Cardiovascular Diseases ; epidemiology ; prevention & control ; China ; epidemiology ; Female ; Humans ; Hypercholesterolemia ; prevention & control ; Hypertension ; prevention & control ; Life Style ; Male ; Risk Factors

A noncommunicable disease (NCD) is a medical condition or disease that is by definition non-infectious and non-transmissible among people. Currently, NCDs are the leading causes of death and disease burden worldwide. The four main types of NCDs, including cardiovascular disease, cancer, chronic lung disease, and diabetes, result in more than 30 million deaths annually. To reduce the burden of NCDs on global health, current public health actions stress the importance of preventing, detecting, and correcting modifiable risk factors; controlling major modifiable risk factors has been shown to effectively reduce NCD mortality. The World Health Organization's World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure, and high cholesterol as the most important risk factors for NCDs. Accordingly, the present report set out to review the prevalence and trends of these modifiable risk factors in the Korean population. Over the past few decades, we observed significant risk factor modifications of improved blood pressure control and decreased smoking rate. However, hypertension and cigarette smoking remained the most contributable factors of NCDs in the Korean population. Moreover, other major modifiable risk factors show no improvement or even worsened. The current status and trends in major modifiable risk factors reinforce the importance of prevention, detection, and treatment of risk factors in reducing the burden of NCDs on individuals and society.
Alcohol Drinking/adverse effects/epidemiology/prevention & control ; Chronic Disease/epidemiology/*prevention & control ; Female ; Humans ; Hypercholesterolemia/complications/epidemiology/prevention & control ; Hypertension/complications/epidemiology/prevention & control ; Male ; Overweight/complications/epidemiology/prevention & control ; Prevalence ; *Public Health Practice ; Republic of Korea/epidemiology ; Risk Factors ; Sedentary Lifestyle ; Smoking/adverse effects/epidemiology/prevention & control ; World Health Organization

INTRODUCTIONFew studies in Asia have assessed the burden of hypercholesterolaemia based on the global cardiovascular risk assessment. This study determines the burden of hypercholesterolaemia in an Asian population based on the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) guidelines, and examines predictors of low-density lipoprotein cholesterol (LDL-C) goal attainment.

MATERIALS AND METHODSFive thousand and eighty-three Chinese, Malays and Asian-Indians living in Singapore were assigned to coronary heart disease (CHD)-risk category based on the NCEP-ATPIII guidelines. Awareness, treatment and control of hypercholesterolaemia based on risk- specific LDL-C goal were determined, including the use of lipid-lowering therapy (LLT). Cox-regression models were used to identify predictors of LDL-C above goal among those who were aware and unaware of hypercholesterolaemia.

RESULTSOne thousand five hundred and sixty-eight (30.8%) participants were aware of hypercholesterolaemia and 877 (17.3%) were newly diagnosed (unaware). For those who were aware, 39.3% participants received LLT. Among those with 2 risk factors, only 59.7% attained LDL-C goal. The majority of them were taking statin monotherapy, and the median dose of statins was similar across all CHD risk categories. Among participants with 2 risk factors and not receiving LLT, 34.1% would require LLT. Malays or Asian-Indians, higher CHD risk category, increasing body mass index (BMI), current smoking and lower education status were associated with higher risk of LDL-C above goal. Being on LLT reduced the risk of having LDL-C above goal.

CONCLUSIONThe burden of hypercholesterolaemia is high in this multi-ethnic population especially those in the higher CHD risk categories, and might be partly contributed by inadequate titration of statins therapy. Raising awareness of hypercholesterolaemia, appropriate LLT initiation and titration, weight management and smoking cessation may improve LDL-C goal attainment in this population.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cholesterol, LDL ; blood ; Cross-Sectional Studies ; Female ; Humans ; Hypercholesterolemia ; blood ; epidemiology ; prevention & control ; Male ; Middle Aged ; Practice Guidelines as Topic ; Prevalence ; Singapore ; epidemiology ; Young Adult

OBJECTIVETo evaluate the effect of 3-month kale (Brassica oleracea acephala) juice supplementation on coronary artery disease risk factors among hypercholesterolemic men.

METHODSThirty-two men with hypercholesterolemia (> 200 mg/dL) were recruited after annual health examinations among the faculty and staff at university. The subjects consumed 150 mL of kale juice per day for a 12-week intervention period. Dietary and anthropometric assessments were performed and blood samples were collected to evaluate biochemical profiles before and after supplementation.

RESULTSSerum concentrations of HDL-cholesterol, and HDL- to LDL-cholesterol ratio were significantly increased by 27% (P<0.0001) and 52% (P<0.0001), respectively. The LDL-cholesterol concentration and the atherogenic index were significantly reduced by 10% (P=0.0007) and 24.2% (P<0.0001), respectively without affecting body mass index, waist and hip circumferences, or nutrient intakes after three months of supplementation. While there was no difference in the concentration of malondialdehyde, significant increase in glutathione peroxidase activity (P=0.0005) were accompanied by a significant increase in the serum selenium level (P=0.0132). It was also found that the responses of these risk factors to kale juice administration were dependent on smoking status.

