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Original Articles
Socioeconomic status and adverse pregnancy outcome increase the risk of long-term cardiovascular disease: an analysis using the UK Biobank
Ji Hoi Kim, Un Yung Choi, Jeesun Lee, Manu Shivakumar, Dokyoon Kim, Kue Hyun Kang, So-hee Kim, Haibin Bai, Chan-Wook Park, Joong Shin Park, Juwon Lim, Jeehoon Kang, Soo Heon Kwak, Seung Mi Lee
Epidemiol Health. 2025;47:e2025075.   Published online December 25, 2025
DOI: https://doi.org/10.4178/epih.e2025075
  • 2,213 View
  • 2,147,483,786 Download
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
Adverse pregnancy outcomes (APOs) and low socioeconomic status (SES) are both associated with an increased long-term risk of atherosclerotic cardiovascular disease (ASCVD). In this analysis, we evaluated whether the association between a history of APO and ASCVD risk varies across different SES groups.
METHODS
We conducted this analysis using data from the UK Biobank, a large prospective cohort including participants aged 40 years to 69 years recruited between 2006 and 2010, with ongoing follow-up. APOs included hypertensive disorders of pregnancy, gestational diabetes mellitus, low birth weight (<2.5 kg), and stillbirth. At enrollment, SES was assessed using the following indicators: household income, education, employment, and Townsend Deprivation Index. The adjusted hazard ratio (aHR) for new-onset ASCVD was analyzed according to history of APO and SES categories.
RESULTS
Among 146,064 women, those with a history of APO had a higher risk of new-onset ASCVD and overall lower SES—including lower income, less education, higher unemployment, and greater deprivation—compared with those without APO (p<0.001). The increased ASCVD risk associated with APO history was significant only in the low SES group (aHR, 1.26; 95% confidence interval [CI], 1.16 to 1.36), but not in the high SES group (aHR, 1.07; 95% CI, 0.74 to 1.55, p=0.716).
CONCLUSIONS
We found that women with low SES were more vulnerable to the adverse effects of APO history, resulting in a greater increase in ASCVD risk. This study highlights the need for SES-tailored preventive policies to reduce long-term cardiovascular disease in women with a history of APO.
Summary
Cardiovascular disease risk disparities between immigrants and native Koreans: a population-based study in Gwangju, Korea
Jung-Ho Yang, Yerin Choi, Ran Lee, Seong Eun Kim, Kyung-Hwa Park, Seong-Woo Choi, BongKyu Sun, Kyunghak Kim, Sun-Seog Kweon
Epidemiol Health. 2025;47:e2025067.   Published online December 8, 2025
DOI: https://doi.org/10.4178/epih.e2025067
  • 1,623 View
  • 60 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Korea is becoming a multiethnic society, with immigrants comprising nearly 5% of the population. Evidence on cardiovascular disease (CVD) risk among immigrants remains limited.
METHODS
We conducted a population-based study of 582 immigrants in Gwangju and 2,328 age-matched and gender-matched native Koreans (2022-2023). Immigrant data were obtained from direct health assessments, while native Korean data were drawn from the Korea National Health and Nutrition Examination Survey. CVD risk was estimated using the Framingham risk score (FRS) and pooled cohort equations (PCE). Logistic regression was employed to compare the odds of elevated risk (10-year CVD risk ≥7.5%), adjusting for socio-demographic and behavioral factors.
RESULTS
Immigrants had a higher prevalence of hypertension (37.3 vs. 16.1%), diabetes (11.5 vs. 5.6%), poor self-rated health (69.6 vs. 61.3%), and unmet medical needs (30.9 vs. 8.9%), as well as lower rates of health checkups and cancer screening (all p<0.001), compared to native Koreans. Elevated CVD risk was more frequent in immigrants (FRS, 31.4 vs. 20.8%; PCE, 33.6 vs. 22.8%). The adjusted odds ratios (95% confidence intervals) were 1.47 (1.14 to 1.88) for FRS and 1.49 (1.07 to 2.08) for PCE. Disparities were greatest among women, adults ≥40 years, uninsured people, low-income groups, and migrants from Central Asia, Russia, and Africa.
CONCLUSIONS
Immigrants in Korea face substantially higher CVD risk than native Koreans, particularly within socioeconomically vulnerable subgroups. Targeted prevention and policies addressing structural barriers are urgently needed.
Summary
Korean summary
국내 거주 이민자는 한국인보다 불리한 건강 상태와 더 높은 심혈관질환 위험을 보였다. 특히 여성, 고령자, 저소득층 등 취약 집단에서 격차가 두드러졌으며, 이는 구조적·사회경제적 요인이 이민자 건강 불평등에 기여함을 보여준다. 이러한 결과는 포용적 보건의료 정책과 맞춤형 예방 전략 마련의 필요성을 시사한다.
Key Message
Immigrants in South Korea face unmet healthcare needs, such as limited screening access, low disease awareness, and undertreatment of dyslipidemia. Our study shows consistently higher cardiovascular risk among immigrants compared with native Koreans, especially among women, older adults, uninsured individuals, and Central Asian migrants. These findings underscore the epidemiological importance of structural and socioeconomic disadvantages in shaping immigrant health disparities and emphasize the need for culturally tailored interventions and inclusive health policies to achieve cardiovascular health equity.
Explainable SHAP-XGBoost models for identifying important social factors associated with the atherosclerotic cardiovascular disease risk score using the LASSO feature selection technique
Jungtae Choi, Jooeun Jeon, Hyoeun An, Hyeon Chang Kim
Epidemiol Health. 2025;47:e2025052.   Published online September 10, 2025
DOI: https://doi.org/10.4178/epih.e2025052
  • 2,494 View
  • 55 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Extensive evidence indicates that social factors play an essential role in explaining atherosclerotic cardiovascular disease (ASCVD). This study aimed to examine which social factors are associated with the estimated 10-year ASCVD risk score among male and female adults, incorporating both multifaceted social network components and conventional risk factors.
METHODS
Using data from 4,368 middle-aged Korean adults, we explored factors most likely to explain ASCVD risk with interpretable machine learning algorithms. The ASCVD risk was determined using the 10-year ASCVD risk score, as calculated using pooled cohort equations. Social network components were assessed through the name generator module. A total of 52 variables were included in the model.
RESULTS
For male participants (area under the receiver operating characteristic curve [AUC], 0.65), the average years known for network members contributed most to ASCVD risk prediction (mean Shapley additive explanations value, 0.31), followed by spouse’s education level (0.22), medical history with diagnosis (0.18), and snoring frequency (0.14). By contrast, for female participants (AUC, 0.60), medical history with diagnosis was the strongest predictor (0.47), followed by logged income (0.21), education level (0.19), and the average number of years known in network members (0.17).
CONCLUSIONS
Several important social factors were associated with the ASCVD risk score in both male and female adults. However, longitudinal research is needed to determine whether these factors predict future ASCVD events.
Summary
Korean summary
40세에서 64세 사이의 한국 성인 4,368명을 대상으로, 남성과 여성의 10년 추정 ASCVD 위험 점수와 관련된 주요 사회적 요인을 확인하였다. 남성의 경우 '네트워크 구성원 간 평균 알고 지낸 기간'이 위험 예측에 가장 큰 기여도를 보인 반면, 여성의 경우 '진단된 병력'이 가장 영향력 있는 요인으로 나타났다. 이러한 결과는 ASCVD 위험을 설명하는 데 있어 사회적 요인과 건강 요인의 상대적 중요도가 성별에 따라 다르다는 점을 시사한다.
Key Message
Among 4,368 Korean adults aged 40-64 years, we identified key social factors associated with the estimated 10-year ASCVD risk score in males and females. For males, the "average years known in network members" showed the highest contribution to risk prediction, whereas for females, "medical history with diagnosis" was the most influential feature. These findings suggest that the relative importance of social and health factors in explaining ASCVD risk varies by sex.

Citations

Citations to this article as recorded by  
  • Predicting cardiovascular diseases using imbalanced data: An XGBoost-based analysis of the 2022 BRFSS dataset
    Masoud Imani, Ali Maroosi, Seyedshayan Shojaei, Kimia Heidari, Seyed Mahdi Hoseinzadeh, Nima Daneshi, Zahra Saber, Negar Sajadi, Morteza Mohammadzadeh
    American Heart Journal Plus: Cardiology Research and Practice.2026; 63: 100719.     CrossRef
Association of dietary inflammatory index with mortality risk: a prospective analysis of the Korea National Health and Nutrition Examination Survey
Dahyun Park, Hee Ju Jun, Garam Jo, Soyoung Kwak, Min-Jeong Shin
Epidemiol Health. 2025;47:e2025017.   Published online April 9, 2025
DOI: https://doi.org/10.4178/epih.e2025017
  • 8,158 View
  • 110 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The energy-adjusted dietary inflammatory index (E-DII), a tool developed based on comprehensive research and literature reviews, is used to assess the inflammatory potential of specific diets. Although previous research has demonstrated an association between E-DII and mortality, longitudinal studies investigating a causal relationship in Asian populations are lacking. This study aimed to explore the prospective association between E-DII and the risk of all-cause, cancer, and cardiovascular disease (CVD) mortality using a population-based Korean cohort.
METHODS
The analysis included data from 40,596 individuals who participated in the Korea National Health and Nutrition Examination Survey between 2007 and 2015. The exclusion criteria encompassed the diagnosis of cancer or CVD at baseline, pregnancy at baseline, and death within the first 2 years after baseline. The E-DII was calculated using data from 24-hour dietary recall interviews. Cox proportional hazard regression models were employed to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for mortality risk across E-DII tertiles.
RESULTS
Over an 8.2-year follow-up period, 2,070 deaths were recorded. Compared with the lowest E-DII, a higher index was associated with an increased risk of mortality from all causes (HR, 1.45; 95% CI, 1.25 to 1.69), cancer (HR, 1.41; 95% CI, 1.09 to 1.81), and CVD (HR, 1.53; 95% CI, 1.07 to 2.18). The association between E-DII and all-cause mortality was particularly pronounced among individuals with metabolic conditions.
CONCLUSIONS
Our findings suggest a strong positive association between high E-DII and increased mortality in Korean adults, especially those with metabolic disorders.
Summary
Korean summary
본 연구는 2007–2015년 국민건강영양조사-사망원인통계 연계 데이터를 바탕으로 한국 성인을 대상으로 식이염증지수(E-DII)와 전체, 암, 심혈관질환 사망률 간의 연관성을 분석하였음. 높은 식이염증지수는 전체 사망(HR, 1.45; 95% CI, 1.25–1.69), 암 사망(HR, 1.41; 95% CI, 1.09–1.81), 심혈관질환 사망(HR, 1.53; 95% CI, 1.07–2.18) 위험 증가와 유의하게 관련되었으며, 특히 대사질환 보유자에서 그 연관성이 두드러졌음.
Key Message
This prospective cohort study analyzed nationally representative data from the Korea National Health and Nutrition Examination Survey (2007–2015) to examine the association between the energy-adjusted Dietary Inflammatory Index (E-DII) and mortality risk. A higher E-DII was significantly associated with increased risks of all-cause (HR, 1.45; 95% CI, 1.25–1.69), cancer mortality (HR, 1.41; 95% CI, 1.09–1.81), and cardiovascular mortality (HR, 1.53; 95% CI, 1.07–2.18), particularly among individuals with metabolic disorders.

