically older and exhibit more cardiovascular risk factors than men. Diagnosing CAD in women tends to be delayed due to their symptoms being more atypical than men's. While in-hospital outcome was similar between sexes, bleeding complications after percutaneous coronary intervention occur more frequently in women. The differences in long-term prognosis for CAD patients between men and women are still a subject of ongoing debate. Pregnancy and reproductive factors also play a significant role as risk factors for cardiovascular disease in women. A notable sex disparity exists, with women found to use fewer cardiovascular protective drugs and undergo fewer interventional or surgical procedures than men. Additionally, women participate less frequently than men in clinical research. Through concerted efforts to increase awareness of sex differences and mitigate sex disparity, personalized treatment can be provided. This approach can ultimately improve patient prognosis.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
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22
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Yang Y, Da J, Yuan J, Zha Y. One-year change in sarcopenia was associated with cognitive impairment among haemodialysis patients. J Cachexia Sarcopenia Muscle 2023; 14:2264-2274. [PMID: 37559425 PMCID: PMC10570075 DOI: 10.1002/jcsm.13311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/24/2023] [Accepted: 07/11/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Our study aimed to evaluate change in sarcopenia, its defining components over 1 year follow-up and investigate associations with subsequent cognitive decline, incident mild cognitive impairment (MCI) and dementia among patients undergoing haemodialysis (HD). METHODS In the multicentre, longitudinal study, 1117 HD patients aged 56.8 ± 14.3 years (654 men; and 463 women) from 17 dialysis centres in Guizhou Province, China, were recruited in 2019 and followed up for 1 year in 2020. Sarcopenia was diagnosed with Asian Working Group for Sarcopenia criteria using appendicular skeletal muscle mass index (ASMI) and handgrip strength (HGS). Body composition was measured using body composition monitor; body water, weight, and height were corrected to calculate ASMI. HGS was measured by mechanical handgrip dynamometer. Cognitive function was measured with Mini Mental State Examination. Multivariate linear, logistic regression models and subgroup analyses were employed to examine the associations of changes in sarcopenia, ASMI, and HGS with Mini Mental State Examination score change, and incident MCI, dementia. RESULTS Four hundred fourteen (37.1%) patients had sarcopenia at baseline; during 1 year follow-up, 257 (23.0%) developed MCI and 143 (12.8%) developed dementia. According to changes in sarcopenia, patients were stratified into four groups: non-sarcopenia; non-sarcopenia to sarcopenia; sarcopenia; and sarcopenia to non-sarcopenia. HD patients in sarcopenia and non-sarcopenia to sarcopenia groups had higher risk of MCI (34.8%, 32.0%, vs. 17.4%) and dementia (20.6%, 19.8%, vs. 8.7%), compared non-sarcopenia group (P < 0.001). Multivariate linear regression analyses showed that sarcopenia [regression coefficients (β) -1.098, 95% confidence interval (CI) -1.872, -0.324, P = 0.005] and non-sarcopenia to sarcopenia (β -1.826, -2.441, -1.212, P < 0.001) were associated with faster cognitive decline compared to non-sarcopenia. HGS decline (β 0.046, 0.027-0.064, P < 0.001) and ASMI decline (β 0.236, 0.109-0.362, P < 0.001) were both positively associated with cognitive decline. Multivariate logistic regression analyses demonstrated that patients with sarcopenia and non-sarcopenia to sarcopenia were both at increased risk of developing MCI [odds ratio (OR) 1.788, 95% CI 1.115-2.870, P = 0.016 and OR 1.589, 95% CI 1.087-2.324, P = 0.017, respectively], but only non-sarcopenia to sarcopenia was at increased risk of dementia (OR 1.792, 95% CI 1.108-2.879, P = 0.017). Both greater change of ASMI and HGS had lower risk of MCI with adjusted ORs of 0.857 (0.778-0.945, P = 0.002) and 0.976 (0.963-0.989, P < 0.001). Robust associations were found among female individuals, aged >60 years, and with low educational level. CONCLUSIONS Longitudinal associations were observed between new-onset, persistent sarcopenia, and cognitive impairment. Early detection and intervention should be implemented to delay the onset of sarcopenia and improve cognitive health among HD patients.
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Affiliation(s)
- Yuqi Yang
- Department of NephrologyGuizhou Provincial People's HospitalGuiyangChina
| | - Jingjing Da
- Department of NephrologyGuizhou Provincial People's HospitalGuiyangChina
| | - Jing Yuan
- Department of NephrologyGuizhou Provincial People's HospitalGuiyangChina
| | - Yan Zha
- Department of NephrologyGuizhou Provincial People's HospitalGuiyangChina
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23
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Kwon HW, Rhee MH, Shin JH. The Inhibitory Effects of Protaetia brevitarsis seulensis Larvae Extract on Human Platelet Aggregation and Glycoprotein IIb/IIIa Expression. Prev Nutr Food Sci 2023; 28:328-334. [PMID: 37842257 PMCID: PMC10567598 DOI: 10.3746/pnf.2023.28.3.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/23/2023] [Accepted: 06/26/2023] [Indexed: 10/17/2023] Open
Abstract
The white-spotted flower chafer, Protaetia brevitarsis seulensis, is used as a traditional remedy against liver cirrhosis, hepatitis, and hepatic cancer. In this study, we investigated if P. brevitarsis extract (PBE) inhibited platelet aggregation via integrin αIIb/β3 regulation. We observed that PBE inhibited αIIb/β3 activation by regulating the cyclic nucleotides, cyclic adenosine monophosphate and cyclic guanosine monophosphate. Additionally, PBE affected phosphatidylinositol-3 kinase, Akt, SYK, glycogen synthase kinase-3α/β, cytosolic phospholipase A2, and p38 expression, which are signal transduction molecules expressed by platelets, and consequently suppressed αIIbβ3 activity and thromboxane A2 generation. Taken together, PBE showed strong antiplatelet effects and may be used to block thrombosis- and platelet-mediated cardiovascular diseases.
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Affiliation(s)
- Hyuk-Woo Kwon
- Department of Biomedical Laboratory Science, Far East University, Chungbuk 2760, Korea
- Microbiological Resource Research Institute, Far East University, Chungbuk 7601, Korea
| | - Man Hee Rhee
- Department of Veterinary Medicine, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
- Cardiovascular Research Institute, School of Medicine, Kyungpook National University, Daegu 19, Korea
| | - Jung-Hae Shin
- Department of Veterinary Medicine, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
- Cardiovascular Research Institute, School of Medicine, Kyungpook National University, Daegu 19, Korea
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24
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Nabila S, Choi J, Kim JE, Hahn S, Hwang IK, Kim TI, Park HK, Choi JY. Bidirectional associations between periodontal disease and systemic diseases: a nationwide population-based study in Korea. Sci Rep 2023; 13:14078. [PMID: 37640779 PMCID: PMC10462734 DOI: 10.1038/s41598-023-41009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023] Open
Abstract
To evaluate the associations of periodontal disease (PD) with systemic diseases, including diabetes mellitus (DM) and cardiovascular disease (CVD), as well as the reciprocal association. The CVD included the cases of coronary heart disease and heart failure. A prospective study was conducted from 2007 to 2019 using linked data from three databases in Korea. Three separate study groups were formed to individually determine the risks of PD (n = 10,533), DM (n = 14,523) and CVD (n = 14,315). All diseases were confirmed based on physicians' diagnoses using medical records and self-reports. Cox proportional hazard regression was applied with 95% confidence intervals (CIs) to obtain hazard ratios (HRs). PD was significantly associated with an elevated risk of DM (HR [95% CI]: 1.22 [1.07-1.39]) after full adjustment for age, sex, lifestyle factors, body mass index, dental behaviour and CVD. PD was also found to increase the risk of CVD (1.27 [1.03-1.57]), whereas CVD increased the risk of PD (1.20 [1.09-1.32]) after full adjustment for other covariates including DM. This study found a bidirectional association between PD and CVD, as well as a positive association of PD with DM.