CONCLUSIONRegular meals supplementation with kale juice can favorably influence serum lipid profiles and antioxidant systems, and hence contribute to reduce the risks of coronary artery disease in male subjects with hyperlipidemia.

Adult ; Antioxidants ; metabolism ; Beverages ; Brassica ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Coronary Artery Disease ; complications ; epidemiology ; prevention & control ; Glutathione Peroxidase ; blood ; Humans ; Hypercholesterolemia ; complications ; Lipid Peroxidation ; Male ; Middle Aged ; Risk Factors ; Spectrophotometry, Atomic ; Trace Elements ; blood

The American College of Cardiology and the American Heart Association (ACC/AHA) 2013 joint guidelines for the treatment of hypercholesterolemia expand the indications for statin therapy. This study was performed to estimate the numbers of diabetic patients indicated for statin therapy according to the Third Adult Treatment Panel (ATP-III) of the National Cholesterol Education Program guidelines and the new ACC/AHA guidelines in Korea. We analyzed the data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012. Patients with diabetes over 30 yr of age were analyzed by the two guidelines. Of the total 1,975 diabetic patients, only 377 (19.1%) were receiving drugs for dyslipidemia. Among 1,598 patients who had not taken any medications for dyslipidemia, 65.6% would be indicated for statin therapy according to the ATP-III guidelines. When we apply the new guidelines, 94.3% would be eligible for statin therapy. Among the total diabetic patients, the new guidelines, compared with the ATP-III guidelines, increase the number eligible for statin therapy from 53.1% to 76.2%. The new guidelines would increase the indication for statin therapy for most diabetic patients. At present, many diabetic patients do not receive appropriate statin therapy. Therefore efforts should be made to develop the Korean guidelines and to ensure that more diabetic patients receive appropriate statin therapy.
Adult ; Aged ; Animals ; Cardiology/*standards ; Causality ; Comorbidity ; Diabetes Mellitus/drug therapy/*epidemiology ; Female ; Guideline Adherence/utilization ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use ; Hypercholesterolemia/*epidemiology/*prevention & control ; Male ; Middle Aged ; *Practice Guidelines as Topic ; Prevalence ; Republic of Korea/epidemiology ; Risk Assessment ; United States/epidemiology

Participation in a screening program by itself may not improve clinical outcomes. Treatment gaps in the program may limit its full benefit. We evaluated statin prescription rates for subjects with sustained hypercholesterolemia to assess the treatment gaps in the National Health Screening Program (NHSP) in Korea. A retrospective, random cohort was established among National Health Insurance Corporation (NHIC) members. Finally, we examined 465,499 individuals who attended the NHSP from 2003 to 2010 without any history of dyslipidemia, statin prescription, or hospitalization for cardiovascular events until the end of 2002. The subsequent statin prescription rates were identified from the NHIC medical service claim database from 2003 to 2011. Descriptive data and odds ratio from multivariate logistic analyses on statin prescription rates and the corresponding correlations were evaluated. The NHSP detected 114,085 (24.5%) cases of newly diagnosed hypercholesterolemia. However, only 8.6% of these received statin prescription within 6 months of diagnosis. For cases of sustained hypercholesterolemia determined in the next screening visit by the NHSP, the statin prescription rate increased, but only to 12.2%. Statin prescriptions were more common among females, older individuals, and hypertension or diabetes patients. Furthermore, the statin prescription rates had increased over the study period. The NHSP exhibited low statin prescription rate which has been improving. For the NHSP to be effective, it would be worthwhile to decrease the gap between the diagnosis of hypercholesterolemia and the following treatment.
Adult ; Chronic Disease ; Drug Prescriptions/statistics & numerical data ; Female ; Health Services Accessibility/statistics & numerical data ; Healthcare Disparities/*statistics & numerical data ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use ; Hypercholesterolemia/*diagnosis/epidemiology/*prevention & control ; Insurance Claim Reporting/statistics & numerical data ; Male ; Mass Screening/*utilization ; Middle Aged ; National Health Programs/*utilization ; Prevalence ; Republic of Korea/epidemiology ; Risk Assessment ; Treatment Outcome ; Young Adult

OBJECTIVES: This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. METHODS: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP > or =140 mmHg, a diastolic BP > or =90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. RESULTS: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. CONCLUSIONS: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Ambulatory Care Facilities ; Antihypertensive Agents/therapeutic use ; Blood Pressure ; Diabetes Complications ; Female ; Humans ; Hypercholesterolemia/complications ; Hypertension/drug therapy/epidemiology/*prevention & control ; Interviews as Topic ; Logistic Models ; Male ; Middle Aged ; Obesity/complications ; Republic of Korea ; Risk Factors ; Rural Population ; Sex Factors ; Stress, Psychological/complications