• Journal of Korean Academy of Nursing
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• v.38 no.1
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• pp.64-73
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• 2008

Purpose: This study examined the effects of a nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease (CVD). Method: Sixty-four CVD subjects (37 experimental, 27 control) were recruited from a cardiac center, at a university hospital located in D city, Korea. All subjects attended a first heart camp where pretest measures were performed, and a second heart camp at 6 months for the posttest measures. During the 6 month study period, the experimental group was required to attend five monthly nutrition education sessions, while the control group received only routine outpatient follow-ups. Data were analyzed by $x^2$-test and independent t-test using the SPSSWIN 11.5 program. Result: Group comparisons revealed that the experimental group had significantly more improved self-efficacy, frequency of food selection, gustation of salt, systolic blood pressure, and serum total-cholesterol compared to the control group. Conclusion: A nutrition education program may be effective in improving self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.319-328
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• 2013

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.

• Journal of Preventive Medicine and Public Health
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• v.50 no.6
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• pp.386-392
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• 2017

Objectives: Refugees resettled in the US may be at risk for cardiovascular disease (CVD). However, little is known about CVD-related issues among Karen refugees who have migrated to the US from the Thai-Myanmar border. The purpose of this study was to examine CVD-related health beliefs and lifestyle issues among Karen refugees resettled in the US. Methods: Karen refugees resettled in the US from the Thai-Myanmar border (n=195) participated in a survey study on health beliefs related to CVD, salt intake, physical activity (PA), and smoking in the fall of 2016. Results: A high-salt diet, physical inactivity, and smoking were major lifestyle problems. Participants who adhered to a low-salt diet considered themselves to be susceptible to CVD. Most participants did not engage in regular PA. Regular PA was associated with less perceived susceptibility to CVD and greater perceived benefits of a healthy lifestyle for decreasing the likelihood of CVD. Conclusions: Each refugee population may require individualized strategies to promote PA and a healthy diet. Future studies should develop health education programs that are specifically designed for Karen refugees and evaluate such programs. In addition to health education programs on healthy lifestyle choices, tobacco cessation programs seem to be necessary for Karen refugees. At the same time, it is important to foster strategies to increase the utilization of preventive care among this population by promoting free or reduced-fee resources in the community to further promote their health.

• Research in Community and Public Health Nursing
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• v.31 no.spc
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• pp.534-548
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• 2020

Purpose: This study was conducted to evaluate the prevalence and lifestyle habits of cardiovascular disease (CVD) according to the type of disability in Korean adults compared to adults without disability. Methods: This study was secondary data analysis using the National Health check-up database from 2010 to 2013. Among the total 395,627 adults aged 30~80, the physically disabled (n=21,614) and the mentally disabled (n=1,448) who met the diagnosis criteria were extracted and compared with non-disabled (n=372,565) through 1:2 propensity score matching for nine characteristics. Results: Prior to matching, the prevalence of CVD was 34.4% in individuals without disabilities, accounting for 53.8% in those with physical disabilities and 22.4% in those with mental disabilities, showing significant differences between groups (p<.001). After matching, compared to the individuals without disability, those with physically disabled had significantly higher prevalence of CVD and the average number of CVD (p<.001). The prevalence of hypertension, diabetes, and vascular disease was significantly higher in the physically disabled (p<.05). Drinking was significantly higher in the non-disabled than in the physically and mentally disabled, and smoking was more in the non-disabled than in the mentally disabled. Physical activity was found to be significantly less in both the physically and mentally disabled than in the non-disabled (p<.01). Conclusion: It is necessary to confirm the differences in the prevalence of CVD risk factors and lifestyle according to the type of disability, suggesting the development and verification of health promotion programs including physical activity for CVD prevention in the disabled with CVD risk factors.

• Journal of Nutrition and Health
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• v.26 no.9
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• pp.1071-1084
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• 1993

This study was performed to investigate the relationships between obese index and major risk factors of cardiovascular disease in CVD patients. Anthropometry, food intake patterns, blood pressure, serum lipids and hematological values were analyzed in 550 patients from June, 1991 to August, 1992. The results are as follows: Total food intakes, especially total vegetable food and alcohol intakes were significantly related with obese index, so that the heavier patients tended to consume more carbohydrate and less fat. The blood pressure were observed to have positive correlation with obese index in man but not in women. However, both in men and women, blood levels of TG, TC, and VLDL tended to be related to obese index positively, while HDL and HDL-C were shown to be oppositive. So, it seems that as the degree of obesity is higher the blood pressure and blood lipids patterns worse. Therefore, these results suggest that obesity is one of the major risk factors of CVD, and for prevention & treatment of the disease, controlling body weight by nutritionally adequate diet along with alcohol restriction is necessary.

• Korean Journal of Occupational Health Nursing
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• v.25 no.4
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• pp.362-372
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• 2016

Purpose: This study intended to grasp real context of Cardiovascular disease (CVD)-related factors of Korean blue-collar workers, especially CVD-related knowledge, perception, beliefs, benefits and barriers of behaviors according to the health belief model. Methods: We interviewed twenty two workers working in two small-sized companies and performed two series of focus group interviews. Data were analyzed by deductive content analysis approach based on Elo & $Kyng{\ddot{a}}s$. Results: Excepting participants who have CVD risk factors, most participants had lower level of CVD risk perception. The level of CVD knowledge was low but there was difference by gender. CVD-related beliefs were 'fatal disease', 'caused by lifestyle' and 'difficult to prevent by themselves'. The risk reduction behaviors were motivated by current or family history of hypertension. But there were barriers to interfere practice of preventive behaviors such as poor quality of food provided by cafeteria in the workplace, frequent overtime, victim mentality as one of vulnerable social group, housework and financial burden, lack of facilities for rest and physical activity in the workplace. Conclusion: To develop intervention for reducing CVD risks in Korean blue-collar workers, we need to focus on improving CVD knowledge and perception and modifying work-related environments such as low quality of food and lack of facilities for rest and physical activity in the workplace.