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Affiliation(s)
- Salma Nabila
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea
- BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Korea
| | - Jaesung Choi
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ji-Eun Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea
- BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Korea
| | - Seokyung Hahn
- Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - In-Kyung Hwang
- Department of Periodontology, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Korea
| | - Tae-Il Kim
- Department of Periodontology, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Korea
| | - Hee-Kyung Park
- Department of Oral Medicine and Oral Diagnosis, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, 101 Daehak-ro, Jongno-gu, Seoul, 110-749, Korea.
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea.
- BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Korea.
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
- Cancer Research Institute, Seoul National University, Seoul, Korea.
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25
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Kang HS, Lee NE, Yoo DM, Han KM, Hong JY, Choi HG, Lim H, Kim JH, Kim JH, Cho SJ, Nam ES, Park HY, Kim NY, Baek SU, Lee JY, Kwon MJ. An elevated likelihood of stroke, ischemic heart disease, or heart failure in individuals with gout: a longitudinal follow-up study utilizing the National Health Information database in Korea. Front Endocrinol (Lausanne) 2023; 14:1195888. [PMID: 37680887 PMCID: PMC10482324 DOI: 10.3389/fendo.2023.1195888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/13/2023] [Indexed: 09/09/2023] Open
Abstract
Objective Accumulating evidence from other countries indicates potential associations between gout and cardiovascular diseases; however, the associations of gout with cardiovascular diseases, particularly stroke, ischemic heart disease, and heart failure, remain ambiguous in the Korean population. We hypothesized that individuals with gout are at a higher likelihood of stroke, ischemic heart disease, or heart failure. This study expands upon previous research by ensuring a comparable baseline between patient and control groups and analyzing 16 years of data derived from an extensive healthcare database. Methods We selected 22,480 patients with gout and 22,480 control individuals from the Korean National Health Insurance Service-Health Screening Cohort database (2002-2019), and matched them at a 1:1 ratio according to sex, age, income, and residence. A Cox proportional hazard model with weighted overlap was employed to examine the relationship between gout and the risk of stroke, ischemic heart disease, or heart failure after adjustment for several covariates. Results The incidences of stroke, ischemic heart disease, or heart failure in participants with gout were slightly higher than those in controls (stroke: 9.84 vs. 8.41 per 1000 person-years; ischemic heart disease: 9.77 vs. 7.15 per 1000 person-years; heart failure: 2.47 vs. 1.46 per 1000 person-years). After adjustment, the gout group had an 11% (95% confidence interval [CI] = 1.04-1.19), 28% (95% CI = 1.19-1.37), or 64% (95% CI = 1.41-1.91) higher likelihood of experiencing stroke, ischemic heart disease, or heart failure, respectively, than the control group. Conclusion The present findings suggest that individuals with gout in the Korean population, particularly those aged ≥ 60 years, were more likely to have stroke, ischemic heart disease, or heart failure.
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Affiliation(s)
- Ho Suk Kang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Na-Eun Lee
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Kyeong Min Han
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Ji Yeon Hong
- Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology, Suseo Seoul E.N.T. Clinic, Seoul, Republic of Korea
- MD Analytics, Seoul, Republic of Korea
| | - Hyun Lim
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Joo-Hee Kim
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Seong-Jin Cho
- Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Eun Sook Nam
- Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Ha Young Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang, Republic of Korea
| | - Sung Uk Baek
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Joo Yeon Lee
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
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26
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Kim HC, Lee H, Lee HH, Lee G, Kim E, Song M, Moon J, Seo Y. Korea hypertension fact sheet 2022: analysis of nationwide population-based data with a special focus on hypertension in the elderly. Clin Hypertens 2023; 29:22. [PMID: 37580841 PMCID: PMC10426053 DOI: 10.1186/s40885-023-00243-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/25/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND The Korean Society of Hypertension has published the Korea Hypertension Fact Sheet 2022 to provide an overview of the magnitude and management status of hypertension and their recent trends. METHODS The Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 1998-2020 Korea National Health and Nutrition Examination Survey and the 2002-2020 National Health Insurance Big Data. RESULTS As of 2020, 29.4% of the adult population aged 20 or older in Korea, about 12.6 million people, have high blood pressure, of which 5.0 million (40%) are 65 years of age or older and 1.2 million (10%) are 80 years of age or older. Among those with hypertension, the awareness rate is 69%, the treatment rate is 65%, and the control rate is 47%. The number of people diagnosed with hypertension increased from 3.0 million in 2002 to 10.5 million in 2020. During the same period, the number of people using antihypertensive medication increased from 2.5 million to 9.9 million, and the number of people adherent to treatment increased from 0.6 million to 7.4 million. Among those treated for hypertension in 2020, 74% used angiotensin blockers, 61% used calcium channel blockers, 24% used diuretics, and 15% used beta blockers. Combination therapy with at least two classes of antihypertensive medication consisted of 60% of all antihypertensive prescriptions. The number of people with hypertension aged 65 or older is increasing very rapidly compared to those aged 20-64. Awareness and treatment rates of hypertension improved rapidly, especially in those aged 65 or older, but the rate of improvement slowed since 2012. CONCLUSIONS In Korea, the level of hypertension management is improving, but the absolute number of people with hypertension, especially elderly hypertension, is increasing due to the rapid aging of the population. It is necessary to develop more efficient and target-specific policies to control blood pressure and prevent cardiovascular disease.
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Affiliation(s)
- Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Republic of Korea.
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Republic of Korea
| | - Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gabin Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunji Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Moses Song
- Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Republic of Korea
| | - Jenny Moon
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Yeeun Seo
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
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Kim DE, Moon I, Park S, Park M, Park S, Kwon SS, Kong MG, Park HW, Choi HO, Seo HS, Cho YH, Lee NH, Suh J. Temporal Trend of the Incidence and Characteristics of Renal Infarction: Korean Nationwide Population Study. J Korean Med Sci 2023; 38:e239. [PMID: 37550807 PMCID: PMC10412037 DOI: 10.3346/jkms.2023.38.e239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/04/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Large-scale studies about epidemiologic characteristics of renal infarction (RI) are few. In this study, we aimed to analyze the incidence and prevalence of RI with comorbidities in the South Korean population. METHODS We investigated the medical history of the entire South Korean adult population between 2013 and 2019 using the National Health Insurance Service database (n = 51,849,591 in 2019). Diagnosis of RI comorbidities were confirmed with International Classification of Disease, Tenth Revision, Clinical Modification codes. Epidemiologic characteristics, distribution of comorbidities according to etiologic mechanisms, and trend of antithrombotic agents were estimated. RESULTS During the 7-years, 10,496 patients were newly diagnosed with RI. The incidence rate increased from 2.68 to 3.06 per 100,000 person-years during the study period. The incidence rate of RI increased with age peaking in the 70s with 1.41 times male predominance. The most common comorbidity was hypertension, followed by dyslipidemia and diabetes mellitus. Regarding etiologic risk factor distribution, high embolic risk group, renovascular disease group, and hypercoagulable state group accounted for 16.6%, 29.1%, and 13.7% on average, respectively. For the antithrombotic treatment of RI, the prescription of antiplatelet agent gradually decreased from 17.0% to 13.0% while that of anticoagulation agent was maintained around 35%. The proportion of non-vitamin K antagonist oral anticoagulants remarkably increased from only 1.4% to 17.6%. CONCLUSION Considering the progressively increasing incidence of RI and high prevalence of coexisting risk factors, constant efforts to raise awareness of the disease are necessary. The current epidemiologic investigation of RI would be the stepping-stone to establishing future studies about clinical outcomes and optimal treatment strategies.
