Journal of Preventive Medicine and Public Health

Original Articles

Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study: Dal-Lae Jin, Kyoung-Hoon Kim, Euy Suk Chung, Seok-Jun Yoon; J Prev Med Public Health. 2024;57(3):260-268. Published online May 30, 2024; DOI: https://doi.org/10.3961/jpmph.24.057

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Abstract Summary PDF Supplementary Material: Objectives
Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival.
Methods
A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed.
Results
The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91).
Conclusions
Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.; Summary

Korean summary
심혈관 관련 수술을 대상으로 지역적 불균형을 분석한 결과, 관상동맥우회술, 경피적 관상동맥중재술, 스텐트 삽입술은 전국적으로 광범위하게 분포되었다. 반면에 대동맥류 절제술은 지역적 불균형이 발생하였고, 사망률 또한 유의한 차이가 있었다. 따라서 의료 격차 해소를 위해 병원 간 협력체계 구축, 지역 균형적 의료자원 확충 등 정책적 노력이 필요하다

Key Message
An analysis of regional disparities in cardiovascular surgeries revealed that coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and stent insertion procedures were widely distributed nationwide. However, there was a regional imbalance in aortic aneurysm resection (AAR) surgeries, which also showed significant differences in mortality rates. Therefore, policy efforts are needed to bridge the healthcare gap, such as establishing collaborative systems among hospitals and ensuring a balanced distribution of medical resources across regions.

Comorbid Conditions in Persons Exposed to Ionizing Radiation and Veterans of the Soviet–Afghan War: A Cohort Study in Kazakhstan: Saule Sarkulova, Roza Tatayeva, Dinara Urazalina, Ekaterina Ossadchaya, Venera Rakhmetova; J Prev Med Public Health. 2024;57(1):55-64. Published online November 1, 2023; DOI: https://doi.org/10.3961/jpmph.23.333

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Abstract Summary PDF: Objectives
This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet–Afghan war.
Methods
This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet–Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations.
Results
Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population.
Conclusions
The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet–Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.; Summary

Key Message
This study investigated the long-term health effects on 675 individuals exposed to ionizing radiation at Semipalatinsk and Chornobyl, and those involved in the Soviet–Afghan war. Results showed a higher prevalence of cardiovascular diseases, notably hypertension (55%) and cardiac ischemia (32.9%), compared to the general population. The findings highlight the need for early detection of cardiovascular and central nervous system disorders in these groups, emphasizing tailored treatment and prevention strategies.

Incidence, Risk Factors, and Prediction of Myocardial Infarction and Stroke in Farmers: A Korean Nationwide Population-based Study: Solam Lee, Hunju Lee, Hye Sim Kim, Sang Baek Koh; J Prev Med Public Health. 2020;53(5):313-322. Published online July 14, 2020; DOI: https://doi.org/10.3961/jpmph.20.156

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Abstract PDF

Objectives
This study was conducted to determine the incidence and risk factors of myocardial infarction (MI) and stroke in farmers compared to the general population and to establish 5-year prediction models.
Methods
The farmer cohort and the control cohort were generated using the customized database of the National Health Insurance Service of Korea database and the National Sample Cohort, respectively. The participants were followed from the day of the index general health examination until the events of MI, stroke, or death (up to 5 years).
Results
In total, 734 744 participants from the farmer cohort and 238 311 from the control cohort aged between 40 and 70 were included. The age-adjusted incidence of MI was 0.766 and 0.585 per 1000 person-years in the farmer and control cohorts, respectively. That of stroke was 0.559 and 0.321 per 1000 person-years in both cohorts, respectively. In farmers, the risk factors for MI included male sex, age, personal history of hypertension, diabetes, current smoking, creatinine, metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). Those for stroke included male sex, age, personal history of hypertension, diabetes, current smoking, high γ-glutamyl transferase, and metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). The prediction model showed an area under the receiver operating characteristic curve of 0.735 and 0.760 for MI and stroke, respectively, in the farmer cohort.
Conclusions
Farmers had a higher age-adjusted incidence of MI and stroke. They also showed distinct patterns in cardiovascular risk factors compared to the general population.

Summary

Citations

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Brief Report

Age-period-cohort Analysis of Cardiovascular Disease Mortality in Japan, 1995-2018: Tasuku Okui; J Prev Med Public Health. 2020;53(3):198-204. Published online April 14, 2020; DOI: https://doi.org/10.3961/jpmph.20.037

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Abstract PDF Supplementary Material

Objectives
This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis.
Methods
We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases’ mortality rates into age, period, and cohort effects.
Results
The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later.
Conclusions
The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.

