• Communications for Statistical Applications and Methods
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• v.25 no.3
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• pp.297-306
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• 2018

Cardiovascular disease (CVD) is the leading cause of death worldwide and has a high mortality rate after onset; therefore, the CVD management requires the development of treatment plans and the prediction of prevalence rates. In our study, age, income, education level, marriage status, diabetes, and obesity were identified as risk factors for CVD. Using these 6 factors, we proposed a nomogram based on a $na{\ddot{i}}ve$ Bayesian classifier model for CVD. The attributes for each factor were assigned point values between -100 and 100 by Bayes' theorem, and the negative or positive attributes for CVD were represented to the values. Additionally, the prevalence rate can be calculated even in cases with some missing attribute values. A receiver operation characteristic (ROC) curve and calibration plot verified the nomogram. Consequently, when the attribute values for these risk factors are known, the prevalence rate for CVD can be predicted using the proposed nomogram based on a $na{\ddot{i}}ve$ Bayesian classifier model.

• Journal of Korean Academy of Nursing
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• v.45 no.1
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• pp.25-34
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• 2015

Purpose: This study was conducted to examine effects of a cardiocerebrovascular disease (CVD) prevention education program on knowledge, self-efficacy and health behavior among postmenopausal middle-aged women. Methods: A non-equivalent control group pretest-posttest design was used. Participants were 53 postmenopausal middle-aged women who registered in two community culture centers in G metropolitan city. Experimental group (n=26) received a CVD prevention education program 8 times over 8 weeks. Knowledge, self-efficacy and health behavior of the participants were examined with self-report structured questionaries. Data were collected between October 15 and December 11, 2013, and were analyzed using chi-square test, Fisher's exact test, independent t-test, and analysis of covariance with SPSS/PC version 21.0. Results: After the intervention the experimental group showed significant increases in the knowledge of CVD symptoms (p<.001) and CVD risk factors (p<.001), level of self-efficacy (p=.028) and health behavior (p<.001) compared to the control group. However, no significant difference was found between groups for knowledge of CVD prevention (p<.133). Conclusion: Results suggest that a CVD prevention education program can be an effective strategy to improve knowledge on CVD symptoms and risk factors, self-efficacy and health behavior for postmenopausal middle-aged women.

• Nutrition Research and Practice
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• v.1 no.4
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• pp.363-370
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• 2007

Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G${\rightarrow}$T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G${\rightarrow}$T was analyzed and dietary intakes were assessed by a Food Frequency Questionnaire. The prevalence of G/G, G/T, and T/T genotype was 47.6%, 43.3%, and 9.1%, respectively. Male subjects with T/T genotype showed significantly lower level of adiponectin and HDL-cholesterol and significantly higher C-reactive protein (CRP) level compared to G/G and G/T genotypes. In G/G genotype, protein intake was negatively correlated to body weight, BMI, and waist circumference, and there were positive correlation between carbohydrate intake and BMI, waist-hip ratio, and ApoB/apoA-1 ratio in G/T genotype. However, in T/T genotype, there was no significant association between macronutrient intakes and anthropometric and hematological values. In conclusion, CVD risk would be high in type 2 DM patients with T/T genotype, and the association of macronutrient intakes with anthropometric and hematologic factors was different among the three adiponectin genotypes. These results may imply the need for different dietary management regime according to adiponectin genotype to lower CVD complications in Korean type 2 DM patients.

• Research in Community and Public Health Nursing
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• v.24 no.2
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• pp.111-122
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• 2013

Purpose: This study was conducted to evaluate effects of a comprehensive lifestyle improvement program for middle-aged women with cardio-cerebrovascular disease (CVD)-related risk factors. Methods: The research adopted a non-equivalent control group pretest-posttest design. The number of participants was 18 in the experimental group and 16 in the control group sampled among middle-aged women who had CVD-related risk factors residing in a community. The experimental group participated in a four-session comprehensive lifestyle promotion program, which consisted of lectures, demonstrations, small-group meetings and telephone-counseling. The effects of the program were evaluated by measuring knowledge, attitude, health behavior, and self-efficacy for CVD prevention. Results: The experimental group showed a significant increase in self-efficacy for CVD prevention compared to the control group. There was no significant increase in knowledge, attitude, and health behavior. Conclusion: The results suggest that the comprehensive lifestyle improvement program was effective in improving self-efficacy for CVD prevention. There is a need to develop more effective lifestyle improvement programs designed to improve knowledge, attitude, and health behavior for CVD prevention. In further research, a follow-up evaluation is also needed to investigate any delayed effects on targeted variables among which no significant differences emerged immediately after the completion of the program.