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Affiliation(s)
- Dong-Eon Kim
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Inki Moon
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Suyeong Park
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Minae Park
- Department of Data Science, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Sojeong Park
- Department of Data Science, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Seong Soon Kwon
- Division of Cardiology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Min Gyu Kong
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hyun Woo Park
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hyung Oh Choi
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hye-Sun Seo
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Yoon Haeng Cho
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Nae Hee Lee
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jon Suh
- Division of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
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Bhandari P. Prevalence of cardiovascular risk factors among Asian migrant workers in South Korea. PLoS One 2023; 18:e0288375. [PMID: 37428813 DOI: 10.1371/journal.pone.0288375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/24/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The burden of non-communicable diseases is rapidly increasing among young adults in middle- and low-income countries. Asian migrant workers continue to be a significant contributor to South Korea's economy; however, their cardiovascular health is neglected. We explored the prevalence of cardiovascular risk factors among Asian migrant workers in South Korea. METHODS Cross-sectional survey, anthropometric measurements, blood pressure measurements, and biochemical tests including triglyceride, high-density lipoprotein, low-density lipoprotein, total cholesterol, fasting blood sugar, HbA1c, and C-reactive protein levels were conducted in 141 Asian migrant workers in South Korea. RESULTS The mean age of the participants was 31.3 (5.6) years. Of the participants, 14.8% were current smokers, and 47.5% consumed alcohol. The prevalence of overweight/obesity was 32.4%. The prevalence of hypertension and dyslipidemia were 51.2% and 64.6%, respectively. Of the participants, 98.5% had an increased waist circumference; elevated HbA1C and C-reactive protein was seen in 20.9% and 4.3%, respectively. The prevalence of metabolic syndrome was 5.5%. Clustering of two or more risk factors was seen in 45% of the participants. Factors associated with a high risk of cardiovascular diseases (clustering of two or more risk factors) were age (odds ratio 1.16, p < 0.01) and smoking (4.98, p < 0.05). CONCLUSION The prevalence of cardiovascular risk factors was alarmingly high among Asian migrant workers employed in South Korea. Efforts to mitigate and eliminate those risk factors are urgently required.
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Affiliation(s)
- Pratibha Bhandari
- School of Nursing and Midwifery, University of Technology Sydney, Sydney, New South Wales, Australia
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Kim S, Lee JW, Lee Y, Song Y, Linton JA. Association between triglyceride-glucose index and low-density lipoprotein particle size in korean obese adults. Lipids Health Dis 2023; 22:94. [PMID: 37403101 DOI: 10.1186/s12944-023-01857-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Small dense low-density lipoprotein cholesterol (sdLDL-C) is the lipoprotein marker among the various lipoproteins that is most strongly related to atherosclerosis. Insulin resistance (IR) can alter lipid metabolism, and sdLDL-C is characteristic of diabetic dyslipidemia. Therefore, this study sought to inspect the relationship between the triglyceride-glucose (TyG) index and mean low-density lipoprotein (LDL) particle size. METHODS In this study, a total of 128 adults participated. The correlation coefficients between various lipoproteins and the TyG index were compared using Steiger's Z test and the Spearman correlation. The independent link between the TyG index and mean LDL particle size was demonstrated by multiple linear regression analysis. To identify the TyG index cutoff value for the predominance of sdLDL particles, receiver operating characteristic curves were plotted. RESULTS Mean LDL particle size correlated more strongly with the TyG index than did very low-density lipoprotein, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Regression analysis demonstrated that mean LDL particle size had a strong association with the TyG index (β coefficient = -0.038, P-value < 0.001). The TyG index optimal cutoff value for sdLDL particle predominance and the corresponding area under the curve (standard error: 0.028, 95% confidence interval: 0.842-0.952) were 8.72 and 0.897, respectively, which were close to the cutoff value of diabetes risk in Koreans. CONCLUSIONS Mean LDL particle size is more strongly correlated with the TyG index than do other lipid parameters. After correcting for confounding variables, mean LDL particle size is independently linked with the TyG index. The study indicates that the TyG index is strongly related to atherogenic sdLDL particles predominance.
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Affiliation(s)
- Sanghoon Kim
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, 06237, Republic of Korea
| | - Yaeji Lee
- Department of Biostatistics and Computing, Yonsei University, Seoul, 03722, Republic of Korea
| | - Youhyun Song
- Healthcare Research Team, Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea.
| | - John A Linton
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
- International Health Care Center, Severance Hospital, Yonsei University Health System, Seoul, 03722, Republic of Korea.
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30
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Choi HE, Kim C, Lee DJ, Joo JE, Kim HS. Participation and Prognostic Impact of Cardiac Rehabilitation After Acute Coronary Syndrome: Big-Data Study of the Korean National Health Insurance Service. J Korean Med Sci 2023; 38:e119. [PMID: 37069813 PMCID: PMC10111042 DOI: 10.3346/jkms.2023.38.e119] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/03/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND To investigate the actual rate and quality of cardiac rehabilitation (CR) participation in South Korea and its short-term impact on clinical outcomes after acute coronary syndrome (ACS). METHODS Data, including confirmed ACS diagnosis, socio-demographics, comorbidities, clinical outcomes, and CR claim codes, were collected from the Korean National Health Insurance Service claims database and compared between the CR and non-CR groups. RESULTS Overall, 102,544 patients were included in the study, of which only 5.8% attended CR. Regarding testing, 83.6% of CR patients performed the cardiopulmonary exercise test, but follow-up testing was infrequently performed; in addition, 53.1% of them participated in an electrocardiogram monitoring exercise, but over half participated in only one session. After 1:1 propensity score matching, post-ACS cardiovascular events were significantly lower in the CR group than in the non-CR group. The cumulative 3-year hazard ratio for all-cause death was 0.612 (95% confidence interval [CI], 0.495-0.756), recurrent ACS was 0.92 (95% CI, 0.853-0.993), CR readmission was 0.817 (95% CI, 0.768-0.868), and major adverse cardiovascular events (MACE) was 0.827 (95% CI, 0.781-0.874) in the CR group. CR was associated with a significant dose-response effect on MACE, with a reduction in incidence from 0.854 to 0.711. CONCLUSION The actual rate of CR participation in South Korea remains low, and participation quality was not outstanding despite National Health Insurance coverage. Nevertheless, the impact of CR on cardiovascular outcomes after ACS was significantly superior. Efforts to increase CR participation should be increased by establishing new CR facilities and strategies to resolve associated barriers.
