Determinants of brachial-ankle pulse wave velocity and carotid-femoral pulse wave velocity in healthy Koreans.

The aim of this study was to determine the normal value of brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) according to age group, gender, and the presence of cardiovascular risk factors in healthy Koreans, and to investigate the association between PWV and risk factors such as prehypertension, dyslipidemia, smoking, and obesity. We measured an arterial stiffness in 110 normal subjects who were 20 to 69 yr-old with no evidence of cardiovascular disease, cerebrovascular accident or diabetes mellitus. The mean values of baPWV and cfPWV were 12.6 (± 2.27) m/sec (13.1 ± 1.85 in men, 12.1 ± 2.51 in women; P=0.019) and 8.70 (± 1.99) m/sec (9.34 ± 2.13 in men, 8.15 ± 1.69 in women; P=0.001), respectively. The distribution of baPWV (P<0.001) and cfPWV (P=0.006) by age group and gender showed an increase in the mean value with age. Men had higher baPWV and cfPWV than women (P<0.001). There was a difference in baPWV and cfPWV by age group on prehypertension, dyslipidemia, current smoking, or obesity (P<0.001). In multiple linear regression, age and prehypertension were highly associated with baPWV and cfPWV after adjustment for confounding factors (P<0.001). The present study showed that baPWV and cfPWV are associated with age, gender, and prehypertension in healthy Koreans.

Prehypertension and obesity in middle-aged Korean men and women: the third Korea national health and nutrition examination survey (KNHANES III) study.

BACKGROUND: The aim of this study was to investigate the association between obesity and prehypertension (preHT) after adjustment for socioeconomic position and health behavior factors. METHODS: The study sample included 1973 Korean men and women, 45-64 years of age. Subjects were classified into three groups based on their baseline blood pressure: prehypertensive, hypertensive and normotensive. Men with a waist circumference ≥90 cm or women ≥80 cm were considered abdominally obese. Body mass index (BMI) obesity was defined as having a BMI ≥25. The prevalence of abdominal obesity and BMI obesity was calculated with age adjustment using a direct method. Multinomial logistic regression analysis was applied. RESULTS: The prevalence of preHT in our study was 52.8%. We found that subjects with abdominal obesity were 2.06 times as likely to be prehypertensive as those without it and people with BMI obesity were 1.89 times as likely to be prehypertensive as those without it. Interestingly, men with BMI obesity had a higher preHT risk, while women with abdominal obesity had a higher preHT risk. CONCLUSIONS: Statistical analyses of a community-based random sample of the Korean population indicate that obesity is associated with preHT in Korean middle-aged subjects.

First flatus time and xerostomia associated with gum-chewing after liver resection.

AIMS AND OBJECTIVES: The aim of this study was to compare the return of bowel function and xerostomia in patients who were and were not instructed to chew gum after elective open liver resection. BACKGROUND: Patients who undergo liver resection have limited early ambulation, because they require bed rest after surgery to prevent internal bleeding. They normally also require narcotic analgesics or patient-controlled analgesia for pain control. For these reasons, they often have symptoms of intestinal gas accumulation, abdominal distension and/or abdominal pain. DESIGN: Prospective case-control study. METHODS: Forty-two patients with hepatocellular carcinoma who were treated at Samsung Medical Center from September 2010 to February 2011 were included in this study. Patients who were scheduled for elective liver resection for hepatocellular carcinoma and were over 30 years of age were eligible. Patients were assigned to a gum-chewing group or a non-gum-chewing (control) group before surgery. RESULTS: The mean age of the gum-chewing group was 54·9 (±9·7) years, and the mean age of the control group was 55·1 (±8·4) years. The mean values of first flatus time and xerostomia were higher in the control group than in the gum-chewing group. First flatus time and xerostomia grade were significantly decreased in gum-chewing group compared with the control group after adjustment for hospitalisation days, duration of surgery and amount of analgesics administered. CONCLUSION: Patients who were instructed to chew gum after surgery demonstrated faster bowel function recovery and lower xerostomia grade after elective open liver resection than patients who did not chew gum. RELEVANCE TO CLINICAL PRACTICE: Gum-chewing is an inexpensive, helpful adjunct to standard postoperative care after liver resection.

Chronic kidney disease and metabolic syndrome in a general Korean population: the Third Korea National Health and Nutrition Examination Survey (KNHANES III) Study.