Citations

Citations to this article as recorded by  
  • Dietary Inflammatory Index and the Risk of Gastric Precancerous Lesions Among Korean Adults in a Rural Area
    Yewon Cho, Dongkyu Lee, Chang Soo Eun, Dong Soo Han, Hyun Ja Kim
    Nutrients.2025; 17(22): 3502.     CrossRef
  • Age-period-cohort analysis of dietary sodium, potassium, and sodium-to-potassium ratio in Korea
    Hee Ju Jun, Shieon Kim, Garam Jo
    Epidemiology and Health.2025; 47: e2025062.     CrossRef
Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021
Sung-Bin Hong, Ji-Eun Kim, Seung Seok Han, Joseph J. Shearer, Jungnam Joo, Ji-Yeob Choi, Véronique L. Roger
Epidemiol Health. 2025;47:e2025005.   Published online February 14, 2025
DOI: https://doi.org/10.4178/epih.e2025005
  • 14,650 View
  • 366 Download
  • 6 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The American Heart Association (AHA) recently defined cardiovascular-kidney-metabolic (CKM) syndrome to better characterize the associations among cardiovascular, kidney, and metabolic diseases. Although about 9 in 10 United States adults have at least 1 risk factor for CKM syndrome, its prevalence in other populations is less understood. To fill this gap, we examined the prevalence of CKM syndrome in Korea and its association with demographic and socioeconomic status (SES).
METHODS
Using data from the Korean National Health and Nutrition Examination Survey between 2011 and 2021, we calculated the prevalence of CKM syndrome across the following stages: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stages 3-4 (subclinical/clinical cardiovascular diseases) among adults aged ≥20 years. Weighted analyses were used to estimate prevalence and 95% confidence intervals (CIs) for each CKM syndrome stage, stratified by age, gender, and SES factors.
RESULTS
Among 54,994 Korean adults, the prevalence of CKM syndrome was as follows: stage 0 (25.2%; 95% CI, 24.7 to 25.8), stage 1 (19.3%; 95% CI, 18.9 to 19.7), stage 2 (51.6%; 95% CI, 51.1 to 52.2), and stages 3-4 (3.9%; 95% CI, 3.7 to 4.0). The prevalence of stages 2 and 3-4 was higher in men than in women. In addition, stages 3-4 were more prevalent among rural residents and those with lower education or income.
CONCLUSIONS
About 3 out of 4 Koreans are at risk for CKM syndrome. These findings highlight that CKM syndrome is a global health problem and that interventions are urgently needed to prevent further progression.
Summary
Korean summary
최근, 심장-신장-대사 증후군을 하나로 묶어 관리하는 것의 필요성이 대두되고 있다. 본 연구 결과 20세 이상의 한국 성인들의 74.8%가 심장-신장-대사 증후군의 위험군에 속해 있었다. 또한 그 정도가 증가하는 추세로 나타나 적절한 관리가 필요해 보인다.
Key Message
Recently, the need for an integrated approach to managing cardiovascular-kidney-metabolic (CKM) syndrome has been emphasized. This study found that 74.8% of Korean adults aged 20 and older had a risk for CKM syndrome. Moreover, the prevalence is increasing, highlighting the necessity of proper management.

Citations

Citations to this article as recorded by  
  • Stage-specific risks of mortality and renal outcomes in cardiovascular-kidney-metabolic syndrome: findings from a nationwide Japanese cohort
    Kenta Fujimoto, Masao Kikuchi, Michikazu Nakai, Tsuneo Konta, Kunitoshi Iseki, Kazuhiko Tsuruya, Kunihiro Yamagata, Ichiei Narita, Toshiki Moriyama, Yugo Shibagaki, Masato Kasahara, Masahide Kondo, Koichi Asahi, Tsuyoshi Watanabe, Koichi Kaikita, Shouichi
    Clinical and Experimental Nephrology.2026; 30(3): 434.     CrossRef
  • 2026 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association
    Latha P. Palaniappan, Norrina B. Allen, Zaid I. Almarzooq, Cheryl A.M. Anderson, Pankaj Arora, Christy L. Avery, Carissa M. Baker-Smith, Nisha Bansal, Maria E. Currie, Rebecca S. Earlie, Wenjun Fan, Jessica L. Fetterman, Bethany Barone Gibbs, Debra G. Hea
    Circulation.2026;[Epub]     CrossRef
  • The Prevalence of Cardiovascular–Kidney–Metabolic Syndrome: A Review of Published Estimates and New Findings from BRFSS Surveys
    Steven S. Coughlin, Nikul Parikh, Ashley Oh, Biplab Datta, Marlo Vernon, Jennifer Sullivan
    Cardiovascular Medicine.2026; 29(1): 5.     CrossRef
  • Residual cholesterol inflammatory index and its prognostic role in mortality among individuals with cardiovascular–kidney–metabolic syndrome stages 0–3 based on U.S. and Chinese national cohorts
    Shouxin Wei, Sijia Yu, Chuan Qian, Zhengwen Xu, Yindong Jia
    European Journal of Medical Research.2025;[Epub]     CrossRef
  • Relationship between estimated pulse wave velocity trajectories and cardiovascular disease risk in patients with cardiovascular-kidney-metabolic syndrome stages 0–3
    Tingting Chen, Huangyi Yin, Yubo Zhou, Min Liang
    Nutrition, Metabolism and Cardiovascular Diseases.2025; 35(11): 104192.     CrossRef
  • The Reply
    Ji-Eun Kim, Véronique L. Roger, Joseph J. Shearer
    The American Journal of Medicine.2025; 138(8): e163.     CrossRef
  • Prevalence of Cardiovascular–Kidney–Metabolic (CKM) Syndrome in Lithuanian Adults: Insights from a Nationwide Real-World Study Using Electronic Health Records
    Gediminas Urbonas, Indrė Čeponienė, Inga Arūnė Bumblytė, Marius Miglinas, Lina Gatelytė, Živilė Steponkutė, Aušra Degutytė, Ingrida Grabauskytė, Džilda Veličkienė
    Medicina.2025; 61(12): 2106.     CrossRef
  • Data-driven cluster analysis identifies distinct types of cardiovascular-kidney-metabolic syndrome
    Mengge Yang, Chang Su, Xiaona Chang, Guang Wang, Jia Liu
    European Journal of Preventive Cardiology.2025;[Epub]     CrossRef
Causal effect of fasting serum glucose on atherosclerotic cardiovascular disease: a multivariable Mendelian randomization
Su Hyun Lee, Heejin Kimm, Byung-Wan Lee, Chung Mo Nam, So Young Kim, Sunmi Lee, Sun Ha Jee
Epidemiol Health. 2024;46:e2024096.   Published online December 6, 2024
DOI: https://doi.org/10.4178/epih.e2024096
  • 8,782 View
  • 161 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Observational studies have reported that diabetes is a risk factor that increases the risk of atherosclerotic cardiovascular disease (ASCVD). However, the causal relationship remains a matter of debate. This study aimed to analyze the relationship between fasting serum glucose (FSG) and ASCVD.
METHODS
This study used data from the Korean Cancer Prevention Study-II (KCPS-II) Biobank, consisting of 159,844 people recruited with consent from 18 health examination centers from 2004 to 2013. Outcomes were confirmed based on diagnoses on hospital discharge summaries from National Health Insurance System. We used linear and non-linear Mendelian randomization (MR) methods. The outcome data were obtained from KCPS-II, and the exposure data were derived from the Korean Genome Epidemiology Study.
RESULTS
First, a prospective cohort study estimated that for each 10 mg/dL increase in FSG level, the risk of ASCVD increased by 4% (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.03 to 1.05). Second, the 2-sample MR study showed that every 10 mg/dL increase in FSG influenced the risk of ASCVD (odds ratio [OR], 1.11; 95% CI, 1.04 to 1.18). Third, the multivariable MR study showed that the OR per 10 mg/dL increase in FSG on ASCVD was 1.14 (p<0.001). Similar results were found for a 10 mg/dL increase in FSG and ischemic heart disease (IHD), but a significant relationship with stroke was not found. When performing non-linear MR, a linear relationship was observed between fasting blood sugar and ASCVD, including IHD and stroke.
CONCLUSIONS
FSG showed a linear and causal association with IHD, but not with stroke.
Summary
Korean summary
그동안 당뇨병이 심뇌혈관질환 발생에 위험요인이라는 역학적인 관찰연구는 많이 발표되었지만, 이러한 관련성에 대한 인과적 관련성에 대부분 연구는 서양인을 대상으로 발표되었고, 한국인 자료를 통해 발표된 적은 없었다. 이 연구는 관찰연구의 제한점으로 부각되는 혼란변수와 측정오류에 덜 영향을 받는 새로운 방법론으로써 다변수 멘델리언 무작위화 방법을 사용하여 공복혈당과 심뇌혈관질환의 인과성을 분석하였다. 분석결과, 공복혈당은 허혈성 심질환 발생위험에 인과적인을 관련성을 보였고 뇌졸중에 대해서는 인과적이지 않았다.
Key Message
Over the years, numerous epidemiological observational studies have reported that diabetes is a risk factor for cardiovascular and cerebrovascular diseases. However, most of these studies examining this association were conducted on Western populations, and no studies have been published using Korean data. This study employed a new methodology—multivariable Mendelian randomization—which is less affected by confounding factors and measurement errors, often highlighted as limitations of observational studies, to analyze the causal relationship between fasting glucose levels and cardiovascular and cerebrovascular diseases. The analysis revealed a causal relationship between fasting glucose levels and the risk of ischemic heart disease, while no causal association was observed with stroke.
Systematic Review
Tea consumption and risk of all-cause, cardiovascular disease, and cancer mortality: a meta-analysis of thirty-eight prospective cohort data sets
Youngyo Kim, Youjin Je
Epidemiol Health. 2024;46:e2024056.   Published online June 21, 2024
DOI: https://doi.org/10.4178/epih.e2024056
  • 34,209 View
  • 200 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Tea consumption has been considered beneficial to human health because tea contains phytochemicals such as polyphenols and theaflavins. We conducted a systematic review and meta-analysis on the association between tea consumption and mortality from all causes, cardiovascular disease (CVD), and cancer to provide a quantitative assessment of current evidence.
METHODS
The PubMed, Web of Science, and Scopus databases were searched through April 2024 to identify eligible studies. Random effects models were used to combine study-specific effect estimates (ESs).
RESULTS
A total of 38 prospective cohort data sets (from 27 papers) with 1,956,549 participants were included in this meta-analysis. The pooled ESs of the highest versus lowest categories of tea consumption were 0.90 (95% confidence interval [CI], 0.86 to 0.95) for all-cause mortality, 0.86 (95% CI, 0.79 to 0.94) for CVD mortality, and 0.90 (95% CI, 0.78 to 1.03) for cancer mortality. In the dose-response analysis, a non-linear association was observed. The greatest risk reductions were observed for the consumption of 2.0 cup/day for all-cause mortality (ES, 0.91; 95% CI, 0.88 to 0.94) and 1.5 cup/day for cancer mortality (ES, 0.92; 95% CI, 0.89 to 0.96), whereas additional consumption did not show a further reduction in the risk of death. A plateau was observed for CVD mortality at moderate consumption levels (1.5-3.0 cup/day), but a sustained reduction in mortality risk was observed at higher intake levels.
CONCLUSIONS
Moderate tea consumption (e.g., 1.5-2.0 cup/day) was associated with lower all-cause, CVD, and cancer mortality compared to no tea consumption. Further well-designed prospective studies are needed for a definitive conclusion.
Summary
Korean summary
차는 전세계적으로 널리 소비되는 음료로 그 공중보건학적 영향력이 크다. 차의 섭취와 만성질환의 관련성은 아직 일관성 있게 결론이 나지 않았는데 최근에 이 주제에 대하여 대규모의 코호트 연구 결과들이 발표된 바 있었다. 38개의 코호트 데이터에 근거한 본 메타분석의 결과는 하루 한 잔 반에서 두 잔의 차를 마시는 것이 총사망위험과 심혈관계질환이나 암으로 인한 사망 위험을 낮추는 것과 관계가 있음을 나타내고 있다.
Key Message
Tea is a commonly consumed beverage worldwide and has a significant public health impact. The association between tea consumption and risk of mortality from chronic disease remains inconsistent, and extensive cohort studies have been published recently. In this meta-analysis, including thirty-eight cohort studies, people who drank one and a half to two cups of tea daily had a lower risk of mortality from all causes, cardiovascular disease, and cancer than those who drank less tea.