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Affiliation(s)
- Hee-Eun Choi
- Department of Rehabilitation Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Chul Kim
- Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
| | - Da-Jung Lee
- Department of Rehabilitation Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jae-Eun Joo
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Ho-Seob Kim
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Korea
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Cho JY, Cho DH, Youn JC, Kim D, Park SM, Jung MH, Hyun J, Choi J, Cho HJ, Park SM, Choi JO, Chung WJ, Yoo BS, Kang SM. Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Definition and Diagnosis. Korean Circ J 2023; 53:195-216. [PMID: 37161680 PMCID: PMC10172202 DOI: 10.4070/kcj.2023.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/27/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023] Open
Abstract
The Korean Society of Heart Failure guidelines aim to provide physicians with evidence-based recommendations for diagnosing and managing patients with heart failure (HF). In Korea, the prevalence of HF has been rapidly increasing in the last 10 years. HF has recently been classified into HF with reduced ejection fraction (EF), HF with mildly reduced EF, and HF with preserved EF (HFpEF). Moreover, the availability of newer therapeutic agents has led to an increased emphasis on the appropriate diagnosis of HFpEF. Accordingly, this part of the guidelines will mainly cover the definition, epidemiology, and diagnosis of HF.
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Affiliation(s)
- Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Catholic Research Institute for Intractable Cardiovascular Disease, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Darae Kim
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Min Park
- Department of Cardiology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Mi-Hyang Jung
- Division of Cardiology, Department of Internal Medicine, Catholic Research Institute for Intractable Cardiovascular Disease, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Junho Hyun
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jimi Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyun-Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jin-Oh Choi
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wook-Jin Chung
- Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seok-Min Kang
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Cho JY, Cho DH, Youn JC, Kim D, Park SM, Jung MH, Hyun J, Choi J, Cho HJ, Park SM, Choi JO, Chung WJ, Yoo BS, Kang SM. Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Definition and Diagnosis. INTERNATIONAL JOURNAL OF HEART FAILURE 2023; 5:51-65. [PMID: 37180563 PMCID: PMC10172081 DOI: 10.36628/ijhf.2023.0009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/27/2023] [Accepted: 04/04/2023] [Indexed: 05/16/2023]
Abstract
The Korean Society of Heart Failure guidelines aim to provide physicians with evidence-based recommendations for diagnosing and managing patients with heart failure (HF). In Korea, the prevalence of HF has been rapidly increasing in the last 10 years. HF has recently been classified into HF with reduced ejection fraction (HFrEF), HF with mildly reduced ejection fraction (EF), and HF with preserved EF (HFpEF). Moreover, the availability of newer therapeutic agents has led to an increased emphasis on the appropriate diagnosis of HFpEF. Accordingly, this part of the guidelines will mainly cover the definition, epidemiology, and diagnosis of HF.
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Affiliation(s)
- Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University Medicine, Seoul, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Darae Kim
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Min Park
- Department of Cardiology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Mi-Hyang Jung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Junho Hyun
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jimi Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University Medicine, Seoul, Korea
| | - Hyun-Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University Medicine, Seoul, Korea
| | - Jin-Oh Choi
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wook-Jin Chung
- Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seok-Min Kang
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Kim SR, Bae S, Lee JY, Kim MS, Kim MN, Chung WJ, Bae JH, Lee J, Park SM. Gender disparities in prevalence by diagnostic criteria, treatment and mortality of newly diagnosed acute myocardial infarction in Korean adults. Sci Rep 2023; 13:4120. [PMID: 36914709 PMCID: PMC10011387 DOI: 10.1038/s41598-023-31014-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 03/06/2023] [Indexed: 03/14/2023] Open
Abstract
Acute myocardial infarction (AMI) is highly prevalent and remains the leading cause of mortality. Particularly in women, under-recognition and management of AMI have been raised. The aim of this study was to investigate the long-term trends of prevalence, treatment methodologies, and mortality of AMI by gender. The subjects of this study were patients hospitalized for AMI according to the Korean National Health Insurance Claims Database from 2002 to 2018. Total 633,097 AMI patients were hospitalized, 40% women. The incidence of AMI has been increasing since 2011, with a lower incidence in women. Overall, 53.1% of patients underwent CAG, with a lower tendency in women than in men (39.8% vs. 62.3%). Furthermore, fewer women underwent PCI than men (77.5% vs. 85.8% in 2018, p < 0.0001). Of the 336,463 AMI patients undergoing CAG, women were undertreated with a lower prescription rate of beta-blockers or statins at discharge. When adjusted for age, women showed higher 7-day mortality but lower 1-year mortality relative to men. According to the Korean National Health Insurance Claims Database, women with AMI have been under-recognized, underdiagnosed, and undertreated in terms of revascularization or medical therapy for years suggesting that efforts to close the gender gap are necessary.
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Affiliation(s)
- So Ree Kim
- Division of Cardiology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - SungA Bae
- Division of Cardiology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Ji Yoon Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Min Sun Kim
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Mi-Na Kim
- Division of Cardiology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Wook-Jin Chung
- Gachon Cardiovascular Research Institute, Gachon University, Incheon, Republic of Korea
| | - Jang-Ho Bae
- Division of Cardiology, Department of Internal Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seong-Mi Park
- Division of Cardiology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. .,Korea University Anam Hospital, Goryeodae-ro 73, Seongbuk-gu, Seoul, 02841, Republic of Korea.
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Kim G, Jang H, Kwon S, Lee B, Jang SY, Chae W, Jang SI. Engaging social activities prevent stroke and myocardial infraction by raising awareness of warning symptoms: A cross-sectional survey study. Front Public Health 2023; 10:1043875. [PMID: 36726633 PMCID: PMC9885037 DOI: 10.3389/fpubh.2022.1043875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Background Stroke and myocardial infarction (MI) are medical emergencies, and early treatment within the golden hour is crucial for good prognosis. Adequate knowledge about the warning symptoms can shorten the onset-to-door time. Various factors affect the level of awareness, including social activity. This study aimed to determine if engaging in social activity is associated with the awareness of the warning symptoms of stroke and MI. Methods This cross-sectional study analyzed 451,793 participants from the 2017 and 2019 Korea Community Health Survey. Based on five questions for each of stroke and MI symptoms, participants were divided into an awareness group (replied "Yes" to all five questions) and unawareness group. Engagement in social activities (i.e., religious, friendship, leisure, and volunteer activity) was evaluated through a questionnaire. Multiple logistic regression analysis was performed to evaluate the relation between social activity and awareness of warning symptoms. Results Overall, 52.6% participants were aware of the warning symptoms of stroke, and 45.8% of MI. Regular engagement in at least one social activity, particularly friendship or volunteer activity, was associated with better awareness of the warning symptoms, both stroke (OR: 1.21, 95% CI: 1.20-1.23) and MI (OR: 1.22, 95% CI: 1.20-1.24). Additionally, more diverse types of social activities were associated with higher levels of awareness. Relationship between social activity and awareness showed positive association with participants older than 60 years, rural residents, or with low socioeconomic status. Conclusion Engagement in social activity was significantly associated with better knowledge about the warning symptoms of stroke and MI. For early hospital treatment after symptom onset, participation in social activities could be beneficial.