BACKGROUND: The aims of this study are to examine the prevalence of chronic kidney disease (CKD) with metabolic syndrome (MS) and to investigate the association between CKD and MS after adjustment for socioeconomic position and health behavior factor. METHODS: The random sample used in this study included 5136 Korean subjects ≥20 years of age. We divided the subjects into two groups based on the presence of MS, for which the criteria described in the NCEP ATP III and International Diabetes Federation were used. Also, CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m(2). RESULTS: The prevalence of CKD in our study was 6.8%. The age-adjusted prevalence of CKD among those with MS was 9.0% whereas those without MS was 5.6%. After adjusting for age and confounders, people with MS had a 1.77 times greater risk of CKD than those without MS. The adjusted OR increased as the number of MS components increased (P < 0.05). CONCLUSION: The age-adjusted prevalence of CKD in the MS group was higher than that in the non-MS group. After adjustment for socioeconomic position and health behavior factor, MS showed significant association with CKD.

Association between restriction of activity related to chronic diseases and suicidal ideation in older adults in Korea.

AIM: The aim of the present study was to show an association between restricted activity related to chronic diseases and suicidal ideation (SI) in elderly Korean adults after adjusting for age, sex, mental health status, socioeconomic position and health behavior factors. METHODS: The study sample included 3545 Korean men (n=1473) and women (n=2073), aged over 65 years from the 2007-2009 Korea National Health and Nutrition Examination Survey carried out by the Ministry of Health and Welfare of Korea. Participants were classified into two groups based on whether they had previously experienced suicidal thoughts. Restricted activity was related to chronic conditions, such as cardiovascular diseases, cerebrovascular accident and so on. We analyzed the data using Student's t-test or χ(2) -test. Multiple logistic regression analysis was used to determine the association between restricted activity as the independent variable and SI as the dependent variable after adjustment for confounders. RESULTS: The proportion of participants with SI population was 29.1%. People with SI reported a significantly higher proportion of restrictive activity (62.3%) than those who did not have SI (34.5%). The adjusted risk excess (OR) of SI was statistically significant with regard to restricted activity (2.11, 95% CI 1.65-2.70; 2.85, 95% CI 1.95-4.15) in males; 1.69 (95% CI 1.22-2.34) in females after adjustment for potential confounders. In particular, women who lived alone showed high adjusted OR (1.50, 95% CI 1.01-2.24). CONCLUSIONS: Statistical analyses from this community-based, random sample drawn from a selected sample of the elderly Korean population showed that restricted activity appears to be significantly associated with SI.

Changes in the etiology of valvular heart disease in the rapidly aging Korean population.

BACKGROUND: The aim of this study is to assess the changes in the causes of valvular heart disease between 2006 and 2011 in Korea. METHODS: Data were collected from the Korean National Health Insurance Service from 2006 through 2011. These data consisted of primary diagnoses related to valvular heart disease regardless of other conditions. Valvular heart disease included non-rheumatic mitral valve disorders, non-rheumatic aortic valve disorders, rheumatic mitral valve disorders, and rheumatic aortic valve disorders. RESULTS: Overall, the age-standardized cumulative prevalence of non-rheumatic valvular heart disease was 70.6 per 100,000 persons in 2006 and 110.3 in 2011. This represented an increase from 42.2 to 65.2 in women and from 28.4 to 45.1 in men. In particular, there was a greater increase in prevalence in patients aged 65 years or older compared with groups aged 20-44 years or 45-64 years for both genders. The age-standardized cumulative prevalence of rheumatic valve disease did not change dramatically between 2006 and 2011. CONCLUSIONS: The overall age-standardized cumulative prevalence of non-rheumatic valvular heart diseases increased between 2006 and 2011, especially in individuals older than 65 years. These changes should be considered in future designs of cardiovascular healthcare services in countries with a rapidly aging population.

Comparison of cardiovascular risk factors for peripheral artery disease and coronary artery disease in the korean population.

BACKGROUND AND OBJECTIVES: The objective of this study was to analyze and compare risk factors for peripheral artery disease (PAD) and coronary artery disease (CAD). SUBJECTS AND METHODS: The sample included 7936 Korean patients aged ≥20 years who were hospitalized from 1994 to 2004. Of the 7936 subjects, PAD (n=415), CAD (n=3686), and normal controls (Control) (n=3835) were examined at the Health Promotion Center, Samsung Medical Center. RESULTS: The mean age (years) of PAD subjects was 64.4 (±9.3), while CAD subjects was 61.2 (±9.9), and Control subjects was 59.9 (±9.1) (p<0.01). The proportion of males was 90.6% for PAD, 71.4% for CAD, and 75.5% for Control subjects (p<0.01). The adjusted odds ratios (ORs) for hypertension, diabetes mellitus, hypercholesterolemia, smoking, metabolic syndrome and chronic kidney disease were significantly higher in subjects with PAD or CAD compared to those in Control. However, the ORs for high density lipoprotein, being overweight, and being obese were significantly lower in PAD subjects compared to those in Control. CONCLUSION: We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.