Citations

Citations to this article as recorded by  
  • Bioavailability of Tea Polyphenols: A Key Factor in Understanding Their Mechanisms of Action In Vivo and Health Effects
    Mingchuan Yang, Xiangchun Zhang, Chung S. Yang
    Journal of Agricultural and Food Chemistry.2025; 73(7): 3816.     CrossRef
  • Associations of a healthy beverage pattern with all-cause and cause-specific mortality among US adults: a nationwide cohort study
    Yu Feng, Haoming Wang, Kang Wang, Ziyue Li, Bohao Tan, Qirui Li, Fan Ouyang, Zhangling Chen
    Nutrition Journal.2025;[Epub]     CrossRef
  • Color Stability of Three Ceramics After Thermocycling in Coffee, Black Tea, Cola, and Water: An In Vitro Study
    Dina Maleki, Donya Maleki, Arayeh Maleki, Helia Zare, AmirHossein SohrabiFar, Boonlert Kukiattrakoon
    International Journal of Dentistry.2025;[Epub]     CrossRef
  • The Impact of Tea Consumption on Cardiovascular Health
    Farid Aldhuhli, Mohammed Fazal, Gouse Bin Mohammad Shaik, Srijit Das
    The Natural Products Journal.2025;[Epub]     CrossRef
  • Beneficial health effects and possible health concerns of tea consumption: a review
    Mingchuan Yang, Li Zhou, Zhipeng Kan, Zhoupin Fu, Xiangchun Zhang, Chung S. Yang
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  • Green Tea: A Magical Herb with Miraculous Outcomes
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Brief Communication
Association between cardiac arrhythmia before pregnancy and gestational diabetes: a nationwide population-based study in Korea
You-Jung Choi, Won Young Wi, Geum Joon Cho, Jin Oh Na
Epidemiol Health. 2023;45:e2023103.   Published online December 4, 2023
DOI: https://doi.org/10.4178/epih.e2023103
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Given the higher prevalence of cardiac arrhythmias in individuals with diabetes, we investigated the relationship between cardiac arrhythmias and the incidence of gestational diabetes (GDM). This retrospective cohort study utilized data from the Korean Health Insurance Service database, encompassing 1,113,729 women who gave birth between January 2007 and December 2015. After excluding those who did not undergo National Health Screening tests within 1 year prior to pregnancy, those with multifetal pregnancies, and those diagnosed with diabetes, we analyzed 365,880 singleton pregnancies without a history of diabetes. Of these, 3,253 (0.9%) had cardiac arrhythmias, including premature extra beats, supraventricular tachyarrhythmias, and/or atrial flutter/fibrillation. GDM occurred in 31,938 (8.7%) subjects during pregnancy, and was more prevalent in women with cardiac arrhythmia than in those without (14.9 vs. 8.7%, p<0.001). In the multivariate analysis, the association between cardiac arrhythmia and GDM remained statistically significant (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). Subgroup analysis revealed that the risk of GDM was consistently statistically significant in subjects with cardiac arrhythmia, regardless of age, body mass index, and the presence or absence of chronic hypertension. Therefore, cardiac arrhythmias before and during pregnancy appear to be associated with an increased risk of developing GDM.
Summary
Korean summary
본 연구에서는 부정맥과 임신성 당뇨병의 발생과의 관계를 확인인하기 위하여 2007년부터 2015년까지 국민건강보험 공단 데이터를 이용하여 분만력을 가진 1,113,729명의 여성을 대상으로 진행되었습니다. 최종 분석은 과거 당뇨병 진단병력을 가지고 있는 환자를 제외하고 365,880건의 단태아 임산부를 포함하였고, 전체 대상자 중 31,938 (8.7%)에서 임신성 당뇨병을 확인하였습니다. 그 중 부정맥 병력이 확인되지 않은 임산부와 비교하였을 때, 부정맥 병력이 있는 경우 임신 기간 중 임신성 당뇨병 발생률이 높았으며 (8.7% vs. 14.9%, p<0.001), 다변량 분석에서도 부정맥과 임신 당뇨병 간의 연관성이 통계적으로 유의미하게 나타났습니다 (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). 따라서, 본 연구는 임신 전후의 부정맥 병력은 임신성 당뇨병 발병 위험 증가와 관련 있음을 시사합니다.
Key Message
This nationwide population-based cross-sectional study using the Korean Health Insurance Service database showed that women with a history of cardiac arrhythmia had an elevated risk of incident GDM during pregnancy. The prevalence of GDM was significantly higher in women with cardiac arrhythmias (8.7% vs. 14.9%). There was a statistically significant association between cardiac arrhythmia and GDM (adjusted odds ratio: 1.78), suggesting that cardiac arrhythmias before and during pregnancy are linked to an increased risk of developing GDM, independent of age, BMI, and chronic hypertension.
Original Articles
Association of blood pressure measurements in sitting, supine, and standing positions with the 10-year risk of mortality in Korean adults
Inkyung Baik, Nan Hee Kim, Seong Hwan Kim, Chol Shin
Epidemiol Health. 2023;45:e2023055.   Published online June 8, 2023
DOI: https://doi.org/10.4178/epih.e2023055
  • 33,082 View
  • 355 Download
  • 11 Web of Science
  • 11 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This prospective cohort study investigated the association between blood pressure (BP) as measured in different body postures and all-cause and cardiovascular (CV) mortality risk.
METHODS
This population-based investigation included 8,901 Korean adults in 2001 and 2002. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured sequentially in the sitting, supine, and standing positions and classified into 4 categories: (1) normal, SBP <120 mmHg and DBP <80 mmHg; (2) high normal/prehypertension, SBP 120-129 mmHg and DBP <80 mmHg/SBP 130-139 mmHg or DBP 80-89 mmHg; (3) grade 1 hypertension (HTN), with SBP 140-159 mmHg or DBP 90-99 mmHg; and (4) grade 2 HTN, SBP ≥160 mmHg or DBP ≥100 mmHg. The date and cause of individual deaths were confirmed in the death record data compiled until 2013. Data were analyzed using Cox proportional hazard regression.
RESULTS
Significant associations were found between the BP categories and all-cause mortality, but only when BPs were measured in the supine position. The multivariate hazard ratios (95% confidence intervals, [CIs]) were 1.36 (95% CI, 1.06 to 1.75) and 1.59 (95% CI, 1.06 to 2.39) for grade 1 HTN and grade 2 HTN, respectively, compared with the normal category. The associations between the BP categories and CV mortality were significant regardless of body posture among participants ≥65 years, whereas they were significant for supine BP measurements only in those <65 years.
CONCLUSIONS
BP measured in the supine position predicted all-cause mortality and CV mortality better than BP measured in other postures.
Summary
Korean summary
본 역학 연구는 한국 성인 8,901명을 연구대상자로 하여 기초조사에서 세가지 자세, 즉 앉은 자세, 누운 자세, 일어선 자세에서 혈압을 측정하고, 이후 10년 동안의 사망 여부를 추적조사하여, 측정 자세에 따른 혈압과 사망 위험과의 관련성을 분석하였다. 그 결과, 누운 자세에서 측정된 고혈압(기준: 수축기 혈압이 140 mmHg 이상 혹은 이완기 혈압이 90 mmHg 이상)인 사람은 정상 혈압(기준: 수축기 혈압이 120 mmHg 미만이고 이완기 혈압이 80 mmHg 미만)인 사람에 비해 36%(1단계 고혈압) 혹은 59%(2단계 고혈압) 가량 총 사망 위험이 유의적으로 증가하는 것으로 나타났다. 이에 비해, 앉은 자세 및 일어선 자세에서 측정, 정의된 고혈압은 총 사망 위험을 증가시켰지만 유의적인 결과를 나타내지 못했다. 추후 연구에서 재확인이 필요하지만, 본 연구 결과가 시사하는 바는 앉은 자세나 일어선 자세보다 누운 자세에서 측정하는 혈압이 총 사망 위험을 더 잘 예측하므로, 고혈압 진단 외의 추가적인 활용 가능성이 있는 것으로 평가된다.
Key Message
The current epidemiological study revealed that blood pressure measured in a supine position could predict all-cause mortality and cardiovascular mortality better than blood pressure measured in a sitting or standing position. As a result, blood pressure measurements in a supine position may be useful in assessing mortality risk.

Citations

Citations to this article as recorded by  
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Prediction of the 10-year risk of atherosclerotic cardiovascular disease in the Korean population
Sangwoo Park, Yong-Giun Kim, Soe Hee Ann, Young-Rak Cho, Shin-Jae Kim, Seungbong Han, Gyung-Min Park
Epidemiol Health. 2023;45:e2023052.   Published online May 12, 2023
DOI: https://doi.org/10.4178/epih.e2023052
  • 21,451 View
  • 403 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Proper risk assessment is important for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, no validated risk prediction tools are currently in use in Korea. This study sought to develop a 10-year risk prediction model for incident ASCVD.
METHODS
Using the National Sample Cohort of Korea, 325,934 subjects aged 20-80 years without previous ASCVD were enrolled. ASCVD was defined as a composite of cardiovascular death, myocardial infarction, and stroke. The Korean atherosclerotic cardiovas cular disease risk prediction (K-CVD) model was developed separately for men and women using the development dataset and validated in the validation dataset. Furthermore, the model performance was compared with the Framingham risk score (FRS) and pooled cohort equation (PCE).
RESULTS
Over 10 years of follow-up, 4,367 ASCVD events occurred in the overall population. The predictors of ASCVD included in the model were age, smoking status, diabetes, systolic blood pressure, lipid profiles, urine protein, and lipid-lowering and blood pressure-lowering treatment. The K-CVD model had good discrimination and strong calibration in the validation dataset (time-dependent area under the curve=0.846; 95% confidence interval, 0.828 to 0.864; calibration χ<sup>2</sup>=4.73, goodness-of-fit p=0.32). Compared with our model, both FRS and PCE showed worse calibration, overestimating ASCVD risk in the Korean population.
CONCLUSIONS
Through a nationwide cohort, we developed a model for 10-year ASCVD risk prediction in a contemporary Korean population. The K-CVD model showed excellent discrimination and calibration in Koreans. This population-based risk prediction tool would help to appropriately identify high-risk individuals and provide preventive interventions in the Korean population.
Summary
Korean summary
국민건강보험공단 표본 코호트를 이용하여, 한국인 인구에서 10년 죽상경화성 심혈관질환 위험 예측 (K-CVD) 모델을 개발하였다. 한국인 인구집단을 기반으로 개발된 K-CVD 모델은 한국 인구집단에서 판별력과 교정력 측면에서 우수한 성능을 보여주었다. K-CVD 모델은 한국인 집단에서 심혈관질환의 고위험군을 적절하게 식별하고, 예방적 중재를 시행하는데 있어 도움이 될 것으로 생각된다.
Key Message
Using a nationwide cohort, the Korean ASCVD risk prediction (K-CVD) model was developed for 10-year ASCVD risk prediction. The K-CVD model showed excellent discrimination and calibration in a contemporary Korean population. This population-based risk prediction tool would help to appropriately identify high-risk individuals and provide preventive interventions in the Korean population.

Citations

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  • Increased risk of colorectal cancer in young males with higher cardiovascular risk: A nationwide population-based cohort study
    Ji Hyun Song, Su-Yeon Choi, Young Sun Kim, Sun Young Yang, Kyung-Do Han
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Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data
Hong Ki Min, Hyeongsu Kim, Ho Jin Jeong, Se Hee Kim, Hae-Rim Kim, Sang-Heon Lee, KunSei Lee, Soon-Ae Shin, Jong Heon Park
Epidemiol Health. 2023;45:e2023045.   Published online April 15, 2023
DOI: https://doi.org/10.4178/epih.e2023045
  • 23,596 View
  • 372 Download
  • 23 Web of Science
  • 22 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA).
METHODS
We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups.
RESULTS
Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups.
CONCLUSIONS
In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.
Summary
Korean summary
1. 한국인 류마티스관절염 환자를 대상으로 한 실제임상자료 결과, JAK 억제제가 종양괴사인자 억제제에 비해 심혈관질환, 혈전증, 암 등의 심각한 부작용을 증가시키지는 않았다. 2. 본 연구를 토대로 한국인 대상자에서 JAK 억제제가 심혈관질환 등의 심각한 부작용을 증가시키는지에 대한 재평가가 필요하다.
Key Message
1. The real word-data based results showed that risks of MACE, thromboembolism, and cancers were not increased in Korean RA patients with JAK inhibitor when compared to Korean RA patients with TNF inhibitors. 2. Therefore, the risk of serious adverse events of JAK inhibitors in Korean population should be reconsidered and reassessed before adding black box warning of JAK inhibitors.