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Affiliation(s)
- Gahyeon Kim
- Medical School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeokjoo Jang
- Medical School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sebin Kwon
- Medical School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bumyeol Lee
- Medical School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Wonjeong Chae
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea,Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea,Wonjeong Chae ✉
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea,Department of Preventive Medicine, Yonsei University, Seoul, Republic of Korea,*Correspondence: Sung-In Jang ✉
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35
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Lee JY, Bak JK, Kim M, Shin HG, Park KI, Lee SP, Lee HS, Lee JY, Kim KI, Kang SH, Lee JH, Jang SY, Lee JH, Kim KH, Cho JY, Park JH, Park SK, Lee HY. Long-term cardiovascular events in hypertensive patients: full report of the Korean Hypertension Cohort. Korean J Intern Med 2023; 38:56-67. [PMID: 36514267 PMCID: PMC9816676 DOI: 10.3904/kjim.2022.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/AIMS This study evaluated the long-term cardiovascular complications among Korean patients with hypertension and compared them with that of controls without hypertension. METHODS The Korean Hypertension Cohort (KHC) enrolled 11,043 patients with hypertension and followed them for more than 10 years. Age- and sex-matched controls without hypertension were enrolled at a 1:10 ratio. We compared the incidence of cardiovascular events and death among patients and controls without hypertension. RESULTS The mean age was 59 years, and 34.8% and 16.5% of the patients belonged to the high and moderate cardiovascular risk groups, respectively. During the 10-year follow-up, 1,591 cardiovascular events (14.4%) with 588 deaths (5.3%) occurred among patients with hypertension and 7,635 cardiovascular events (6.9%) with 4,826 deaths (4.4%) occurred among controls. Even the low-risk population with hypertension showed a higher cardiovascular event rate than the population without hypertension. Although blood pressure measurements in the clinic showed remarkable inaccuracy compared with those measured in the national health examinations, systolic blood pressure (SBP) ≥ 150 mmHg was significantly associated with a higher risk of cardiovascular events. CONCLUSION This long-term follow-up study confirmed the cardiovascular event rates among Korean hypertensive patients were substantial, reaching 15% in 10 years. SBP levels ≥ 150 mmHg were highly associated with occurrence of cardiovascular event rates.
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Affiliation(s)
- Jin Young Lee
- Department of Applied Statistics, Chung-Ang University, Seoul,
Korea
| | - Jean Kyung Bak
- National Evidence-based Healthcare Collaborating Agency (NECA), Seoul,
Korea
| | - Mina Kim
- Department of Applied Statistics, Chung-Ang University, Seoul,
Korea
| | - Ho-Gyun Shin
- National Evidence-based Healthcare Collaborating Agency (NECA), Seoul,
Korea
| | - Kyun-Ik Park
- National Evidence-based Healthcare Collaborating Agency (NECA), Seoul,
Korea
| | - Seung-Pyo Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Hee-Sun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Ju-Yeun Lee
- College of Pharmacy, Seoul National University, Seoul,
Korea
| | - Kwang-il Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Si-Hyuck Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Ju-Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju,
Korea
| | - Kye Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju,
Korea
| | - Jae Yeong Cho
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Jae-Hyeong Park
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
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36
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Kim JH, Kwon MJ, Choi HG, Lee SJ, Kim SW, Kim JH, Kwon BC, Lee JW. The association between hyperuricemia and cardiovascular disease history: A cross-sectional study using KoGES HEXA data. Medicine (Baltimore) 2022; 101:e32338. [PMID: 36595830 PMCID: PMC9794208 DOI: 10.1097/md.0000000000032338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
This cross-sectional study examines the association between hyperuricemia and cardiovascular diseases (CVDs). Data from the Korean Genome and Epidemiology Study from 2004 to 2016 were analyzed. Among the 173,209 participants, we selected 11,453 patients with hyperuricemia and 152,255 controls (non-hyperuricemia). We obtained the history of CVDs (stroke and ischemic heart disease [IHD]) from all participants. Crude and adjusted odds ratios (aORs) (age, income group, body mass index, smoking, alcohol consumption, anthropometry data, and nutritional intake) for CVDs were analyzed using a logistic regression model. Participants with hyperuricemia reported a significantly higher prevalence of stroke (2.4% vs 1.3%) and IHD (5.6% vs 2.8%) than controls did (P < .001). Participants with hyperuricemia had a significantly higher aOR for CVD than the controls. The aOR of hyperuricemia for stroke was 1.22 (95% confidence interval = 1.07-1.39, P = .004). When analyzed by subgroup according to age and sex, this result was only persistent in women. The aOR of hyperuricemia for IHD was 1.45 (95% confidence interval = 1.33-1.59, P < .001). In the subgroup analyses, the results were similar, except in young men. Hyperuricemia was significantly associated with CVD in the Korean population.
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Affiliation(s)
- Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea
| | - Sang Jun Lee
- Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, Republic of Korea
| | - Sung-Woo Kim
- Yonsei Wonju Severance Christian Hospital, Wonju, Korea
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University College of Medicine, Anyang, Korea
| | - Bong Cheol Kwon
- Department of Orthopedic Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Jung Woo Lee
- Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- Bigdata Platform Business Group, Wonju Yonsei Medical Center, Yonsei University, Wonju, Korea
- * Correspondence: Jung Woo Lee, Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, Gangwon-do 26426, Korea (e-mail: )
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37
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Lee HH, Lee H. Smoking and Cardiovascular Disease in Young Adults: Can We Restore the Risk by Cessation Alone? Korean Circ J 2022; 53:31-33. [PMID: 36627737 PMCID: PMC9834559 DOI: 10.4070/kcj.2022.0315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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38
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Kwon HW, Kim SD, Rhee MH, Shin JH. Pharmacological Actions of 5-Hydroxyindolin-2 on Modulation of Platelet Functions and Thrombus Formation via Thromboxane A 2 Inhibition and cAMP Production. Int J Mol Sci 2022; 23:ijms232314545. [PMID: 36498873 PMCID: PMC9739977 DOI: 10.3390/ijms232314545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
Platelets play a very significant role in hemostasis while simultaneously posing a risk for the development of various cardiovascular diseases. Platelet-mediated issues can occur in blood vessels and trigger various medical problems. Therefore, controlling platelet function is important in the prevention of thrombosis. In this regard, we need to find compounds that provide potent antiplatelet activity with minimum side effects. Therefore, we examined the effect of 5-hydroxyindolin-2-one isolated from Protaetia brevitarsis larvae having antiplatelet properties and investigated different pathways that mediate the antiplatelet activity. We examined the effect of 5-hydroxyindolin-2-one (5-HI) on the regulation of phosphoproteins, thromboxane A2 generation, and integrin αIIbβ3 action. Our data showed that human platelet aggregation was inhibited by 5-HI (75, 100, 150, 200 μM) without cytotoxicity, and it suppressed intracellular Ca2+ concentration through the regulation of inositol 1, 4, 5-triphosphate receptor I (Ser1756) and extracellular signal-regulated kinase (ERK). Moreover, collagen-elevated thromboxane A2 production and αIIbβ3 action were inhibited by 5-HI through the regulation of cytosolic phospholipase A2 (cPLA2), mitogen-activated protein kinase p38 (p38MAPK), vasodilator-stimulated phosphoprotein (VASP), phosphoinositide 3-kinase (PI3K), and Akt (protein kinase B). Therefore, we suggested that 5-HI could be a potential substance for the prevention of thrombosis-mediated thrombosis.