• Korean Journal of Adult Nursing
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• v.28 no.4
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• pp.424-435
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• 2016

Purpose: This study examined knowledge about cardio-cerebrovascular disease (CVD) and its relationship to health behaviors among middle-aged postmenopausal women with CVD risk factors. Methods: The study was a cross-sectional descriptive study. One hundred and thirty-six postmenopausal women were recruited from outpatient departments of four hospitals. The women were $60.69{\pm}6.5$ years old. Self-reported questionnaires were administered, and waist-hip ratios (WHR) were measured. Results: Among the women, 72.8% reported hypertension, 19.1% reported diabetes, 33.8% reported hypercholesterolemia, and 24.2% reported angina pectoris. Moreover, 73.9% of the women reported not knowing of CVD prevention, and only 26.1% reported exercising regularly. A majority of the women (80.9%) had a WHR > 0.85. Multiple linear regression analysis after adjusting for age and marital status indicated that the risk of myocardial infarction and stroke increased (p<.001). Waist-hip ratio${\leq}0.85$ (p=.022) and living with family members (p=.006) were significant predictors of healthier behaviors ($R^2$=0.21, p<.001). Knowledge of CVD and health behaviors were not correlated. Conclusion: Obese women and women who live alone are no more likely to practice health behaviors aimed at CVD prevention than their counterparts in the sample. Education and exercise interventions are needed, especially for obese women, to promote healthy behaviors among middle-aged postmenopausal women with CVD risk factors.

• Nutrition Research and Practice
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• v.7 no.1
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• pp.43-48
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• 2013

Quantities as well as distributions of adipose tissue (AT) are significantly related to cardiovascular disease (CVD) risk factors and can be altered with caloric restriction. This study investigated which cross-sectional slice location of AT is most strongly correlated with changes in CVD risk factors after caloric restriction in obese Korean women. Thirty-three obese pre-menopausal Korean women ($32.4{\pm}8.5$ yrs, BMI $27.1{\pm}2.3\;kg/m^2$) participated in a 12 weeks caloric restriction program. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were measured using computed tomography (CT) scans at the sites of L2-L3, L3-L4, and L4-L5. Fasting serum levels of glucose, insulin, triglyceride, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), leptin and homeostasis model assessment-insulin resistance (HOMA-IR) were observed. Pearson's partial correlation coefficients were used to assess the relationship between AT measurement sites and changes in CVD risk factors after calorie restriction. When calories were reduced by 350 kcal/day for 12 weeks, body weight (-2.7%), body fat mass (-8.2%), and waist circumference (-5.8%) all decreased (P < 0.05). In addition, following caloric restriction, serum levels of glucose (-4.6%), TC (-6.2%), LDL-C (-5.3%), leptin (-17.6%) and HOMA-IR (-18.2%) decreased significantly (P < 0.05) as well. Changes in VAT at the level of L3-L4 were significantly greater than those at other abdominal sites, and these changes were correlated with changes in TC (P < 0.05), LDL-C (P < 0.001), SBP (P < 0.001) and HOMA-IR (P < 0.01). These results show that VAT at L3-L4 had a stronger correlation with CVD risk factors than with other AT measurement sites after caloric restriction.

• Nutrition Research and Practice
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• v.6 no.2
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• pp.162-168
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• 2012

Vitamin D deficiency is a risk factor for metabolic syndromes. We examined whether vitamin D deficiency altered the prevalence of cardiovascular disease (CVD) in older Koreans. Cross-sectional analysis of data from the Korean National Health and Nutrition Examination Survey IV 2008-2009 was used to examine the association between serum 25-hydroxyvitamin D (25(OH)D) levels and the prevalence of CVD in a representative population-based sample of 5,559 men and women aged ${\geq}50$ years. CVD was defined as angina pectoris, myocardial infarction, or stroke. The prevalence of CVD (7.0%) in the older Korean population was lower than that in the older US population, although average serum 25(OH)D levels were much lower in the Korean population. Additionally, serum 25(OH)D levels did not differ significantly between the CVD and non-CVD groups. However, subjects in the lowest category (< 25 nmol/l) of serum 25(OH)D level had the greatest prevalence of CVD, about two-fold higher than subjects in the highest category (> 75 nmol/l), after adjusting for age, gender, body mass index, education level, residence location, and region. The prevalence of other risk factors for CVD, including higher waist circumference, fasting glucose, low-density lipoprotein (LDL) cholesterol, and triglyceride levels and lower high-density lipoprotein (HDL) cholesterol levels, was also higher among subjects in the lowest category than among those in the highest category. In conclusion, low serum 25(OH)D may be an independent risk factor for CVD in older Koreans.