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Association of group-level segregation with cardiovascular health in older adults: an analysis of data from the Korean Social Life, Health, and Aging Project
Sung-Ha Lee, Hyeok-Hee Lee, Kiho Sung, Yoosik Youm, Hyeon Chang Kim
Epidemiol Health. 2023;45:e2023041.   Published online April 4, 2023
DOI: https://doi.org/10.4178/epih.e2023041
  • 16,684 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The adverse health effects of individual-level social isolation (e.g., perceived loneliness) have been well documented in older adults. However, little is known about the impact of collective-level social isolation on health outcomes. We sought to examine the association of group-level segregation with cardiovascular health (CVH) in older adults.
METHODS
From the prospective Korean Social Life, Health, and Aging Project database, we identified 528 community-dwelling older adults who were aged ≥60 years or were married to those aged ≥60 years. Participants who belonged to smaller social groups separate from the major social group were defined as group-level-segregated. The CVH score was calculated as the number of ideal non-dietary CVH metrics (0-6), as modified from the American Heart Association’s Life’s Simple 7. Using ordinal logistic regression models, we assessed cross-sectional and longitudinal associations between group-level segregation and CVH.
RESULTS
Of the 528 participants (mean age, 71.7 years; 60.0% female), 108 (20.5%) were segregated at baseline. In the crosssectional analysis, group-level segregation was significantly associated with lower odds of having a higher CVH score at baseline after adjusting for socio-demographic factors and cognitive function (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.43 to 0.95). Among 274 participants who completed an 8-year follow-up, group-level segregation at baseline was marginally associated with lower odds of having a higher CVH score at 8 years (OR, 0.49; 95% CI, 0.24 to 1.02).
CONCLUSIONS
Group-level segregation was associated with worse CVH. These findings imply that the social network structure of a community may influence its members’ health status.
Summary
Korean summary
본 연구는 “한국인의 사회적 삶, 건강과 노화에 대한 조사”(Korean Social Life, Health and Aging Project, KSHAP)에서 측정한 한 지역 내의 사회적 연결망 자료를 이용하여 사회적 분리와 심혈관 건강 사이의 관계를 살펴보았다. 그 결과, 사회적 분리는 비만, 고혈압, 콜레스테롤, 흡연, 음주 신체적 활동 등을 종합한 ‘라이프 심플 7’ 지표와 부정적인 관련성을 보였으며, 8년 후 추적 조사에서도 이 패턴이 유지되었다. 본 연구 결과는 사회적, 집단적 분리 현상이 신체적 건강에도 악영향을 초래할 수 있음을 시사한다.
Key Message
Using the prospective Korean Social Life, Health, and Aging Project (KSHAP) database, we discovered that group-level segregation was significantly associated with worse cardiovascular health (CVH). Also, we observed a tendency for baseline group-level segregation to be linked to worse CVH after an 8-year follow-up period. These findings emphasize the significance of group-level segregation as a potential contributing factor in the health outcomes of older adults.

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  • Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey
    Shiqi Wang, Hao Zhang, Yiling Lou, Qiqi You, Qingqing Jiang, Shiyi Cao
    Journal of Affective Disorders.2024; 349: 577.     CrossRef
Impact of statin treatment on cardiovascular events in patients with retinal vein occlusion: a nested case-control study in Korea
Joonsang Yoo, Joo Youn Shin, Jimin Jeon, Jinkwon Kim
Epidemiol Health. 2023;45:e2023035.   Published online March 15, 2023
DOI: https://doi.org/10.4178/epih.e2023035
  • 17,876 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Retinal vein occlusion (RVO) is associated with an increased risk of future cardiovascular events. Statin therapy is a key cornerstone in prevention for patients at high cardiovascular risk. However, little is known about the role of statin therapy for patients with RVO. This study evaluated whether statin treatment in patients with RVO was associated with a lower risk of cardiovascular events.
METHODS
A population-based, nested case-control study was conducted with a cohort of newly diagnosed RVO patients without prior cardiovascular disease between 2008 and 2020 using a nationwide health claims database in Korea. From this cohort of RVO patients, we identified cases of cardiovascular events (stroke or myocardial infarction) after RVO and matched controls based on sex, age, insurance type, antiplatelet use, and underlying comorbidities using 1:2 incidence density sampling.
RESULTS
Using a cohort of 142,759 patients with newly diagnosed RVO, we selected 6,810 cases and 13,620 matched controls. A significantly lower risk of cardiovascular events (adjusted odds ratio, 0.604; 95% confidence interval, 0.557 to 0.655) was observed in RVO patients with statin treatment than in those without statin treatment. Statin treatment was associated with a reduced risk for both stroke and myocardial infarction after RVO. Longer statin treatment after RVO was associated with a lower risk for cardiovascular events.
CONCLUSIONS
Statin treatment was associated with a lower risk for future cardiovascular events in patients with newly diagnosed RVO. Further studies are warranted to clarify the potential cardiovascular preventive role of statins in patients with RVO.
Summary
Korean summary
· 망막정맥폐색 환자들은 심뇌혈관질환의 발생 위험이 높다고 알려져 있다. · 이번 연구를 통해 망막정맥폐색의 발생 이후 스타틴을 복용한 환자들에서 심근경색 및 뇌졸중 발생 위험도가 감소함을 확인하였다. · 고위험군인 망막정맥폐색 환자들에서 적극적인 스타틴의 사용이 심뇌혈관질환의 예방에 도움이 될 수 있을 것이다.
Key Message
· Statin was associated with a lower risk of cardiovascular events in RVO patients. · The reduced risk was observed in both stroke and myocardial infarction after RVO. · Statins might be a good candidate for cardiovascular prevention in RVO patients.

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  • Artificial intelligence based retinal imaging for cardiovascular risk and statin guidance in retinal vein occlusion
    Dongjin Nam, Yong-Hwan Jang, So Jung Ryu, Sahil Thakur, Simon Nusinovici, Junseok Park, Moonsu Kim, Sunjin Hwang
    American Journal of Preventive Cardiology.2026; 26: 101427.     CrossRef
  • Retinal Imaging as a Window into Cardiovascular Health: Towards Harnessing Retinal Analytics for Precision Cardiovascular Medicine
    Jay Bharatsingh Bisen, Hayden Sikora, Anushree Aneja, Sanjiv J. Shah, Rukhsana G. Mirza
    Journal of Cardiovascular Development and Disease.2025; 12(6): 230.     CrossRef
  • Exploring the role of oxidative stress in retinal vein occlusion: an updated and comprehensive review on the pathophysiology and treatment perspectives
    Jiaqi Zhang, Xuejun Xie, Ya Mo
    International Ophthalmology.2025;[Epub]     CrossRef
  • Oclusión venosa de retina y su asociación con la enfermedad vascular aterosclerótica
    María Larrousse Morellón, Yéssica López Loureiro, Susana Ruiz Bilbao
    Medicina Clínica.2024; 163(4): 199.     CrossRef
  • Zerumbone Inhibits the Viability, Motility, and Angiogenesis of Human Retinal Microvascular Endothelial Cells (HRCECs) by Inhibiting Vascular Endothelial Growth Factor
    Jiexin Yu, Shule Jiang, Yanli Liu
    Current Eye Research.2024; 49(11): 1201.     CrossRef
  • Retinal venous occlusion and its association with atherosclerotic vascular disease
    María Larrousse Morellón, Yéssica López Loureiro, Susana Ruiz Bilbao
    Medicina Clínica (English Edition).2024; 163(4): 199.     CrossRef
  • Retinal Findings and Cardiovascular Risk: Prognostic Conditions, Novel Biomarkers, and Emerging Image Analysis Techniques
    Joseph Colcombe, Rusdeep Mundae, Alexis Kaiser, Jacques Bijon, Yasha Modi
    Journal of Personalized Medicine.2023; 13(11): 1564.     CrossRef
Physical activity, sedentary behavior, and cardiovascular disease risk in Korea: a trajectory analysis
Jina Han, Yeong Jun Ju, Soon Young Lee
Epidemiol Health. 2023;45:e2023028.   Published online February 22, 2023
DOI: https://doi.org/10.4178/epih.e2023028
  • 17,996 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA).
METHODS
We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants’ self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included socio-demographic factors, the predisposing diseases of CVD, and baseline health behaviors.
RESULTS
Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28 to 0.90).
CONCLUSIONS
Despite increased time spent in SB, maintaining PA about 2 days to 3 days per week reduced the occurrence of CVD.
Summary

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  • Modulating the Expression of Exercise-induced lncRNAs: Implications for Cardiovascular Disease Progression
    Li-Hua Yu, Ge-Lin Zhang
    Journal of Cardiovascular Translational Research.2025; 18(6): 1632.     CrossRef
  • Physical activity for prevention of cardiovascular disease: consensus statement of Korean Society of Cardio-cerebrovascular Disease Prevention
    Ye Seul Yang, Eu Jeong Ku, Seung-Hyun Ko, Eun-Jung Rhee, Sang-Hyun Ihm, Sung Hee Choi, Won-Young Lee
    The Korean Journal of Internal Medicine.2025; 40(5): 696.     CrossRef
  • Physical activity for prevention of cardiovascular disease: a consensus statement of the Korean Society of Cardio-cerebrovascular Disease Prevention
    Ye Seul Yang, Eu Jeong Ku, Seung-Hyun Ko, Eun-Jung Rhee, Sang-Hyun Ihm, Sung Hee Choi, Won-Young Lee
    Cardiovascular Prevention and Pharmacotherapy.2025; 7(4): 120.     CrossRef
  • Effects of physical activity and sedentary behaviors on cardiovascular disease and the risk of all-cause mortality in overweight or obese middle-aged and older adults
    Yongqiang Zhang, Xia Liu
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • The mediating role of depression on the link between physical activity and health-related quality of life among people with diabetes: A cross-sectional study
    Djoko Priyono, Sanghee Kim, Md. Feroz Kabir
    PLOS ONE.2024; 19(12): e0312774.     CrossRef
  • Joint association of sedentary behavior and physical activity domains with depression in Korean adults: Cross-sectional study combining four biennial surveys (2016–2022)
    Sungjin Park, June-Hee Lee, Rashid Menhas
    PLOS ONE.2024; 19(10): e0312029.     CrossRef
A hypertension risk score for adults: a population-based cross-sectional study from the Dubai Household Survey 2019
Ibrahim Mahmoud, Nabil Sulaiman, Amal Hussein, Heba Mamdouh, Wafa K. AL Nakhi, Hamid Y. Hussain, Gamal M. Ibrahim
Epidemiol Health. 2021;43:e2021064.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021064
  • 31,725 View
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The aim of this study was to develop a risk score model for predicting hypertension specific to the population of Dubai in the United Arab Emirates (UAE) to facilitate prevention and early intervention.
METHODS
A retrospective analysis of data from the Dubai Household Health Survey 2019 was conducted. Demographic and physical parameters, as well as blood glucose levels, were included in the data. The risk factors for hypertension were identified using bivariate analysis. A risk score model was developed using the enter method, where all significant predictors of hypertension in bivariate analyses were entered in a single step with the primary outcome of hypertension status (yes/no). The model was validated internally by splitting the data into Emirati and non-Emirati populations.
RESULTS
A total of 2,533 subjects were studied. The significant risk factors for hypertension identified were male sex, older age (≥40 years), education level, body mass index, diabetes mellitus, and dyslipidaemia. The model showed a high discrimination ability between individuals with and without hypertension, with an area under the curve of 0.77 (95% confidence interval [CI], 0.75 to 0.79), excellent sensitivity (81.0%; 95% CI, 71.9 to 88.2) and moderate specificity (56.0%; 95% CI, 45.7 to 65.9).
CONCLUSIONS
The model developed by this study is simple, convenient, and based on readily available demographic and medical characteristics. This risk score model could support initial hypertension screening and provide an effective tool for targeted lifestyle counselling and prevention programs.
Summary
Key Message
To prevent hypertension in Dubai's adult population, primary health care physicians can use our risk score model to recommend preventative measures, with a focus on men over 40 years old, with a low educational level, who are obese, and who have other morbidities, such as diabetes mellitus and dyslipidemia.