• Journal of Preventive Medicine and Public Health
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• v.47 no.4
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• pp.216-229
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• 2014

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 ${\beta}$-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.

• Journal of Community Nutrition
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• v.6 no.3
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• pp.155-163
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• 2004

In our country, cardiovascular disease (CVD) and Coronary heart diseases (CHD) are the leading causes of death. It is well known that CHD is multifactorial, involving environmental factors such as diet, level of exercise and cigarette smoking, and inherited factors. According to the statistical data in 2003, the cause of death with the highest mortality was including hypertension, ischemic heart disease and atherosclerosis, which accounted for $24.7\%$ of total mortality. In spite of, there have been few study reports on the change of biochemical markers and mechanisms concerned. The development of biochemical markers is required for an early diagnosis and treatment of cardiovascular diseases that are related with dietary habits of Korean people enjoying mixtures of traditional dietary style and westernized food-styles. Therefore, the most efficient cost-saving biochemical marker was established in this study, through analysis of biochemical markers related with dietary habits which are susceptibly being changed in association to cardiovascular diseases from the pre-disease phase, and through reanalysis and assessment of early diagnosis of and preventive effects of diagnosis of cardiovascular diseases by demographical character including sex, age, and socioeconomic level with use of biochemical markers that are identified and selected among the parameters in consideration of the effectiveness and appropriateness of early diagnosis of diseases. The appropriateness of biochemical markers was reviewed by professionals (medical, pharmaceutical area and food/ nutrition area) and CRP(C-Reactive Protein) and was identified to be possible in Korea. It is thought that these biochemical markers may be used as the basic data for early diagnosis and prevention of cardiovascular diseases (CVD) which may be used for Korean people.

• The Korean journal of internal medicine
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• v.39 no.2
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• pp.283-294
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• 2024

Background/Aims: Epicardial adipose tissue (EAT) shares pathophysiological properties with other visceral fats and potentially triggers local inflammation. However, the association of EAT with cardiovascular disease (CVD) is still debatable. The study aimed to observe the changes and associations in EAT and risk factors over time, as well as to investigate whether EAT was associated with CVD. Methods: A total of 762 participants from Seoul National University Hospital (SNUH) and SNUH Gangnam Center were included in this study. EAT was measured using coronary computed tomography angiography. Results: Baseline EAT level was positively associated with body mass index (BMI), calcium score, atherosclerotic cardiovascular disease (ASCVD) 10-year risk score, glucose, triglycerides (TG)/high-density lipoprotein (HDL), but not with total cholesterol, low-density lipoprotein (LDL). At follow-up, EAT levels increased in all groups, with low EAT groups demonstrating a significant increase in EAT per year. Change in EAT was associated with a change in BMI, TG/HDL, and glucose, while changes in LDL, calcium score, and ASCVD 10-year risk score were not associated. Although calcium score and ASCVD 10-year risk score were associated with CVD events, baseline information of EAT, baseline EAT/body surface area, or EAT change was not available. Conclusions: Metabolic risks, e.g., BMI, TG/HDL, and glucose, were associated with EAT change per year, whereas classical CVD risks, e.g., LDL, calcium score, and ASCVD 10-year risk score, were not. The actual CVD event was not associated with EAT volume, warranting future studies combining qualitative assessments with quantitative ones.

• Korean Journal of Community Nutrition
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• v.3 no.5
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• pp.685-694
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• 1998

This cross-sectional study was conducted to describe the changes of plasma cardiovascular disease(CVD) risk factors in Korea. Overnight fasting plasma levels of total cholesterol, high density lipoprotein(HDL)-cholesterol, triacylglycerol and glucose were analyzed. Blood pressure and anthropometric data were also measured. Health practice factors such as smoking status, alcohol consumption and frequency fo exercise were evaluated by a self-administered questionnaire. Questions regarding dietary habits and food preferences were also asked. Seventy eight percent of the subjects had more than one CVD risk factor. Plasma total cholesterol, triacylglycerol, and fasting blood glucose were significantly increased according to the subjects body mass index$(kg/m^2$, BMI), whereas HDL-cholesterol, low density lipoprotein(LDL)-cholesterol and blood pressure showed no significant differences with BMI. Current smokers had significantly high plasma total cholesterol, LDL-cholesterol and triacylglycerol levels. Alcohol consumption significantly increased plasma total cholesterol and fasting blood sugar, but regular exercise had no effects on the plasma CVD risk factors. Overeating and frequency of fast food consumption were positively correlated with the CVD risk score, whereas intake of grains, meats and vegetables were negatively correlated with that score. A stepwise multiple regression analysis was performed to examine the effects of specific dietary factors on plasma lipid levels. For plasma total cholesterol level, the frequency of fast food intake explained 8% of the variance, followed by habitual overeating, frequency of grain intake and high cholesterol food intake(Model $R^2$=22.4%). For plasma triacylglycerol level, preference of oily foods accounted for 7.5% of the variance, followed by eating breakfast, preference of fruit and frequency of grain intake(Model $R^2$=22.0%). The findings suggest that intervention programs to reduce the risk of CVD should focus on health practice through reducing BMI, smoking cessation and moderate or no alcohol drinking. Moreover, desirable dietary habits such as eating breakfast, not overeating and reduced intake of fast food may improve CVD risk.