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Affiliation(s)
- Hyuk-Woo Kwon
- Department of Biomedical Laboratory Science, Far East University, Eumseong 27601, Republic of Korea
- Department of Microbiological Resource Research Institute, Far East University, Eumseong 27601, Republic of Korea
| | - Sung Dae Kim
- Department of Veterinary Medicine, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Man Hee Rhee
- Department of Veterinary Medicine, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea
- Cardiovascular Research Institute, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Correspondence: author: (M.H.R.); (J.-H.S.)
| | - Jung-Hae Shin
- Department of Veterinary Medicine, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea
- Cardiovascular Research Institute, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Correspondence: author: (M.H.R.); (J.-H.S.)
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39
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Association between Seafood Intake and Cardiovascular Disease in South Korean Adults: A Community-Based Prospective Cohort Study. Nutrients 2022; 14:nu14224864. [PMID: 36432548 PMCID: PMC9695428 DOI: 10.3390/nu14224864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Cardiovascular disease (CVD) is the most common non-communicable diseases causing 18.6 million deaths worldwide. Several studies have revealed that seafood consumption has a protective effect against CVD. This study investigated the correlation between CVD and seafood intake based on a 10-year follow-up of the Korean Genome and Epidemiology Study (KoGES). The study population, which included 6565 adults age, 55.65 (±8.68), was divided into seafood intake-based tertiles. CVD included myocardial infarction, coronary artery disease, congestive heart failure, cerebrovascular disease, and peripheral vascular disease. At baseline, participants with low seafood intake also had low eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intakes. Prospectively, hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD were analyzed using Cox proportional hazards regression models. Seafood intake exhibited a significantly inverse relationship with the cumulative CVD incidence over 10 years regardless of sex (women: log-rank test p < 0.001 and men: log-rank test p < 0.0401). The longitudinal association of low seafood intake with the CVD risk was significantly stronger in female participants after adjusting for confounding variables (HR (95% confidence interval (CI)) = 0.718 (0.519−0.993) p-trend = 0.043). These results suggested that seafood consumption potentially ameliorates CVD risk in middle-aged adults.
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40
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Kang HS, Kim SY, Choi HG, Lim H, Kim JH, Kim JH, Cho SJ, Nam ES, Min KW, Park HY, Kim NY, Choi Y, Kwon MJ. Comparison of the Concordance of Cardiometabolic Diseases and Physical and Laboratory Examination Findings between Monozygotic and Dizygotic Korean Adult Twins: A Cross-Sectional Study Using KoGES HTS Data. Nutrients 2022; 14:nu14224834. [PMID: 36432523 PMCID: PMC9693823 DOI: 10.3390/nu14224834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022] Open
Abstract
This study investigated the contribution of genetic and environmental factors to cardiometabolic diseases (CMDs) by comparing disease concordance in monozygotic and dizygotic twins. This cross-sectional study analyzed 1294 (1040 monozygotic and 254 dizygotic) twin pairs (>20 years) based on the Korean Genome and Epidemiology Study data (2005−2014). The odds ratios of disease concordance were calculated using binomial and multinomial logistic regression models. The occurrence of CMDs (hypertension, hyperlipidemia, type 2 diabetes, cerebral stroke, transient ischemic attack, and ischemic heart disease) and related physical and laboratory levels did not differ between the monozygotic and dizygotic twin groups. The odds for concordance of the presence/absence of CMDs and the likelihood of incident CMD within monozygotic twins were comparable to that of dizygotic twins. The absolute differences in hemoglobin A1c, insulin, low- and high-density lipoprotein cholesterol, total cholesterol, triglycerides, and systolic blood pressure were lower in monozygotic twins than in dizygotic twins. Absolute differences in fasting glucose and diastolic blood pressure did not differ between groups. Although baseline levels of several laboratory parameters related to CMD showed a strong likelihood of heritability in monozygotic twins, CMD phenotype appears to be largely affected by environmental factors.
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Affiliation(s)
- Ho Suk Kang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam 13488, Republic of Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Hyun Lim
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Seong-Jin Cho
- Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Republic of Korea
| | - Eun Sook Nam
- Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Republic of Korea
| | - Kyueng-Whan Min
- Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, Republic of Korea
| | - Ha Young Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang 14068, Republic of Korea
| | - Younghee Choi
- Department of Pathology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong 18450, Republic of Korea
- Research Insititute for Complementary & Alternative Medicine, Hallym University, Hwaseong 18450, Republic of Korea
| | - Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
- Correspondence:
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41
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Im SI. What Regional Disparity Trends of Cardiovascular Mortality Have Changed in 2019 Compared to the 1980s? Korean Circ J 2022; 52:844-846. [PMID: 36347520 PMCID: PMC9643568 DOI: 10.4070/kcj.2022.0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Sung Il Im
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
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42
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Lee JH, Hwang KK. End-of-Life Care for End-stage Heart Failure Patients. Korean Circ J 2022; 52:659-679. [PMID: 36097835 PMCID: PMC9470494 DOI: 10.4070/kcj.2022.0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/11/2022] [Indexed: 11/11/2022] Open
Abstract
Although recent heart failure (HF) guidelines highlight integrative palliative care, including end-of-life (EOL), appropriate discussing EOL issues can be challenging due to possibility of unexpected deterioration throughout HF trajectory. Open communication and discussions with multidisciplinary team are important for setting patient and family expectations and establishing mutually agreed goals of care based firmly on the patient’s ‘human dignity’ and ‘right to self-determination.’ Especially when quality-of-life outweighs expanding quantity-of-life, transition to EOL care should be considered. Advanced care planning including resuscitation, device deactivation, site for last days, and bereavement support should focus on ensuring a good death, and be reviewed regularly. Efforts to improve end-of-life (EOL) care have generally been focused on cancer patients, but high-quality EOL care is also important for patients with other serious medical illnesses including heart failure (HF). Recent HF guidelines offer more clinical considerations for palliative care including EOL care than ever before. Because HF patients can experience rapid, unexpected clinical deterioration or sudden death throughout the disease trajectory, choosing an appropriate time to discuss issues such as advance directives or hospice can be challenging in real clinical situations. Therefore, EOL issues should be discussed early. Conversations are important for understanding patient and family expectations and developing mutually agreed goals of care. In particular, high-quality communication with patient and family through a multidisciplinary team is necessary to define patient-centered goals of care and establish treatment based on goals. Control of symptoms such as dyspnea, pain, anxiety/depression, fatigue, nausea, anorexia, and altered mental status throughout the dying process is an important issue that is often overlooked. When quality-of-life outweighs expanding quantity-of-life, the transition to EOL care should be considered. Advanced care planning including resuscitation (i.e., do-not resuscitate order), device deactivation, site for last days and bereavement support for the family should focus on ensuring a good death and be reviewed regularly. It is essential to ensure that treatment for all HF patients incorporates discussions about the overall goals of care and individual patient preferences at both the EOL and sudden changes in health status. In this review, we focus on EOL care for end-stage HF patients.
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Affiliation(s)
- Ju-Hee Lee
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.,Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Kyung-Kuk Hwang
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.,Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.