Summary

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Review

Measurement of Socioeconomic Position in Research on Cardiovascular Health Disparities in Korea: A Systematic Review: Chi-Young Lee, Yong-Hwan Lee; J Prev Med Public Health. 2019;52(5):281-291. Published online August 14, 2019; DOI: https://doi.org/10.3961/jpmph.19.094

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Abstract PDF

Objectives
The validity of instruments measuring socioeconomic position (SEP) has been a major area of concern in research on cardiovascular health disparities. The purpose of this systematic review is to identify the current status of the methods used to measure SEP in research on cardiovascular health disparities in Korea and to provide directions for future research.
Methods
Relevant articles were obtained through electronic database searches with manual searches of reference lists and no restriction on the date of publication. SEP indicators were categorized into compositional, contextual, composite, and life-course measures.
Results
Forty-eight studies published from 2003 to 2018 satisfied the review criteria. Studies utilizing compositional measures mainly relied on a limited number of SEP parameters. In addition, these measures hardly addressed the time-varying and subjective features of SEP. Finding valid contextual measures at the organizational, community, and societal levels that are appropriate to Korea’s context remains a challenge, and these are rarely modeled simultaneously. Studies have rarely focused on composite and life-course measures.
Conclusions
Future studies should develop and utilize valid compositional and contextual measures and appraise social patterns that vary across time, place, and culture using such measures. Studies should also consider multilevel influences, adding a focus on the interactions between different levels of intertwined SEP factors to advance the design of research. More attention should be given to composite and life-course measures.

Summary

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Original Articles

High Level Physical Activity and Prevalence of Cardiovascular Disease Using the Korea National Health and Nutrition Examination Survey Data, 2007-2013: Kyounghoon Park, Byung-Joo Park; J Prev Med Public Health. 2017;50(5):320-327. Published online September 5, 2017; DOI: https://doi.org/10.3961/jpmph.17.073

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Abstract PDF

Objectives
The purpose of our study was to evaluate the association between the intensity of physical activity (PA) and prevalence of cardiovascular disease (CVD) using Korean representative data. Methods: We analyzed 39 804 participant data from the Korea National Health and Nutrition Examination Survey, 2007-2013. Exposure variable was three levels of PA (low, medium, and high) in a week, and outcome variable was prevalence of CVD based on patient self-recognition and doctor’s diagnosis. Complex logistic regression analysis was performed to evaluate the relationship between level of PA and CVD adjusted by body mass index, hypertension, hypercholesterolemia, diabetes mellitus, stress recognition, household income, smoking, and current drinking. The indices of association w ere estimated as crude prevalence odds ratio (POR), adjusted POR, and their 95% confidence interval (CI). All statistical analyzes were performed using complex sample analysis procedure of the SPSS version 23.0. Results: When all variables were adjusted, only high level PA in women showed a significant association with stroke (adjusted POR by patient’s self-recognition, 0.57; 95% CI, 0.32 to 0.99, adjusted POR by doctor’s diagnosis, 0.55; 95% CI, 0.34 to 0.87) and CVD (adjusted POR by doctor’s diagnosis, 0.68; 95% CI, 0.48 to 0.96). Conclusions: High level PA in women has a significant reverse association with prevalence of stroke and CVD in Korea. Further study for elucidating the mechanism will be needed.

Summary

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Role of regular physical activity in modifying cardiovascular disease risk factors among elderly Korean women
Seunghui Baek, Youngmee Kim, Lorraine S. Evangelista
IJASS(International Journal of Applied Sports Scie.2018; 30(1): 20. CrossRef

C-reactive Protein Concentration Is Associated With a Higher Risk of Mortality in a Rural Korean Population: Jung Hyun Lee, Hyungseon Yeom, Hyeon Chang Kim, Il Suh, Mi Kyung Kim, Min-Ho Shin, Dong Hoon Shin, Sang-Baek Koh, Song Vogue Ahn, Tae-Yong Lee, So Yeon Ryu, Jae-Sok Song, Hong-Soon Choe, Young-Hoon Lee, Bo Youl Choi; J Prev Med Public Health. 2016;49(5):275-287. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.025

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Abstract PDF Supplementary Material

Objectives
C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea.
Methods
A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ≥10 mg/L) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant’s vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors.
Results
The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality.
Conclusions
Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.