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  • Explainable AI in action: a comparative analysis of hypertension risk factors using SHAP and LIME
    Turker Berk Donmez, Mustafa Kutlu, Mohammed Mansour, Mustafa Zahid Yildiz
    Neural Computing and Applications.2025; 37(5): 4053.     CrossRef
  • Predictive variables and diagnostic performance of cross-sectional models for hypertension detection: a systematic review
    Víctor Juan Vera-Ponce, Fiorella E. Zuzunaga-Montoya, Jhosmer Ballena-Caicedo, Carmen Inés Gutierrez De Carrillo, Darwin A. León-Figueroa, Mario J. Valladares-Garrido
    Frontiers in Cardiovascular Medicine.2025;[Epub]     CrossRef
  • Spline Estimator in Nonparametric Ordinal Logistic Regression Model for Predicting Heart Attack Risk
    Nur Chamidah, Budi Lestari, Hendri Susilo, Mochamad Yusuf Alsagaff, I Nyoman Budiantara, Dursun Aydin
    Symmetry.2024; 16(11): 1440.     CrossRef
Exploring the associations between cardiovascular health measured with the CANHEART model and early cognitive impairment in a middle-aged population in Korea
Ye Jin Jeon, Ji Heon Lee, Hyeon Chang Kim, Sun Jae Jung
Epidemiol Health. 2021;43:e2021044.   Published online July 13, 2021
DOI: https://doi.org/10.4178/epih.e2021044
  • 20,176 View
  • 288 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Both cardiovascular health (CVH) and inflammation are associated with cognition, and inflammation is also associated with CVH. However, limited information has been reported on these factors in the Korean population. The objective of our study was to investigate the influence of inflammation on the association between CVH and cognition using a cross-sectional design.
METHODS
Data were obtained from the Cardiovascular and Metabolic Diseases Etiology Research Center baseline study. Participants who completed fasting serum analysis, questionnaires, and cognitive function tests were included in the analysis, whereas those with a history of autoimmune disease were excluded. The CVH in Ambulatory Care Research Team health index metrics, including smoking, physical activity, healthy diet, obesity, history of hypertension, and diabetes, were used to assess CVH. Cognitive function was evaluated with the Korean version of the Mini-Mental State Estimation for Dementia Screening. Inflammatory status was assessed based on a high-sensitivity C-reactive protein (hs-CRP) test.
RESULTS
Among 2,622 total participants (mean age, 57.2 years; 1,792 women), 13%, 58%, and 29% had poor, intermediate, and ideal CVH, respectively. Logistic regression analysis demonstrated that CVH was significantly associated with cognitive function only in women. A stratified analysis showed that cognitive impairment due to CVH was not associated with hs-CRP levels. When the same analyses were conducted for each CVH component, the only component affecting the association was hypertension history in men.
CONCLUSIONS
CVH is not significantly associated with cognitive decline in the middle-aged Korean population. Inflammation did not play a significant modifying role in this relationship.
Summary
Korean summary
• 본 연구는 심뇌혈관 및 대상질환원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center, CMERC) 코호트의 기반조사 데이터를 활용하여, 심혈관계건강과 인지기능 사이의 연관성을 한국 도시거주 중년인구에서 확인하고, 염증 지표인 고감도C반응단백 (high-sensitivity C-reactive protein, hs-CRP) 수준에 따른 차이를 탐색하였다. • 남성과 여성 모두에서 CANHEART health index가 낮은 집단에서 인지기능이 평균적으로 더 낮았으나, 통계적으로 유의하지는 않았다. • 염증 수준에 따른 심혈관계건강과 인지기능 사이의 연관성은 해당 연구에서는 확인할 수 없었다.
Key Message
In the Korean middle-aged population, poor cardiovascular health (CVH) assessed by CANHEART health index was associated with low cognitive function, but not statistically significant. Further investigation is suggested to develop CVH index specified in Korean populations and to estimate the association between CVH and cognitive function in larger population.

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  • Cardiovascular disease risk models and dementia or cognitive decline: a systematic review
    Ruirui Jia, Qing Wang, Hengyi Huang, Yanli Yang, Yuet Foon Chung, Tao Liang
    Frontiers in Aging Neuroscience.2023;[Epub]     CrossRef
Predictors of anticipated coping behavior at myocardial infarction symptom onset among a nationwide sample of Korean adults
Kyong Sil Park
Epidemiol Health. 2021;43:e2021006.   Published online January 3, 2021
DOI: https://doi.org/10.4178/epih.e2021006
  • 21,009 View
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  • 3 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This cross-sectional study based on the health belief model investigated predictors of anticipated coping behavior at myocardial infarction (MI) symptom onset using secondary data from the 2017 Korea Community Health Survey.
METHODS
Modifying variables (socioeconomic, health knowledge, perceived threat) were selected as independent variables and anticipated coping behavior at MI symptom onset as the dependent variable. Calling 911 was classified as the correct anticipated coping behavior, while visiting a hospital or an oriental hospital, calling family, and others were classified as incorrect.
RESULTS
Of 227,740 participants, 83.2% reported correct anticipated coping behaviors. The likelihood of calling 911 was low if participants experienced atypical symptoms (jaw, neck, back, arm, and shoulder pain), even if they were aware of those symptoms. However, 69.9% of participants who were aware of typical symptoms (chest pain) stated that they would call-911. Sex, age, hypertension, dyslipidemia, obesity, and awareness of MI symptoms affected the correct anticipated coping behavior.
CONCLUSIONS
Correct coping abilities among the general public are vitally important for early treatment of MI patients and reduction of hospitalization time. Members of the general public in their 20s and 30s, 60 years of age or older, with cardiovascular risk factors (male sex, hypertension, dyslipidemia, and obesity), and who are not aware of MI symptoms should be educated about the typical and atypical symptoms of MI. Emergency medical services should be called without delay if needed, and public relations activities should be carried out to raise awareness that anyone can use emergency medical services.
Summary
Korean summary
심근경색증 증상 발현 시 올바른 대처 행동을 위해 20-39세, 60세 이상, 남성, 고혈압, 이상지질혈증, 비만이 있는 대상자, 심근경색증 증상을 인지하지 못하는 대상자에게 심근경색증의 전형적, 비전형적 증상에 대해 교육해야 한다. 또한, 환자 발생 시 지체없이 응급의료서비스 신고해야하며, 누구나 응급의료서비스를 이용할 수 있도록 인식 전환을 위한 홍보활동을 시행해야 한다.
Key Message
Those in their 20s and 30s, 60 years of age or older, male, with cardiovascular risk factors, and who are not aware of MI symptoms should be educated about the typical and atypical symptoms of MI. Public relations activities should be carried out to raise awareness that anyone can use EMS.

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  • The Impact of Clusters With Distinct Social Determinants by a Two-Step Cluster Analysis on Cardiovascular Health
    Seok Hee Lee, Minsu Ock, Seongmi Moon, Eun Kyeung Song
    Journal of Cardiovascular Nursing.2026; 41(2): E77.     CrossRef
  • Application of intensive management of risk awareness combined with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart failure
    Xiaoli Yin, Cuiping Huang, Binglai Lin
    Medicine.2024; 103(20): e37381.     CrossRef
  • Clinical Impact of Self-Recognition of Recurrent Acute Myocardial Infarction: From KRMI-RCC
    Kyehwan Kim, Moojun Kim, Chang-Ok Seo, Hangyul Kim, Hye Ree Kim, Min Gyu Kang, Jin-Sin Koh, Jeong Rang Park, Rock Bum Kim, Dong Ryeol Ryu, Jang Hoon Lee, Moo Hyun Kim, Tae-Jin Youn, Dae Woo Hyun, Shin-Jae Kim, Sang Jae Rhee, Sang-Don Park, Young Joon Hong
    Journal of Clinical Medicine.2024; 13(16): 4840.     CrossRef
Associations of depression and anxiety with cardiovascular risk among people living with HIV/AIDS in Korea
Kyong Sil Park, Seon Young Hwang, Bo Youl Choi, June Kim, Sang Il Kim, Woo-Joo Kim, Chun Kang
Epidemiol Health. 2021;43:e2021002.   Published online December 24, 2020
DOI: https://doi.org/10.4178/epih.e2021002
  • 25,189 View
  • 408 Download
  • 4 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk.
METHODS
Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety.
RESULTS
Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD.
CONCLUSIONS
Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.
Summary
Korean summary
본 연구를 통해 우울과 불안이 심혈관질환 발생위험을 증가시키는 영향요인임을 확인하였다. 따라서, HIV 감염자의 우울과 불안에 대한 정기적인 검사 및 상담이 필요하며, 우울 또는 불안한 환자의 심혈관질환의 발병 위험을 줄이기위해 좋은 생활 습관을 위한 행동 수정 및 동기 부여 교육프로그램의 개발이 필요하다.
Key Message
healthcare providers need to provide motivational education for behavioral modifications to decrease patients’ risk of developing CVD, especially among those with depression or anxiety symptoms.

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  • Integrated breathing exercises combining diaphragmatic and pursed-lip breathing techniques to reduce anxiety among people living with HIV/AIDS: a quasi-experimental study in Malang, Indonesia
    Dewi Purnama Sari, Sri Yona, Margaretha Anakumi, Merlysa Pramesty, Irenne Sekar Putri, Lilik Supriati, Yusuf Arifin, Heri Prayitno
    AIDS Care.2026; : 1.     CrossRef
  • Revealing the complexity of depression configurations in HIV-positive men who have sex with men: a fuzzy-set qualitative comparative analysis
    Songli Mei, Chengbin Zheng, Leilei Liang, Jian Zhang, Marhaba Kiyum, Junsong Fei, Tongshuang Yuan, Huimin Wang, Jiaying Gao, Xiaoying Liu, Na Du
    BMC Public Health.2025;[Epub]     CrossRef
  • 한국 HIV/AIDS 코호트 연구의 과거, 현재, 그리고 미래
    윤수 최, 윤정 김, 보영 박, 준용 최, 신우 김, 준영 송, 보율 최, 상일 김
    Public Health Weekly Report.2025; 18(50): 23.     CrossRef
  • Depressive Symptoms and Left Ventricular Diastolic Dysfunction Among Men and Women with HIV
    Claudia Martinez, Nel Jason Haw, Violeta J. Rodriguez, Jorge R. Kizer, Wendy S. Post, Katherine C. Wu, Joao A. C. Lima, Jenni M. Wise, Maria L. Alcaide, Michael Plankey, Deborah Konkle-Parker, Sofia Kozlova, Margaret A. Fischl, Adaora A. Adimora, Matthew
    EMJ Cardiology.2024;[Epub]     CrossRef
  • Cardiovascular health (“Life’s Essential 8”), risk of depression and anxiety: a prospective cohort study
    Shuzhen Liu, Xiangju Hu, Meijie Jiang, Ninghao Huang, Hailun Liang, Ruimao Zheng, Shuyan Wang, Jian Qin, Zhiyong Zhang, Tao Huang, Xu Gao
    npj Cardiovascular Health.2024;[Epub]     CrossRef
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    Shyfuddin Ahmed, Angel B. Algarin, Hsu Thadar, Zhi Zhou, Tanjila Taskin, Krishna Vaddiparti, Karina Villalba, Yan Wang, Nicole Ennis, Jamie P. Morano, Charurut Somboonwit, Robert L Cook, Gladys E. Ibañez
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    Beatriz da Silva Araújo, Morgana Gonçalves da Silva
    Revista interdisciplinar em saúde.2021; 8(Único): 292.     CrossRef
Renal hyperfiltration, fatty liver index, and the hazards of all-cause and cardiovascular mortality in Finnish men
Mounir Ould Setti, Ari Voutilainen, Tomi-Pekka Tuomainen
Epidemiol Health. 2021;43:e2021001.   Published online December 24, 2020
DOI: https://doi.org/10.4178/epih.e2021001
  • 23,804 View
  • 380 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Renal hyperfiltration (RHF) and fatty liver are separately associated with adverse health outcomes. In this study, we investigated the mortality hazard of coexisting RHF and fatty liver.
METHODS
Middle-aged men from the Kuopio Ischaemic Disease Risk Factor Study (n=1,552) were followed up for a median of 29 years. Associations among RHF, fatty liver index (FLI) score, age, body mass index, smoking status, alcohol consumption, and hypertension status were assessed using logistic regression. Cox proportional hazards models were used to determine the hazard ratios (HRs) for all-cause and cardiovascular disease (CVD) mortality with respect to RHF and fatty liver.
RESULTS
Of the men, 5% had RHF (n=73), whereas a majority had fatty liver (n=848). RHF was associated specifically with smoking, and fatty liver was associated specifically with overweight. The all-cause mortality hazard was highest (HR, 1.96; 95% confidence interval [CI], 1.27 to 3.01) among men with RHF and fatty liver (n=33). Among men with RHF but normal FLI (n=40), the HR of all-cause mortality was 1.67 (95% CI, 1.15 to 2.42). Among men with fatty liver but a normal estimated glomerular filtration rate (n=527), the HR of all-cause mortality was 1.35 (95% CI, 1.09 to 1.66). CVD mortality hazard was associated with RHF, but not fatty liver. We detected no interaction effect between RHF and fatty liver for all-cause (synergy index, 0.74; 95% CI, 0.21 to 2.67) or CVD (synergy index, 0.94; 95% CI, 0.34 to 2.60) mortality.
CONCLUSIONS
RHF and fatty liver are independently associated with all-cause and CVD mortality
Summary
Key Message
Both prevalent, underdiagnosed, and commonly coexisting, renal hyperfiltration and fatty liver are two notable independent risk factors of all-cause and cardiovascular disease mortality.