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43
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Kim YH, Chung YR, Kim C, Lee K, Lee WK. The Association of Pachydrusen Characteristics with Choroidal Thickness and Patient's Age in Polypoidal Choroidal Vasculopathy versus Central Serous Chorioretinopathy. Int J Mol Sci 2022; 23:ijms23158353. [PMID: 35955481 PMCID: PMC9368714 DOI: 10.3390/ijms23158353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 12/16/2022] Open
Abstract
We investigated the relationship between pachydrusen and choroidal thickness and age in eyes with polypoidal choroidal vasculopathy (PCV) and fellow eyes, compared to eyes with central serous chorioretinopathy (CSC). This retrospective study included 89 eyes with PCV and 146 eyes with CSC. The number, location, and shape of the pachydrusen and their association with choroidal thickness and age were analyzed. PCV eyes showed pachydrusen more frequently than eyes with CSC (52% vs. 20%, p < 0.001). Large solitary type and clustered type were more frequent in PCV eyes compared to CSC eyes (p = 0.003 and p = 0.001, respectively). Subfoveal choroidal thickness was associated with pachydrusen in eyes with PCV (odds ratio [OR] 1.006, 95% confidence interval [CI] 1.001−1.011, p = 0.027), while age was associated with pachydrusen in CSC eyes (OR 1.137, 95% CI, 1.073−1.205; p < 0.001). Pachydrusen were localized directly over the pachyvessel on optical coherence tomographic findings in approximately two thirds of PCV eyes and fellow eyes (62% and 67%, respectively). Risk factors for pachydrusen differ according to diseases. The presence of pachydrusen was associated with choroidal thickness in PCV, while the association with age was more prominent in CSC.
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Affiliation(s)
- Young Ho Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul 02841, Korea;
| | - Yoo-Ri Chung
- Department of Ophthalmology, Ajou University School of Medicine, Suwon 16499, Korea; (Y.-R.C.); (C.K.)
| | - Chungwoon Kim
- Department of Ophthalmology, Ajou University School of Medicine, Suwon 16499, Korea; (Y.-R.C.); (C.K.)
| | - Kihwang Lee
- Department of Ophthalmology, Ajou University School of Medicine, Suwon 16499, Korea; (Y.-R.C.); (C.K.)
- Correspondence: ; Tel.: +82-31-219-7814
| | - Won Ki Lee
- Retina Center, Nune Eye Hospital, Seoul 06198, Korea;
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44
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Kwon YJ, Lee HS, Park G, Kim HM, Lee JW. Association of Dietary Fiber Intake with All-Cause Mortality and Cardiovascular Disease Mortality: A 10-Year Prospective Cohort Study. Nutrients 2022; 14:nu14153089. [PMID: 35956265 PMCID: PMC9370192 DOI: 10.3390/nu14153089] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 12/25/2022] Open
Abstract
Although previous studies have established that dietary fiber (DF) intake reduces the total cardiovascular disease (CVD) mortality in general populations, limited studies have been conducted in individuals with pre-existing chronic conditions, especially in Asian countries. We aimed to investigate the association of DF intake with all-cause and CVD mortality in the general population and in the subpopulation with hypertension, diabetes, and dyslipidemia. We examined the relationship between DF intake and all-cause and CVD mortality using the Korean genome and epidemiology study. Diet was assessed using a food-frequency questionnaire at baseline. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) after adjusting for confounders. During the mean 10.1 years of follow-up, higher DF intake was significantly associated with a lower risk of all-cause mortality after adjusting for confounders (HR and 95% CIs for Q5 vs. Q1: 0.84 (0.76−0.93); p < 0.001). DF intake was inversely associated with a lower risk of CVD mortality after adjusting for the same confounders (HR and 95% CIs for Q5 vs. Q1: 0.61 (0.47−0.78); p < 0.001). Total DF intake was inversely associated with all-cause and CVD mortality in middle-aged and older adults.
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Affiliation(s)
- Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul 16995, Korea;
| | - Hye-Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 03277, Korea;
| | - Goeun Park
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul 06351, Korea;
| | - Hyung-Mi Kim
- Department of Food and Nutrition, Dongduck Women’s University, Seoul 02748, Korea;
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence:
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45
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Lee N, Cho JY, Kim KH, Kim HY, Cho HJ, Lee HY, Jeon ES, Kim JJ, Cho MC, Chae SC, Baek SH, Kang SM, Choi DJ, Yoo BS, Oh BH. Impact of Cardiac Troponin Elevation on Mortality of Patients with Acute Heart Failure: Insights from the Korea Acute Heart Failure (KorAHF) Registry. J Clin Med 2022; 11:jcm11102800. [PMID: 35628925 PMCID: PMC9145996 DOI: 10.3390/jcm11102800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 12/10/2022] Open
Abstract
We aimed to conduct the largest study evaluating the impact of cardiac troponin (TnI) status on mid- and long-term mortality in patients admitted for acute heart failure (AHF) as compared between patients with ischemic (IHF) vs. non-ischemic heart failure (non-IHF). Among 5625 patients from the Korea Acute Heart Failure (KorAHF) registry, 4396 eligible patients with TnI measurement were analyzed. The patients were included on admission with the diagnosis of AHF, and TnI level was measured on the day of admission. A TnI value of <0.05 ng/mL was considered normal. The patients were divided into four groups according to the etiology of heart failure and the status of TnI: non-IHF with normal TnI (n = 1009) vs. non-IHF with elevated TnI (n = 1665) vs. IHF with normal TnI (n = 258) vs. IHF with elevated TnI (n = 1464). The primary outcome was death from all causes according to the etiology (non-IHF vs. IHF) and TnI elevation during the entire follow-up period of 784 days (IQR 446−1116). Elevation of TnI was observed in 71.2% of all patients with AHF. Patients with IHF had higher all-cause mortality compared to those with non-IHF. Elevated TnI was associated with higher 90-day and post-90-day mortality in the non-IHF group. IHF as compared to non-IHF and elevation of TnI were independent predictors of mortality also in the adjustment analysis. In the IHF group, however, elevated TnI had a higher mortality with only 90-day follow-up (18.6% vs. 25.9%, log-rank p < 0.001), not in the post-90-day follow-up (31.1% vs. 32.5%, log-rank p = 0.799). In conclusion, elevated TnI in patients with heart failure is associated with increased all-cause mortality regardless of the etiology of HF. Elevation of TnI was associated to a higher post-90 day mortality in patients with non-IHF but not in patients with IHF.
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Affiliation(s)
- Nuri Lee
- Department of Cardiovascular Medicine, Chonnam National University Hwasun Hospital, Hwasun 58128, Korea;
| | - Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju 61469, Korea;
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju 61469, Korea;
| | - Kye Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju 61469, Korea;
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju 61469, Korea;
- Correspondence: ; Tel.: +82-62-220-6266; Fax: +82-62-223-3105
| | - Hyung Yoon Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju 61469, Korea;
| | - Hyun-Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea; (H.-J.C.); (H.-Y.L.); (B.-H.O.)
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea; (H.-J.C.); (H.-Y.L.); (B.-H.O.)
| | - Eun-Seok Jeon
- Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul 16419, Korea;
| | - Jae-Joong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju 28644, Korea;
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu 37224, Korea;
| | - Sang Hong Baek
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Seok-Min Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea;
| | - Byung-Su Yoo
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Byung-Hee Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea; (H.-J.C.); (H.-Y.L.); (B.-H.O.)