Summary

Citations

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Binary cutpoint and the combined effect of systolic and diastolic blood pressure on cardiovascular disease mortality: A community-based cohort study
Ju-Yeun Lee, Ji Hoon Hong, Sangjun Lee, Seokyung An, Aesun Shin, Sue K. Park, Tariq Jamal Siddiqi
PLOS ONE.2022; 17(6): e0270510. CrossRef
Association of serum high-sensitivity C reactive protein with risk of mortality in an Asian population: the Health Examinees cohort
Sang-Ah Lee, Sung Ok Kwon, Hyerim Park, Xiao-Ou Shu, Jong-Koo Lee, Daehee Kang
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Associations of C-reactive protein and fibrinogen with mortality from all-causes, cardiovascular disease and cancer among U.S. adults
Junxiu Liu, Yanan Zhang, Carl J. Lavie, Fred K. Tabung, Jiting Xu, Qingwei Hu, Lixia He, Yunxiang Zhang
Preventive Medicine.2020; 139: 106044. CrossRef
Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey
Se-Won Park, Seong-Sik Park, Eun-Jung Kim, Won-Suk Sung, In-Hyuk Ha, Boyoung Jung
Health and Quality of Life Outcomes.2020;[Epub] CrossRef

Low Systolic Blood Pressure and Mortality From All Causes and Vascular Diseases Among Older Middle-aged Men: Korean Veterans Health Study: Sang-Wook Yi, Heechoul Ohrr; J Prev Med Public Health. 2015;48(2):105-110. Published online March 11, 2015; DOI: https://doi.org/10.3961/jpmph.15.003

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Abstract PDF

Objectives
Recently, low systolic blood pressure (SBP) was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men.
Methods
From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR) were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004.
Results
Among the participants aged 60 and older, the lowest SBP (<90 mmHg) category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1) and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4) compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8) and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2) also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older.
Conclusions
Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older.

Summary

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Relationship between systolic blood pressure and all-cause mortality: a prospective study in a cohort of Chinese adults
Chunsheng Li, Youren Chen, Qiongbing Zheng, Weiqiang Wu, Zhichao Chen, Lu Song, Shasha An, Zhifang Li, Shuohua Chen, S. L. Wu
BMC Public Health.2018;[Epub] CrossRef
Baseline and longitudinal change in blood pressure and mortality in a Chinese cohort
Jian-Bing Wang, Qiu-Chi Huang, Shu-Chang Hu, Pei-Wen Zheng, Peng Shen, Die Li, Huai-Chu Lu, Xiang Gao, Hong-Bo Lin, Kun Chen
Journal of Epidemiology and Community Health.2018; 72(12): 1083. CrossRef
Low Systolic Blood Pressure and Vascular Mortality Among More Than 1 Million Korean Adults
Sang-Wook Yi, Yejin Mok, Heechoul Ohrr, Jee-Jeon Yi, Young Duk Yun, Jihwan Park, Sun Ha Jee
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The Prevalence of Cardiovascular Disease Risk Factors and the Framingham Risk Score in Patients Undergoing Percutaneous Intervention Over the Last 17 Years by Gender: Time-trend Analysis From the Mayo Clinic PCI Registry: Moo-Sik Lee, Andreas J. Flammer, Hyun-Soo Kim, Jee-Young Hong, Jing Li, Ryan J. Lennon, Amir Lerman; J Prev Med Public Health. 2014;47(4):216-229. Published online July 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.4.216

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Abstract PDF

Objectives
This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for β-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.

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Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality Among Middle-aged Men in Korea: The Seoul Male Cohort Study: Ji Young Kim, Young-Jin Ko, Chul Woo Rhee, Byung-Joo Park, Dong-Hyun Kim, Jong-Myon Bae, Myung-Hee Shin, Moo-Song Lee, Zhong Min Li, Yoon-Ok Ahn; J Prev Med Public Health. 2013;46(6):319-328. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.319

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Abstract PDF

Objectives

This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea.

Methods

In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics.

Results

There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality.