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  • Prognostic Value of Estimated Glomerular Filtration Rate in Older Patients With Acute Coronary Syndrome
    Yifan Li, Tiantian Sang, Zuozhi Li, Naqiang Lv, Jinxing Liu, Yingzhen Gu, Xiaorong Han, Wei Zhang, Aimin Dang
    Reviews in Cardiovascular Medicine.2026;[Epub]     CrossRef
  • Computational Modeling of Network Topology and Molecular Dynamics for the Assessment of Therapeutic Potential of the  Astragalus Membranaceus-Salvia Miltiorrhiza Drug Pair in the Treatment of Chronic Kidney and Heart Failure
    Jiayou Liu, Jianguo Qin
    Journal of Kidney Diseases.2025; 19(02): 69.     CrossRef
  • Impact of gout on cardiovascular disease mortality: a meta-analysis
    Jielin Yuan, Zhitao Xie, Bo Pan, Jingchang Zhang
    Zeitschrift für Rheumatologie.2024; 83(S3): 329.     CrossRef
  • Sex-specific association of body mass index and fatty liver index with prevalence of renal hyperfiltration: a cross sectional study using Japanese health check-up data
    Atsushi Kitazawa, Yoshiharu Fukuda
    BMC Nephrology.2023;[Epub]     CrossRef
  • Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population
    Andrea Dalbeni, Marta Garbin, Mirko Zoncapè, Sara Romeo, Filippo Cattazzo, Anna Mantovani, Annalisa Cespiati, Anna Ludovica Fracanzani, Emmanouil Tsochatzis, David Sacerdoti, Alessandro Mantovani, Rosa Lombardi
    International Journal of Molecular Sciences.2023; 24(21): 15837.     CrossRef
  • Fatty Liver Index Independently Predicts All-Cause Mortality in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis but No Substantial Liver Disease
    Pil Gyu Park, Jung Yoon Pyo, Sung Soo Ahn, Hyun Joon Choi, Jason Jungsik Song, Yong-Beom Park, Ji Hye Huh, Sang-Won Lee
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran
Sohrab Iranpour, Soheila Khodakarim, Abbas Shahsavani, Ardeshir Khosravi, Koorosh Etemad
Epidemiol Health. 2020;42:e2020053.   Published online July 18, 2020
DOI: https://doi.org/10.4178/epih.e2020053
  • 22,457 View
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  • 19 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide).
METHODS
Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value.
RESULTS
We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality.
CONCLUSIONS
A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.
Summary

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  • Sunlight and suicide risk: mediating effect of high temperature in China
    Xiuya Xing, Yiming Gai, Qin He, Wenjun Cheng, Jingli Zhu, Qianyao Cheng, Yinguang Fan, Hong Su, Huadong Wang, Zhongliang Bai, Jian Cheng
    International Journal of Biometeorology.2026;[Epub]     CrossRef
  • Mediation of Fine Particulate Matter on the Association Between Daily Temperature and Mortality
    Dajeong Ham, Youn-Hee Lim, Soontae Kim, Ho-Jang Kwon, Sanghyuk Bae
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  • Health Is Wealth: Exploring Determinants of Health Expenditures in the Emerging Economies
    Zia Ur RAHMAN, Wajid KHAN, Shahab Ud DIN
    Chinese Journal of Urban and Environmental Studies.2025;[Epub]     CrossRef
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    Robabeh Vahidi-Kolur, Zahra Namvar, Sevda Fallah, Fatemeh Ahmadi, Vajihe Hasanzadeh, Philip K. Hopke, Masoumeh Rahmatinia
    Air Quality, Atmosphere & Health.2025; 18(11): 3705.     CrossRef
  • Ambient temperature and the risk of childhood epilepsy hospitalizations: Potentially neglected risk of temperature extremes and modifying effects of air pollution
    Yinguang Fan, Jihong Hu, Lijuan Qiu, Keyu Wu, Zhiwei Li, Yufan Feng, Qiyue Wu, Min Yang, Junwen Tao, Jian Song, Hong Su, Jian Cheng, Xu Wang
    Epilepsy & Behavior.2024; 159: 109992.     CrossRef
  • Associations between ambient temperature and suicide: а systematic review
    Andrej М. Grjibovski, Ivan М. Kobelev, Natalia N. Kukalevskaya, Yulia A. Popova, Alexander V. Baranov
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    Richard V. Remigio, Hao He, Jochen G. Raimann, Peter Kotanko, Frank W. Maddux, Amy Rebecca Sapkota, Xin-Zhong Liang, Robin Puett, Xin He, Amir Sapkota
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Brief Communication
Testosterone levels and cause-specific mortality in the older French men without metabolic syndrome
Nasser Laouali, Sylvie Brailly-Tabard, Catherine Helmer, Marie-Laure Ancelin, Christophe Tzourio, Alexis Elbaz, Anne Guiochon-Mantel, Marianne Canonico
Epidemiol Health. 2020;42:e2020036.   Published online June 1, 2020
DOI: https://doi.org/10.4178/epih.e2020036
  • 22,940 View
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  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
Previous studies have reported controversial findings regarding the association of testosterone with mortality in older men. This heterogeneity might be partially explained by comorbidities and the presence of metabolic syndrome, as well as differential associations according to causes of death.
METHODS
We used data from a random subsample of the Three-City study, in which hormone levels were measured in 338 men ≥65 years without metabolic syndrome who were followed-up for 12 years. Vital status was determined for all participants from different sources. We used inverse-probability-weighted Cox regression to estimate the hazard ratios (HRs) of cause-specific mortality and 95% confidence intervals (CIs).
RESULTS
Over the follow-up period, 130 men died (30 from cardiovascular disease, 45 from cancer, 55 from other causes). The association of testosterone with mortality showed significant heterogeneity across causes of death (p=0.027 and p=0.022 for total and bioavailable testosterone, respectively). Higher testosterone levels were associated with increased cardiovascular mortality (HR for 1-standard deviation increase, 1.86; 95% CI, 1.28 to 2.71 and 1.50; 95% CI, 1.04 to 2.17 for total and bioavailable testosterone, respectively). By contrast, there were no significant associations of testosterone with mortality from cancer and other causes.
CONCLUSIONS
Our data suggest that the association of testosterone with mortality in men without metabolic syndrome might be differential according to the cause of death. These findings may partially explain the heterogeneity across studies on the relationship between testosterone levels and mortality.
Summary

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  • Endogenous Sex Steroid Hormones, Sex Hormone-Binding Globulin, and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies
    Hamidreza Raeisi-Dehkordi, Mojgan Amiri, Sara Beigrezaei, Hugo G Quezada-Pinedo, Farnaz Khatami, Fadi Alijla, Marinka Steur, Beatrice Minder, Angeline Chatelan, Trudy Voortman, Yvonne T van der Schouw, Oscar H Franco, Taulant Muka
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  • Testosterone, atherosclerosis and cardiovascular risks
    Anastasia V. Makarova, Sergey B. Shustov, Yuri S. Khalimov, Sergey V. Gaiduk, Viktor P. Kitsyshin, Dmitry S. Frolov
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Original Articles
Factors affecting awareness of myocardial infarction symptoms among the general public in Korea
Kyong Sil Park
Epidemiol Health. 2020;42:e2020032.   Published online May 18, 2020
DOI: https://doi.org/10.4178/epih.e2020032
  • 24,970 View
  • 265 Download
  • 17 Web of Science
  • 16 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to determine the level of awareness of myocardial infarction (MI) symptoms among the general public in Korea and identify factors affecting awareness of MI symptoms using data from the 2017 Korea Community Health Survey (KCHS).
METHODS
This is a cross-sectional study using KCHS data. Based on five questions about MI symptoms, participants were divided into an awareness group (replied ‘yes’ to all five questions) and an unawareness group (replied ‘no’ or ‘not sure’ to at least one of five questions) for analysis.
RESULTS
Of a total of 228,281 participants, 42.4% were aware of MI symptoms. There was a high level of awareness of chest pain and shortness of breath, but a low level of awareness of gastrointestinal symptoms and pain in the arm, shoulder, jaw, neck, and back. While women had a higher level of overall awareness relative to men, they showed a lower level of awareness regarding chest pain and discomfort. The factors affecting awareness of MI symptoms were gender, age, education level, occupation, smoking, drinking, physical inactivity, and cardiovascular disease risk factors.
CONCLUSIONS
In order to enhance awareness of MI symptoms among the general population, appropriate education and promotion efforts must be implemented based on gender, age, education level, and occupation. Moreover, active efforts by the government, educational institutions, and medical institutions are necessary to improve awareness of both typical and atypical MI symptoms. Furthermore, health policies to promote reduced smoking and drinking and increased physical activity, as well as continuous monitoring and management of individuals with cardiovascular disease risk factors, are required.
Summary
Korean summary
2017년 지역사회건강조사 자료를 분석한 결과, 한국의 심근경색증 증상의 인지율은 42%로 낮은 인식을 보였다. 한국의 지역사회 내 일반인들의 심근경색증 증상의 인지율을 제고하기 위해 성별, 연령, 교육수준, 직업을 고려하여 교육 및 홍보를 실시해야 한다. 그리고, 전형적인 심근경색증 증상뿐만 아니라 비전형적인 심근경색증 증상에 대한 인식에 대한 정부, 교육기관, 의료기관 등의 적극적인 노력이 필요하다. 또한, 금연, 금주, 신체활동 증진에 대한 보건정책적 관리방안과 심혈관질환 위험요인을 가진 대상자들의 지속적인 모니터링 및 관리가 필요하다.

