Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Incidence, Risk Factors, and Prediction of Myocardial Infarction and Stroke in Farmers: A Korean Nationwide Population-based Study

  • Lee, Solam (Department of Preventive Medicine, Yonsei University Wonju College of Medicine) ;
  • Lee, Hunju (Department of Preventive Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Hye Sim (Center of Biomedical Data Science, Yonsei University Wonju College of Medicine) ;
  • Koh, Sang Baek (Department of Preventive Medicine, Yonsei University Wonju College of Medicine)
  • Received : 2020.04.24
  • Accepted : 2020.05.29
  • Published : 2020.09.30
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Abstract

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.

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