Conclusions

Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

Summary

Citations

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Interaction of Body Mass Index and Diabetes as Modifiers of Cardiovascular Mortality in a Cohort Study: Seung Hyun Ma, Bo-Young Park, Jae Jeong Yang, En-Joo Jung, Yohwan Yeo, Yungi Whang, Soung-Hoon Chang, Hai-Rim Shin, Daehee Kang, Keun-Young Yoo, Sue Kyung Park; J Prev Med Public Health. 2012;45(6):394-401. Published online November 29, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.6.394

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Abstract PDF

Objectives

Diabetes and obesity each increases mortality, but recent papers have shown that lean Asian persons were at greater risk for mortality than were obese persons. The objective of this study is to determine whether an interaction exists between body mass index (BMI) and diabetes, which can modify the risk of death by cardiovascular disease (CVD).

Methods

Subjects who were over 20 years of age, and who had information regarding BMI, past history of diabetes, and fasting blood glucose levels (n=16 048), were selected from the Korea Multi-center Cancer Cohort study participants. By 2008, a total of 1290 participants had died; 251 and 155 had died of CVD and stroke, respectively. The hazard for deaths was calculated with hazard ratio (HR) and 95% confidence interval (95% CI) by Cox proportional hazard model.

Results

Compared with the normal population, patients with diabetes were at higher risk for CVD and stroke deaths (HR, 1.84; 95% CI, 1.33 to 2.56; HR, 1.82; 95% CI, 1.20 to 2.76; respectively). Relative to subjects with no diabetes and normal BMI (21 to 22.9 kg/m²), lean subjects with diabetes (BMI <21 kg/m²) had a greater risk for CVD and stroke deaths (HR, 2.83; 95% CI, 1.57 to 5.09; HR, 3.27; 95% CI, 1.58 to 6.76; respectively), while obese subjects with diabetes (BMI ≥25 kg/m²) had no increased death risk (p-interaction <0.05). This pattern was consistent in sub-populations with no incidence of hypertension.

Conclusions

This study suggests that diabetes in lean people is more critical to CVD deaths than it is in obese people.

Summary

Citations

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Associations of Serum Ferritin and Transferrin % Saturation With All-cause, Cancer, and Cardiovascular Disease Mortality: Third National Health and Nutrition Examination Survey Follow-up Study: Ki-Su Kim, Hye-Gyeong Son, Nam-Soo Hong, Duk-Hee Lee; J Prev Med Public Health. 2012;45(3):196-203. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.196

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Abstract PDF

Objectives

Even though experimental studies have suggested that iron can be involved in generating oxidative stress, epidemiologic studies on the association of markers of body iron stores with cardiovascular disease or cancer remain controversial. This study was performed to examine the association of serum ferritin and transferrin saturation (%TS) with all-cause, cancer, and cardiovascular mortality.

Methods

The study subjects were men aged 50 years or older and postmenopausal women of the Third National Health and Nutrition Examination Survey 1988-1994. Participants were followed-up for mortality through December 31, 2006.

Results

Serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality for either men or postmenopausal women. However, all-cause, cancer, and cardiovascular mortality were inversely associated with %TS in men. Compared with men in the lowest quintile, adjusted hazard ratios for all-cause, cancer, and cardiovascular mortality were 0.85, 0.86, 0.76, and 0.74 (p for trend < 0.01), 0.82, 0.73, 0.75, and 0.63 (p for trend < 0.01), and 0.86, 0.81, 0.72, and 0.76 (p for trend < 0.01), respectively. For postmenopausal women, inverse associations were also observed for all-cause and cardiovascular mortality, but cancer mortality showed the significantly lower mortality only in the 2nd quintile of %TS compared with that of the 1st quintile.

Conclusions

Unlike speculation on the role of iron from experimental studies, %TS was inversely associated with all-cause, cancer and cardiovascular mortality in men and postmenopausal women. On the other hand, serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality.

Summary

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Indoor Physical Activity Reduces All-Cause and Cardiovascular Disease Mortality Among Elderly Women: Soyoung Park, Joongyub Lee, Dong Yoon Kang, Chul Woo Rhee, Byung-Joo Park; J Prev Med Public Health. 2012;45(1):21-28. Published online January 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.1.21

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Abstract PDF

Objectives

The aim of this study was to investigate whether a medium to high degree of total physical activity and indoor physical activity were associated with reduced all-cause and cardiovascular mortality among elderly Korean women.

Methods

A prospective cohort study was done to evaluate the association between physical activity and mortality. The cohort was made up of elderly (≥65 years of age) subjects. Baseline information was collected with a self-administered questionnaire and linked to death certificates retrieved from a database. Cox proportional hazard models were used to estimate the hazard ratios (HRs) with 95% confidence interval (CI) levels.