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  • Behavioral delays in seeking care among post-acute myocardial infarction women: a qualitative study following percutaneous coronary intervention
    Vincenza Giordano, Caterina Mercuri, Silvio Simeone, Teresa Rea, Michele Virgolesi, Rita Nocerino, Vincenzo Bosco, Assunta Guillari
    Frontiers in Global Women's Health.2025;[Epub]     CrossRef
  • Impact of health awareness on myocardial infarction
    Ahmed Magdy, Seham Elmarayed, Bassem Zarif, Mohamed Sabry, Ahmed Alsawah, Mohamed E. Hasan, Khaled M. Ismaeil, Mohamed Salama
    Journal of the Egyptian Public Health Association.2025;[Epub]     CrossRef
  • Spontaneous coronary artery dissection in regions of non-Western populations: a systematic literature search and scoping review
    Rasha Kaddoura, Ashraf Ahmed, Mohammed Al-Hijji, Fathima Aaysha Cader, Mirvat Alasnag, David Adlam, Salvatore De Rosa
    European Heart Journal Open.2025;[Epub]     CrossRef
  • Navigating critical time: a qualitative exploration of the experiences of patients and companions in myocardial infarction management
    Malihe Imeni, Nahid Dehghan Nayeri, Leila Sayadi, Hossein Ebrahimi, Abbas Mardani
    BMC Cardiovascular Disorders.2025;[Epub]     CrossRef
  • Recognition of Early Cardiovascular Disease Symptoms in Hypertensive and Dyslipidemic Individuals of Icheon, Korea: Insights into Educational Levels and Health Literacy
    Jeehye Lee, Dong-Hee Ryu
    Healthcare.2024; 12(7): 736.     CrossRef
  • Awareness of Myocardial Infarction in Nangarhar Residents: A Community Based Study
    Akmal Shams, Ikramullah Ibrahimi, Hayatullah Ahmadzai
    Journal of Cardiology and Cardiovascular Medicine.2024; 9(2): 130.     CrossRef
  • Assessment of myocardial infarctions knowledge, attitudes and beliefs among adults living in Riyadh Saudi Arabia – insights from cross-sectional study
    Wajid Syed, Osama Samarkandi, Abdulmajeed A. Alanazi, Nader Alotaibi, Mahmood Basil A. Al-Rawi
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  • Engaging social activities prevent stroke and myocardial infraction by raising awareness of warning symptoms: A cross-sectional survey study
    Gahyeon Kim, Hyeokjoo Jang, Sebin Kwon, Bumyeol Lee, Suk-Yong Jang, Wonjeong Chae, Sung-In Jang
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • “Recognition of heart attack symptoms and treatment-seeking behaviors: a multi-center survey in Tehran, Iran”
    Elnaz Shahmohamadi, Mojtaba Sedaghat, Arash Rahmani, Farnoosh Larti, Babak Geraiely
    BMC Public Health.2023;[Epub]     CrossRef
  • Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries
    Paul Jie Wen Tern, Amar Vaswani, Khung Keong Yeo
    Korean Circulation Journal.2023; 53(9): 594.     CrossRef
  • Awareness of Myocardial Infarction Symptoms and Risk Factors in Saudi Arabia: A Cross-Sectional Study
    Saad M Alsaab, Ahmed M Almutairi, Ghadi K Alsaadi, Ziyad A Altokhais, Samar H Alabdulqader, Wafa Y Alnofal, Nourah M Alduhaim
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  • Gender and Social Inequalities in Awareness of Coronary Artery Disease in European Countries
    Antonio Daponte-Codina, Emily C. Knox, Inmaculada Mateo-Rodriguez, Amanda Seims, Vera Regitz-Zagrosek, Angela H. E. M. Maas, Alan White, Floris Barnhoorn, Fernando Rosell-Ortiz
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    Yeo Won Jeong
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  • Global Awareness of Myocardial Infarction Symptoms in General Population: a Systematic Review and Meta-Analysis
    Akash Sharma, Karavadi Vidusha, Harshini Suresh, Ajan M. J., Kavinkumar Saravanan, Madhvi Dhamania, Nisha B, Rabbanie Tariq Wani
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    Soo-Joong Kim
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    Ivy Mannoh, Ruth‐Alma Turkson‐Ocran, Jasmine Mensah, Danielle Mensah, Stella S. Yi, Erin D. Michos, Yvonne Commodore‐Mensah
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The association between smoking or passive smoking and cardiovascular diseases using a Bayesian hierarchical model: based on the 2008-2013 Korea Community Health Survey
Whanhee Lee, Sung-Hee Hwang, Hayoung Choi, Ho Kim
Epidemiol Health. 2017;39:e2017026.   Published online June 22, 2017
DOI: https://doi.org/10.4178/epih.e2017026
  • 30,556 View
  • 428 Download
  • 33 Web of Science
  • 56 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Smoking and passive smoking have been extensively reported as risk factors of cardiovascular morbidity and mortality. Despite the biological mechanisms underlying the impact of hazardous chemical substances contained in tobacco in cardiovascular diseases (CVD), studies investigating the association between smoking and passive smoking with morbidity are at an inchoate stage in Korea. Therefore, this study aimed to estimate the risks of smoking and passive smoking on cardiovascular morbidity at the national and regional levels.
METHODS
This study calculated sex-standardized and age-standardized prevalence of CVD and smoking indices in 253 community health centers (si/gun/gu) in Korea using the 2008-2013 Korea Community Health Survey data. Furthermore, a Bayesian hierarchical model was used to estimate the association of smoking and passive smoking with the prevalence of CVD from the national and regional community health centers.
RESULTS
At the national level, smoking was significantly associated with stroke (relative risk [RR], 1.060) and hypertension (RR, 1.016) prevalence, whilst passive smoking at home and work were also significantly associated with prevalence of stroke (RR, 1.037/1.013), angina (RR, 1.016/1.006), and hypertension (RR, 1.010/1.004). Furthermore, the effects of smoking and passive smoking were greater in urban-industrial areas than in rural areas.
CONCLUSIONS
The findings of this study would provide grounds for national policies that limit smoking and passive smoking, as well as regionally serve as the basis for region-specific healthcare policies in populations with high CVD vulnerability.
Summary
Korean summary
베이지안 계층화 방법을 이용하여 흡연 및 간접 흡연과 심혈관계 질환 유병의 전국 및 시/군/구별 연관성을 추정한 결과, 흡연은 뇌졸중 (RR=1.060) 과 고혈압 (RR=1.016) 유병에 유의하게 연관되었다.

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Cohort Profile
Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort: study protocol and results of the first 3 years of enrollment
Jee-Seon Shim, Bo Mi Song, Jung Hyun Lee, Seung Won Lee, Ji Hye Park, Dong Phil Choi, Myung Ha Lee, Kyoung Hwa Ha, Dae Jung Kim, Sungha Park, Won-Woo Lee, Hyeon Chang Kim
Epidemiol Health. 2017;39:e2017016.   Published online April 1, 2017
DOI: https://doi.org/10.4178/epih.e2017016
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AbstractAbstract AbstractSummary PDF
Abstract
Although the etiologies of cardiovascular disease (CVD) are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.
Summary
Korean summary
심뇌혈관 및 대사질환 원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center)에서는 심뇌혈관질환 및 대사질환의 새로운 발병 원인을 찾고 효율적인 예방 전략을 개발하고자 코호트(CMERC cohort와 CMERC-HI cohort)를 구축하였다. 지역사회에 거주하는 만 30-64세 건강한 성인을 대상으로 하는 CMERC cohort는 2013년부터 2018년 까지 총 5년 동안 8000명 등록을 목표로 기반조사를 진행 중이며(2016년 12월 현재 6000여명 등록), 이미 알려진 다양한 위험요인 이외에 사회연결망 정보와 면역노화 관련 바이오마커 등 새로운 위험 요인에 관한 광범위한 정보가 수집되고 있다. CMERC cohort는 심뇌혈관 및 대사질환 예방연구의 기초자료로 활용되어 과학적 데이터에 근거한 예방 전략 수립에 기여하게 될 것이다.

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    Epidemiology and Health.2018; 40: e2018049.     CrossRef
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    Seung Won Lee, Jee-Seon Shim, Bo Mi Song, Ho Jae Lee, Hye Yoon Bae, Ji Hye Park, Hye Rin Choi, Jae Won Yang, Ji Eun Heo, So Mi Jemma Cho, Ga Bin Lee, Diana Huanan Hidalgo, Tae-Hoon Kim, Kyung Soo Chung, Hyeon Chang Kim
    Epidemiology and Health.2018; 40: e2018060.     CrossRef
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Original Articles
The burden of infectious and cardiovascular diseases in India from 2004 to 2014
Kajori Banerjee, Laxmi Kant Dwivedi
Epidemiol Health. 2016;38:e2016057.   Published online December 14, 2016
DOI: https://doi.org/10.4178/epih.e2016057
  • 26,596 View
  • 265 Download
  • 8 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
In India, both communicable and non-communicable diseases have been argued to disproportionately affect certain socioeconomic strata of the population. Using the 60th (2004) and 71st (2014) rounds of the National Sample Survey, this study assessed the balance between infectious diseases and cardiovascular diseases (CVD) from 2004 to 2014, as well as changes in the disease burden in various socioeconomic and demographic subpopulations.
METHODS
Prevalence rates, hospitalization rates, case fatality rates, and share of in-patients deaths were estimated to compare the disease burdens at these time points. Logistic regression and multivariate decomposition were used to evaluate changes in disease burden across various socio-demographic and socioeconomic groups.
RESULTS
Evidence of stagnation in the infectious disease burden and rapid increase in the CVD burden was observed. Along with the drastic increase in case fatality rate, share of in-patients deaths became more skewed towards CVD from 2004 to 2014. Logistic regression analysis demonstrated a significant shift of the chance of succumbing to CVD from the privileged class, comprising non-Scheduled Castes and Tribes, more highly educated individuals, and households with higher monthly expenditures, towards the underprivileged population. Decomposition indicated that a change in the probability of suffering from CVD among the subcategories of age, social groups, educational status, and monthly household expenditures contributed to the increase in CVD prevalence more than compositional changes of the population from 2004 to 2014.
CONCLUSIONS
This study provides evidence of the ongoing tendency of CVD to occur in older population segments, and also confirms the theory of diffusion, according to which an increased probability of suffering from CVD has trickled down the socioeconomic gradient.
Summary

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    Mahadev Bramhankar, Murali Dhar
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    Mohd Shannawaz, Isha Rathi, Nikita Shah, Shazina Saeed, Amrish Chandra, Harpreet Singh
    International Journal of Environmental Research and Public Health.2025; 22(4): 539.     CrossRef
  • Cardiovascular Disease and Mental Health in Intellectual Disabilities: A Vicious Cycle of Risk and Care Gaps
    Abhishek Pratap Yadav, Suman Lata, Anita Awasthi, Praveen Katiyar, Priyanka Shukla, Avaneesh Vishwakarma, Sandeep Kumar Singh
    Journal of Intellectual Disability - Diagnosis and Treatment.2025; 13(2): 128.     CrossRef
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    Garima Sharma, Florence Mutua, Ram Pratim Deka, Rajeshwari Shome, Samiran Bandyopadhyay, Bibek Ranjan Shome, Naresh Goyal Kumar, Delia Grace, Tushar Kumar Dey, Johanna Lindahl
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • India’s Opportunities and Challenges in Establishing a Twin Registry: An Unexplored Human Resource for the World’s Second-Most Populous Nation
    Ruby Dhar, Shweta Rana, Tryambak Pratap Srivastava, Arnab Nayek, Jai Bhagwan Sharma, Digjeet Kaur, Krishna R. Kalari, Harpreet Singh, Subhradip Karmakar
    Twin Research and Human Genetics.2022; 25(3): 156.     CrossRef
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    Nirav Nimavat, Mohammad Mehedi Hasan, Sundip Charmode, Gowthamm Mandala, Ghanshyam R Parmar, Ranvir Bhangu, Israr Khan, Shruti Singh, Amit Agrawal, Ashish Shah, Vishi Sachdeva
    World Journal of Virology.2022; 11(4): 186.     CrossRef
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    Kajori Banerjee, Srei Chanda, Laxmi Kant Dwivedi
    BMC Public Health.2019;[Epub]     CrossRef
  • Undernutrition and Overnutrition Burden for Diseases in Developing Countries: The Role of Oxidative Stress Biomarkers to Assess Disease Risk and Interventional Strategies
    Francesca Mastorci, Cristina Vassalle, Kyriazoula Chatzianagnostou, Claudio Marabotti, Khawer Siddiqui, Ahmed Eba, Soueid Mhamed, Arun Bandopadhyay, Marco Nazzaro, Mirko Passera, Alessandro Pingitore
    Antioxidants.2017; 6(2): 41.     CrossRef
Comparison of Prevalence of Metabolic Syndrome Between Korean Emigrants and Host Country Residents in Japan and China-The Korean Emigrant Study
Myung-Hee Shin, Mi Kyung Kim, Zhong Min Li, Hyun-Kyung Oh, Soo Ryang Kim, Miyuki Taniguchi, Jinnv Fang
Epidemiol Health. 2010;32:e2010005.   Published online May 7, 2010
DOI: https://doi.org/10.4178/epih/e2010005
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AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>This study aims to compare the prevalence of metabolic syndrome between Korean emigrants (KEs) and their host country residents in Japan and China.</p></sec><sec><title>METHODS</title><p>The Korean Emigrant Study (KES) is a cohort study initiated in 2005 to elucidate the effect of genetic susceptibility and environmental change on hypertension, diabetes, and metabolic syndrome. Equal numbers of KEs and host country residents, aged 30 or over, were recruited from three regions; Kobe-Osaka in Japan (total number=965), Yanbian in China (n=1,019), and Changchun in China (n=949).</p></sec><sec><title>RESULTS</title><p>The age-adjusted prevalences of metabolic syndrome among KEs in Kobe-Osaka were significantly higher than those among Japanese (in men 24.0% vs. 15.6%, p=0.04, in women 8.4% vs. 2.7%, p=0.01), while the age-adjusted prevalences among KEs in Changchun were similar to those among Chinese (in men 11.7% vs. 16.1%, p=0.37, in women 28.3% vs. 30.1%, p=0.91). The age-adjusted prevalences were generally higher in Yanbian than other regions, and KEs had higher prevalence than Chinese in men but not in women (in men 37.9% vs. 28.3%, p=0.03, women 46.0% vs. 50.6%, p=0.44). The components with significant ethnic differences in prevalence were high blood pressure and abdominal obesity in Japan, and triglyceride in China. The most influential component in diagnosing metabolic syndrome was abdominal obesity in men and triglyceride in women.</p></sec><sec><title>CONCLUSION</title><p>The prevalence of metabolic syndrome was higher in KEs than in host country residents in Japan but not in China. Abdominal obesity and triglyceride are both discriminating and influential components in metabolic syndrome.</p></sec>
Summary