• Journal of Korean Biological Nursing Science
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• v.18 no.4
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• pp.221-230
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• 2016

Purpose: This study was undertaken to explore sex differences in the risk markers of cardiovascular disease (CVD) and psychosocial factors and the relationships among these variables for the community-residing adults. Methods: A cross-sectional study was conducted with a total of 114 participants consisting of 65 men aged 42.85 years old and 49 women aged 46.86 years old. Participants were selected by a convenient sampling of at community cultural centers and churches. They completed a structured questionnaire including demographic characteristics, physiologic risk markers of CVD; lifestyle factors; and depression, social support, and stress. Results: The male participants showed significantly higher systolic and diastolic blood pressures than their counterparts. Significantly higher percent of women were currently non-smokers, and practiced moderate alcohol intake, physical activity, and low fat diet. Among women, the higher the scores of depression and stress were and the lower that of the social support was, the higher blood pressure, waist circumference and BMI were. Among men, those who were less depressed and with higher scores of social support had more physical activity. Conclusion: The findings suggest further studies to explore sex differences of CVD risk markers and psychosocial factors, and their relationships in a larger sample, and to find the mechanism underlying these differences with a prospective design.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.1
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• pp.28-32
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• 2017

Objective: Growing evidence suggests that increased cardiovascular disease (CVD) risk is associated with female infertility caused by conditions such as polycystic ovarian disease, obesity, thyroid dysfunction, and endometriosis. The aim of this study was to evaluate whether any relationship exists between CVD and unexplained infertility. Methods: Sixty-five women with unexplained infertility and 65 fertile controls were enrolled in the study. CVD risk markers such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), insulin resistance (defined by the homeostasis model assessment ratio), and high-sensitivity C-reactive protein (hs-CRP) were assessed. Results: TG, TC, LDL, and hs-CRP levels were higher and HDL levels were lower in patients with unexplained infertility than in fertile controls (p<0.05 for all). Positive associations were found between unexplained infertility and TG, TC, LDL, and hs-CRP levels, and a negative correlation was found for HDL (p<0.05 for all). Multivariate logistic regression analysis showed that TG, HDL, and hs-CRP were independent variables associated with unexplained infertility. Conclusion: Our study showed that women with unexplained infertility had an atherogenic lipid profile and elevated hs-CRP levels, suggesting a higher risk of developing CVD in the future. Further studies with larger groups are needed to investigate the nature of this link.

• Nutrition Research and Practice
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• v.9 no.5
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• pp.496-502
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• 2015

BACKGROUND/OBJECTIVES: This study was performed to investigate the association between the dietary intake of fish and shellfish, and omega-3 polyunsaturated fatty acids (PUFAs) and cardiovascular disease (CVD) risk factors in the middle-aged Korean female patients with Type 2 diabetes (T2D). SUBJECTS/METHODS: A cross-sectional analysis was performed with 356 female patients (means age: 55.5 years), who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire and analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. RESULTS: In a multiple regression analysis after the adjustment for confounding factors such as age, BMI, duration of diagnosed T2D, alcohol consumption, fiber intake, sodium intake, and total energy intake, fish and shellfish intake of the subjects was negatively associated with triglyceride and pulse wave velocity (PWV). Omega-3 PUFAs intake was negatively associated with triglyceride, systolic blood pressures, diastolic blood pressures, and PWV. The multiple logistic regression analysis with the covariates showed a significant inverse relationship between the omega-3 PUFAs consumption and prevalence of hypertriglyceridemia [OR (95% CI) for greater than the median compared to less than the median: 0.395 (0.207-0.753)]. CONCLUSIONS: These results suggest that the consumption of fish and shellfish, good sources of omega-3 PUFAs, may reduce the risk factors for CVD in the middle-aged female patients with T2D.