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46
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Kim KI. Hypertension in Older Women: The Biggest Challenge for Cardiovascular Health in an Aged Society. Korean Circ J 2022; 52:393-394. [PMID: 35388993 PMCID: PMC9064702 DOI: 10.4070/kcj.2022.0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Kwang-Il Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
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47
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Park J, Eah KY, Park J. Epidemiological profile of myasthenia gravis in South Korea using the national health insurance database. Acta Neurol Scand 2022; 145:633-640. [PMID: 35141872 DOI: 10.1111/ane.13596] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness and fatigue. Our objective was to investigate the incidence of MG using the National Health Insurance database of South Korea. MATERIALS AND METHODS We conducted a retrospective cohort analysis of patients with the G70.0 code designated as MG and administered with MG medications for >3 months from 2007 to 2018 using nationwide data from South Korea. RESULTS A total of 8,376 patients with MG during the period of 2010-2018 were identified. There were 3,862 (46.1%) male and 4,517 (53.9%) female patients. The standardized incidence rate was 1.18/100,000 in 2010, and increased to 1.81/100,000 in 2018. The standardized prevalence was 7.50/100,000 in 2010, and changed to 11.15/100,000 in 2018. Pyridostigmine was used to treat 82.3 ± 1.2% of patients with MG during 2010-2018. Among MG patients, 85.7 ± 0.9% used steroids, 31.6 ± 4.8% used azathioprine, 12.9 ± 9.5% used tacrolimus, 7.2 ± 2.1% used cyclosporine, 6.2 ± 1.8% used mycophenolate mofetil, and 0.4 ± 0.1% used methotrexate. Thymectomy was performed in 1,130 MG patients, and the time from MG diagnosis to thymectomy decreased from 2010 to 2018. CONCLUSION Based on the national registry data from 2010 to 2018, the incidence and prevalence rate in South Korea has increased. Whereas the use of IVIG has remained stable, thymectomy is performed earlier than before, and the distribution of immunosuppressant therapies has changed over the years with an increase in tacrolimus and mycophenolate mofetil. We expect that this study will serve as a basis for future South Korean MG epidemiological studies.
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Affiliation(s)
- Jin‐Sung Park
- Department of Neurology School of Medicine Kyungpook National University Daegu South Korea
| | - Kyung Yoon Eah
- Department of Neurology Dongguk University College of Medicine Gyeongju South Korea
| | - Jin‐Mo Park
- Department of Neurology Dongguk University College of Medicine Gyeongju South Korea
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Seo E, Jung S, Lee H, Kim HC. Sex-Specific Trends in the Prevalence of Hypertension and the Number of People With Hypertension: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 1998-2018. Korean Circ J 2022; 52:382-392. [PMID: 35257521 PMCID: PMC9064695 DOI: 10.4070/kcj.2021.0347] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/05/2021] [Accepted: 12/29/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As the Korean population ages fast, it is estimated that the people with hypertension, especially female patients, will increase rapidly. However, there are few data comparing the size of female and male hypertensive patients in the Korean population. Thus we assessed sex-specific trends in the prevalence and the number of people with hypertension. METHODS We analyzed data for 128,949 adults aged ≥20 years with valid blood pressure measurements from the 1998 to 2018 Korea National Health and Nutrition Examination Survey (KNHANES). The prevalence and the absolute number of hypertension were estimated with taking into the sampling weights separately for women and men. RESULTS Overall prevalence of hypertension is higher in men than in women. But, in older adults, women show higher prevalence and the number of people with hypertension. Between 1998 and 2018, prevalence of hypertension increased from 61.8% to 65.9% in elderly (age 65+) women, and from 49.0% to 59.4% in elderly men. During the same period, the number of elderly women with hypertension increased from 1.18 to 2.70 million, while the number of elderly men with hypertension increased from 0.57 to 1.78 million. Among hypertensive patients, undiagnosed hypertension and diagnosed-but-untreated hypertension were more common in men, while treated-but-uncontrolled hypertension were more common in women. CONCLUSION The fast-growing number of elderly women with hypertension will be an important public health challenge for the Korean society to solve in order to reduce the burden of cardiovascular disease.
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Affiliation(s)
- Eunsun Seo
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sunjae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Public Health, Yonsei University Graduate School, Seoul, Korea.,Integrative Research Center for Cerebrovascular and Cardiovascular diseases, Yonsei University College of Medicine, Seoul, Korea.
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Lee H, Lee HW, Kim SU, Chang Kim H. Metabolic Dysfunction-Associated Fatty Liver Disease Increases Colon Cancer Risk: A Nationwide Cohort Study. Clin Transl Gastroenterol 2022; 13:e00435. [PMID: 35080508 PMCID: PMC8806363 DOI: 10.14309/ctg.0000000000000435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/13/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The association between nonalcoholic fatty liver disease (NAFLD) and colorectal cancer (CRC) has been controversial. Using the new consensus-driven definition, we evaluated the association of metabolic dysfunction-associated fatty liver disease (MAFLD) with the risk of developing CRC. METHODS From a nationwide health screening database, we included 8,933,017 participants (48.6% male) aged 40-64 years between 2009 and 2010. Participants were categorized by the presence of fatty liver disease (FLD)-NAFLD and MAFLD, separately-and by the combination of the 2 definitions: neither FLD, NAFLD only, MAFLD only, or both FLD. The primary outcome was the development of CRC. RESULTS Among the participants, 2,517,330 (28.2%) had NAFLD, and 3,337,122 (37.4%) had MAFLD, whereas 2,465,151 (27.6%) met both NAFLD and MAFLD definitions. Over a median follow-up period of 10.1 years, 60,888 new CRC cases developed. NAFLD and MAFLD were each associated with a significantly higher risk of developing CRC. When the neither FLD group was the reference, multivariable-adjusted hazard ratios (95% confidence interval) for CRC were 1.16 (1.06-1.28) in the NAFLD only group, 1.18 (1.16-1.20) in the both FLD group, and 1.32 (1.28-1.35) in the MAFLD only group. The presence of advanced liver fibrosis further increased CRC risk in each FLD group. DISCUSSION FLD was associated with a higher risk of CRC development. CRC risk was higher in the presence of MAFLD, especially when accompanied by liver fibrosis.
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Affiliation(s)
- Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Yoo BS. Current status and problems regarding treating heart failure. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2022. [DOI: 10.5124/jkma.2022.65.1.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Heart failure remains a significant socioeconomic burden and leads to critical health problems due to its high mortality and hospitalization rates. Therefore, proper treatment of heart failure is very important in terms of long-term prognosis and quality of life.Current Concepts: The use of evidence-based drugs, intervention treatment, and patient education are essential recommendations to improve the prognosis of heart failure. However, these recommendations of treatment guidelines are not well implemented in actual clinical situations. A more realistic solution can be sought considering the domestic situation. First, it is necessary to improve public awareness of the disease. It is also necessary to actively educate medical personnel, including primary care doctors. Second, efforts to improve clinical inertia or neglect of treatment of medical personnel are needed. For a systematic treatment approach, developing performance indicators in heart failure management are necessary, which can be a realistic and suitable alternative to the domestic clinics.Discussion and Conclusion: Applying a well-proven treatment to patients with heart failure should be essential, which is not an option in actual clinical practice. To solve this problem, social attention and efforts, more grand decisions by academic societies, and creative concerns from public institutions should be necessary in the face of the so-called heart failure epidemic around the world and in Korea.
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