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  • New Common and Rare Variants Influencing Metabolic Syndrome and Its Individual Components in a Korean Population
    Ho-Sun Lee, Yongkang Kim, Taesung Park
    Scientific Reports.2018;[Epub]     CrossRef
  • Cohort Profile: The Korean Genome and Epidemiology Study (KoGES) Consortium
    Yeonjung Kim, Bok-Ghee Han
    International Journal of Epidemiology.2017; 46(2): e20.     CrossRef
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    Hyeonkyeong Lee, Sunghye Cho, Yune Kyong Kim, Jung Hee Kim
    Workplace Health & Safety.2016; 64(8): 350.     CrossRef
  • Coffee Intake and Liver Enzyme Association in Korean Immigrants and Japanese: A Comprehensive Cross-Sectional Study
    Soo Ki Kim, Myung-Hee Shin, Kayo Sugimoto, Soo Ryang Kim, Susumu Imoto, Ke Ih Kim, Miyuki Taniguchi, Hyun-Kyung Oh, Yoshihiko Yano, Yoshitake Hayashi, Masatoshi Kudo
    Digestive Diseases.2016; 34(6): 665.     CrossRef
Cardiovascular Risk Factors for Incident Hypertension in the Prehypertensive Population
Soo Jeong Kim, Jakyoung Lee, Sun Ha Jee, Chung Mo Nam, Kihong Chun, Il Soo Park, Soon Young Lee
Epidemiol Health. 2010;32:e2010003.   Published online May 1, 2010
DOI: https://doi.org/10.4178/epih/e2010003
  • 29,561 View
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  • 22 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>The aim of this study was to investigate the effect of changes in cardiovascular disease (CVD) risk factors on progression from prehypertension (PreHTN) to hypertension (HTN) using an 8-yr prospective Korean Cancer Prevention Study (KCPS) by the National Health Insurance Corporation (NHIC) in Korea.</p></sec><sec><title>METHODS</title><p>A total of 16,229 subjects, aged 30 to 54, with new onset preHTN at baseline (1994-1996) in a biennial national medical exam were selected and followed up till 2004 at 2-yr intervals. All subjects underwent a biennial health examination including biochemical measurements and behavior. The log-rank test was performed to assess the relationship between changes in CVD risk factors and progression to HTN. The Cox proportional hazard model was used to identify factors influencing progression to HTN.</p></sec><sec><title>RESULTS</title><p>With regards the progression rate in men, ex-smokers (42.9%), abstainers (37.5%), and regular exercisers (37.6%) showed a slower progression rate than continuous smokers (49.5%) and continuous drinkers (50.9%). In women, those who participated in regular exercise (22.6%) had a lower rate of progression than continuous non-exercisers (36.1%). According to the results of the Cox proportional hazard model, improvements in smoking (hazard ratio [HR], 0.756), drinking (HR, 0.669), regular exercise (HR, 0.653), body mass index (HR, 0.715), and total cholesterol (HR, 0.788) played a protective role in progression to HTN in men, while in women, participating in regular exercise (HR, 0.534) was beneficial.</p></sec><sec><title>CONCLUSION</title><p>Improvements in CVD-related behaviors diminished the progression rate of HTN. This study suggests that individuals with PreHTN should be targeted for specific health behavioral intervention to prevent the progression of HTN.</p></sec>
Summary

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    Hyeon Chang Kim, Sang-Hyun Ihm, Gheun-Ho Kim, Ju Han Kim, Kwang-il Kim, Hae-Young Lee, Jang Hoon Lee, Jong-Moo Park, Sungha Park, Wook Bum Pyun, Jinho Shin, Shung Chull Chae
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Association of obesity indices with physiological markers for cardiovascular disease among middle age and elderly in Chuncheon : Hallym Aging Study
Jin Young Jeong, Jeong Hun Kim, Young Ho Choi, Soong Nang Jang, Yong Jun Choi, Dong Hyun Kim
Korean J Epidemiol. 2008;30(1):89-99.   Published online June 30, 2008
DOI: https://doi.org/10.4178/kje.2008.30.1.89
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AbstractAbstract PDF
Abstract
PURPOSE
This study was performed to evaluate association of obesity indices with physiological markers for cardiovascular disease(CVD) in community dwelling middle aged and elderly populations.
METHODS
We evaluated cross-sectional association of obesity indices with physiological markers for CVD using the data of Hallym Aging Study(HAS) conducted in 2004. Information on general characteristics and medical histories were collected by trained interviewers. Also obesity indices including waist circumference(WC), waist to hip ratio(WHR), body mass index(BMI), and body fat mass(BFM), and physiological markers of CVD including systolic blood pressure(SBP), diastolic blood pressure(DBP), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), total cholesterol(TC), and fasting blood sugar(FBS) were measured by clinical staffs. 589 out of the 922 participated in HAS were enrolled in the final analysis, excluding 333 who had been diagnosed and medicated due to obesity-related diseases. Age and gender specific correlation coefficients between obesity indices and physiological markers for CVD were calculated by partial spearman correlations using SAS ver 9.1.
RESULTS
The strength of correlation of obesity indices and physiological markers of CVD changed with age. The correlations between SBP, DBP, TG and HDL-C and obesity indices were attenuated with age, whereas those of TC, FBS and LDL-C were increased among the elderly. These patterns were similar in both gender.
CONCLUSIONS
These findings show that more appropriate obesity indices according to age are needed to evaluate the association between these indices and CVD risks.
Summary

Citations

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  • What is the Most Reliable Obesity Iindex in Korean Elderly Population?
    June Hyung Yoon, Jongwoo Kim, Seon Yeong Lee, Kyunam Kim, In Young Cho, Young M Cho
    The Korean Journal of Obesity.2012; 21(3): 140.     CrossRef
Development of Risk Prediction Model for Cardiovascular Disease Using Intima Media Thickness of Carotid Artery Among Community-Dwelling Elderly.
Jin Young Jeong, Kyung Soon Hong, Soong Nang Jang, Young Ho Choi, Moon Gi Choi, Sang Kon Lee, Hyun Ah Kim, Seok Won Park, Na Rae Hong, Dong Hyun Kim
Korean J Epidemiol. 2007;29(2):187-199.
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AbstractAbstract PDF
Abstract
PURPOSE
This study was performed to develop risk prediction model for cardiovascular disease using intima-media thickness (IMT) of carotid artery among the community dwelling elderly.
METHODS
Follow-up survey was conducted in 2007 to measure the IMT of carotid artery, which is known as a preclinical marker of atherosclerotic change, among participants at the baseline survey of Hallym Aging Study (HAS) in 2004. They were categorized into two groups; increased IMT > or = 0.9 mm and normal IMT < 0.9 mm. To evaluate which factors are independently related with the increased IMT, multiple logistic regression analysis was done. Based on the regression coefficients of these factors weighed by the magnitude of the effect estimates, we calculated the risk scores for increased IMT for every participants. ROC curve was plotted for the each cutoff point of risk scores and its fitness was tested using Area Under the Curve (AUC). Finally, we calculated risk ratios for the increased IMT according to the level of risk based on the risk scores.
RESULTS
Several factors were found as related factors for the increased IMT in the multiple logistic regression: age (beta=0.15), cholesterol (beta=0.01), insulin (beta=0.13), and pulse pressure (beta=0.90) for men, and age (beta=0.08), family history of diabetes mellitus (beta=0.94) and stroke (beta=0.79), alcohol drinking (beta=0.39), and high cholesterol (beta=0.77) for women. We assigned the weighed value for each factors. The average risk scores were 14.48 (range 9.69-18.76) for men and 4.59 (range 2.41-7.48) for women. The Area Under the Curve (AUC) were 0.77 for men and 0.71 for women. We also observed the higher risk of increased IMT as the risk scores increased.
CONCLUSION
Based on the results, we expect to predict the level of the risk for the increased IMT, which is preclinical marker for atherosclerotic change, among the elderly.
Summary
Smoking and cause of death in Korea: 11 years follow-up prospective study.
Sun Ha Jee, Ji Eun Yun, Jung Yong Park, Jae Woong Sull, Il Soon Kim
Korean J Epidemiol. 2005;27(1):182-190.
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AbstractAbstract PDF
Abstract
OBJECTIVE: In Korea, male smoking prevalence is among the world's highest and mortality rates from smoking-caused cancers, particularly lung cancer, are escalating. This cohort study examined the effects of cigarette smoking on the risk of mortality from all causes, cancers and cardiovascular diseases(CVD), and characterized the relationship of the risk with the amount and duration of cigarette smoking.
METHOD
A eleven-year prospective cohort study was carried out of on 1,207,592 Koreans, 30 to 95 years of age. The study population includes participants in a national insurance program, who completed a questionnaire on smoking and other risk factors. The main outcome measures were death from all causes, cancer and CVD, obtained through record linkage. At baseline, 482,997 men(60.0%) and 19,755(5.3%) women were current cigarette smokers.
RESULTS
In multivariate Cox proportional hazards models, controlling for age, alcohol drinking, exercise, and obesity, current smoking among men increased the risks of mortality from all cause death (relative risk[RR], 1.56; 95% confidence interval[CI], 1.52~1.59), all cancer (1.75, 1.68~1.82), and CVD(1.46, 1.38~1.55). Similar results were found for mortality among women. Smoking also increased the risks of mortality for cancer of the lung(4.60, 4.09~5.33) and other cancers, including larynx, bile duct, esophagus, liver, stomach, pancreas, bladder, and also leukemia. Current smoking among women increased the risk of lung cancer mortality(RR=2.83, 95% CI 2.38~3.36).
CONCLUSION
In Korea, smoking is an independent risk factor for death from all causes, CVD and a number of major cancers. The findings affirm the need for aggressive tobacco control in Korea in order to minimize the epidemic of smoking-caused disease.
Summary
Intervention Study for the Effectiveness of Alcohol Restriction to Blood Pressure.
Yeon Ee Song, Kang Sook Lee
Korean J Epidemiol. 2001;23(2):25-32.
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AbstractAbstract PDF
Abstract
PURPOSE
To assess whether blood pressure is reduced by the intervention of intensive weekly counseling to lower alcohol intake for 12 weeks in heavy drinkers with elevated blood pressure, we conducted the quasi-experimental study through workplace health promotion program.
METHODS
Thirty workers with an average intake of alcohol over 180 g/week(2 bottles of Soju, Korean popular liquor) and with over 90 mm Hg in diastolic blood pressure(DBP) or over 140 mm Hg systolic blood pressure(SBP) assigned to intervention group(15 men, IG) and control group(15 men, CG) voluntarily. Mean age was 47.2 6.5 and 43.0 5.4 years old respectivel. The goal of intervention was below 45g/week(1/2 bottle of Soju).
RESULTS
Average weekly alcohol intake after 12 weeks in IG was significantly reduced(before 300.6 114.8g/week, after 24.8 24.5g/week) compared with CG(before 334.4 150.7g/week, after 311.3 150.8g/week). In IG, SBP(before 141.5 9.4mm Hg, after 128.7 13.0mm Hg) and DBP(before 95.5 6.3mm Gg, after 88.0 10.8mm Hg) was significantly decreased after 12 weeks of alcohol restriction program, but in CG there was no change.
CONCLUSION
Restriction program of alcohol intake in workplace was so effective to reduce blood pressure among hypertensives, although this study has a limitation of small subjects, short duration of follow up and no randomized controlled design.
Summary
Genetic Contribution to Cardiovascular Risk Factors in Korea: The Results from the 1998 Korean Nationwide Health and Nutrition Examination Survey.
Sun Ha Jee
Korean J Epidemiol. 2001;23(1):36-42.
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AbstractAbstract PDF
Abstract
PURPOSE
The purpose of this study was to estimate the heritability for cardiovascular disease(CVD) risk factors such as obesity, serum lipids, blood pressure and putative other risk factors.
METHODS
Familial correlations and heritability in CVD risk factors were investigated with use of data from a community-based sample of 435 families involving 2,507 persons collected in the 1998 Korean Nationwide Nutrition and Health Examination Survey over the period November to December in 1998. The risk factors considered were obesity indexes such as waist circumference(WC), hip circumference(HC), waist-to-hip ratio(WHR), body mass index(BMI), serum lipids(total cholesterol, LDL- and HDL- cholesterol and triglyceride), systolic and diastolic blood pressure(SBP and DBP) and other putative risk factors(fasting blood sugar, creatinine, platelet, blood urea nitrate).
RESULTS
First, the estimated heritabilites for obesity variables were 49.5% for WC, 46.6% for BMI, 43.2% for WHR and 39.2% for HC. Second, the estimated heritabilites for well-established CVD risk factors were 53% for LDL-cholesterol, 52% for total cholesterol, 52% for HDL-cholesterol, 24% for triglyceride, 39% for SBP and 30% for DBP. Third, the estimated heritabilites for the putative CVD risk factors were 39% for platelet, 39% for fasting blood sugar, 34% for blood urea nitrate, and 32% for creatinine level.
CONCLUSION
Future linkage studies in these families may be worthwhile to further clarify the molecular basis for biological mechanisms controlling these CVD risk factors showing high heritability.
Summary
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.
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