Results

Women who did not suffer from stroke, cancer, or ischemic heart disease were followed for a median of 8 years (n=5079). A total of 1798 all-cause deaths were recorded, of which 607 (33.8%) were due to cardiovascular disease. The group with the highest level of total physical activity and indoor physical activity was significantly associated to a reduced all-cause mortality (HR, 0.60; 95% CI, 0.51 to 0.71 and HR, 0.58; 95% CI, 0.50 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity. Additionally, the group with the highest level of total physical activity and indoor physical activity was significantly associated to a lower cardiovascular disease mortality (HR, 0.53; 95% CI, 0.40 to 0.71 and HR, 0.51; 95% CI, 0.39 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity.

Conclusions

Our study showed that regular indoor physical activity among elderly Korean women has healthy benefits.

Summary

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English Abstract

Study on the Health Status of the Residents near Military Airbases in Pyeongtaek City.: Hyunjoo Kim, Sangchul Roh, Ho Jang Kwon, Ki Chung Paik, Moo Yong Rhee, Jae Yun Jeong, Myung Ho Lim, Mi Jin Koo, Chang Hoon Kim, Hae Young Kim, Jeong Hun Lim, Dong Hyun Kim; J Prev Med Public Health. 2008;41(5):307-314.; DOI: https://doi.org/10.3961/jpmph.2008.41.5.307

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Abstract PDF

OBJECTIVES
We conducted an epidemiologic survey to evaluate the effect of the aircraft noise exposure on the health of the residents near the military airbases in Pyeongtaek City. METHODS: The evaluation of environmental noise level, questionnaire survey, and health examination were performed for 917 residents. The study population consisted of four groups: subjects who lived in the village close to the fighter airbase (high exposure), subjects who lived along the course of fighters (intermediate exposure), and subjects near a helicopter airbase, and the control group. RESULTS: The prevalence of the aircraft noise related accident and irritable bowel syndrome in the exposure groups were higher than that of the control group. The risks of noise induced hearing loss, hypertension and diabetes mellitus were higher in the exposed groups than in the control group. The prevalence of anxiety disorder and primary insomnia were higher in the exposed groups than in the control group. Prevalence odd ratios of the risk for primary insomnia after adjusting age, sex, agricultural noise, and occupation were 4.03 [95% confidence interval (95% CI) 1.56-10.47] for the subject near the helicopter airbase, 1.23 (95% CI 0.40-3.76) for those intermediately exposed to fighter noise, and 4.99 (95% CI 2.14-11.64) for those highly exposed to fighter noise. CONCLUSIONS: The results of the present study suggest that the aircraft noise may have adverse effects on hearing function, cardiovascular health and mental health. Therefore, it seems to be needed to take proper measures including the control of the aircraft noise and the management of the exposed people's health.

Summary

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The Prevalence of Functional Gastrointestinal Disorders in the Chinese Air Force Population
Wenming Wu, Xu Guo, Yunsheng Yang, Lihua Peng, Gaoping Mao, Hyder Qurratulain, Weifeng Wang, Gang Sun
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Original Article

The Association between the Psychosocial Well-being Status and Adverse Lipid Profiles in a Rural Korean Community.: Chang Hoon Kim, Myoung Hee Kim, Sung Il Cho, Jung Hyun Nam, Bo Youl Choi; Korean J Prev Med. 2003;36(1):24-32.

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Abstract PDF: OBJECTIVES
To identify the psychosocial well-being status in a rural community, and examine the association between the psychosocial well-being status and adverse lipid profile. METHOD: In 2001, we surveyed 575 subjects in Yangpyoung, Kyounggido, including medical examination, fasting-blood sample and questionnaires for the psychosocial well-being status, socioeconomic position and behavioral risk factors. The logistic regression analysis was used to examine explanatory factors of the psychosocial well-being status, and association between the psychosocial well-being status and adverse lipid profiles. RESULT: The association between the psychosocial well-being status and adverse lipid profiles was not strong. The total cholesterol and triglyceridelevels were associated with psychosocial well-being. The adjusted odds ratio for moderate psychosocial well-being relating to total cholesterol was 1.90 (95%CI, 0.82-4.04), but that for triglyceride was 0.65 (95%CI, 0.36-1.21). The HDL-Cholesterol and LDL-Cholesterol level were not associated with the psychosocial well-being status. CONCLUSION: The total cholesterol and psychosocial well-being status were weakly associated, but the between the psychosocial well-being status and adverse lipid profiles were not consistent.; Summary

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