2.Sex- and Age-Specific Trends in Cardiovascular Health in Korea, 2007–2018
So Mi Jemma CHO ; Hokyou LEE ; Hyeon Chang KIM
Korean Circulation Journal 2021;51(11):922-935
		                        		
		                        			 Background and Objectives:
		                        			We illustrated sex- and age-specific temporal trends in cardiovascular health among Korean adults. 
		                        		
		                        			Methods:
		                        			From the Korean National Health and Nutrition Examination Survey 2007–2018, we included 61,408 participants aged 20 years or older. The ideal levels of 6 components of cardiovascular health metrics were defined as never-smoking, ≥75 min/week of vigorous or ≥150 min/week of moderate-to-vigorous physical activity, body mass index (BMI) <23 kg/ m2 , total cholesterol <200 mg/dL, blood pressure (BP) <120/80 mmHg, and fasting glucose <100 mg/dL. Temporal trends in the number of ideal cardiovascular health components and distribution of each component were assessed by sex and age. 
		                        		
		                        			Results:
		                        			The average number of ideal cardiovascular health components decreased from 3.37 in 2007–2009 to 2.86 in 2016–2018. Never smoking increased from 56.0% to 59.2%, largely contributed by young men. Ideal physical activity halved (41.4–21.3%); such decline was more pronounced in women and with older age. Ideal BMI decreased from 44.3% to 42.2%, more apparently in young and elderly men. In contrast, ideal BMI increased in middle-aged and elderly women. Ideal cholesterol decreased from 65.5% to 50.3%, profoundly in young adults and relatively greater in men. Ideal BP declined from 55.1% to 46.9%, more evidently in men.However, ideal BP discernibly increased in middle-aged women. Ideal glucose decreased from 74.6% to 66.0%, comparatively greater and earlier in men. 
		                        		
		                        			Conclusions
		                        			The proportion of Korean adults with ideal cardiovascular health decreased between 2007 and 2018, but the course of responsible factors differed across sex and age groups. 
		                        		
		                        		
		                        		
		                        	
3.Dyslipidemia Fact Sheets in Korea 2020: an Analysis of Nationwide Population-based Data
So Mi Jemma CHO ; Hokyou LEE ; Hyeok-Hee LEE ; Jongmin BAEK ; Ji Eun HEO ; Hyung Joon JOO ; Soon Jun HONG ; Hyeon Chang KIM ;
Journal of Lipid and Atherosclerosis 2021;10(2):202-209
		                        		
		                        			Objective:
		                        			The Korean Society of Lipid and Atherosclerosis (KSoLA) has published the Dyslipidemia Fact Sheets in Korea 2020 to provide an overview of magnitude and management status of dyslipidemia and their recent trends therein. 
		                        		
		                        			Methods:
		                        			The Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 2007–2018 Korea National Health and Nutrition Examination Survey (KNHANES) and the 2002–2018 National Health Insurance Big Data (NHI-BD). 
		                        		
		                        			Results:
		                        			Between 2007 and 2018, the crude prevalence of hypercholesterolemia increased from 9.0% to 20.7%. During the same period, its management rate also improved yet remained unsatisfactory. In 2018, the prevalence of dyslipidemia was 45.6% in men and 31.3% in women, which increased with older age and presence of metabolic abnormalities.Indeed, the number of people diagnosed with dyslipidemia has increased nearly 8-fold from 1.5 million in 2002 to 11.6 million in 2018; alongside, the number of people receiving pharmacological treatment for dyslipidemia has also risen. Of the 7.7 million people treated for dyslipidemia in 2018, statin accounted for the majority (91.8%) of lipid-lowering drug prescriptions, followed by ezetimibe (14.6%), fibrate (8.5%), and omega-3 acid (5.9%). The most frequently used combination therapy was statin plus ezetimibe, accounting for 72% of dual therapy prescriptions. 
		                        		
		                        			Conclusion
		                        			Dyslipidemia continues to impose a substantial disease burden in Korea. Both healthcare practitioners and patients need to actively adopt guideline-recommended lifestyle modification and pharmacological treatment for comprehensive, timely, and sustained management.
		                        		
		                        		
		                        		
		                        	
4.Thirty-six Year Trends in Mortality from Diseases of Circulatory System in Korea
Jongmin BAEK ; Hokyou LEE ; Hyeok-Hee LEE ; Ji Eun HEO ; So Mi Jemma CHO ; Hyeon Chang KIM
Korean Circulation Journal 2021;51(4):320-332
		                        		
		                        			Background and Objectives:
		                        			Understanding the trends in cardiovascular disease (CVD) mortality is important for developing burden reduction strategies. Based on the Cause of Death Statistics, we examined the changing patterns of CVD mortality in Korea between 1983 and 2018. 
		                        		
		                        			Methods:
		                        			Causes of death were coded according to the International Classification of Disease, 10th revision. Deaths from all diseases of circulatory system (I00-I99) and the following 6 subcategories were analyzed: total heart diseases (I00-I13 and I20-I51), hypertensive heart diseases (I10-I13), ischemic heart diseases (I20-I25), myocardial infarction (I21-I23), heart failure (I50), and cerebrovascular diseases (I60-I69). Crude, age-standardized, and age-stratified rates were calculated to assess temporal trends in CVD mortality. 
		                        		
		                        			Results:
		                        			The number of deaths and crude mortality rate for all diseases of circulatory system increased recently mainly due to the population ageing. Specifically, total heart diseases showed increasing trend, whereas cerebrovascular diseases showed decreasing trend. Between 1983 and 2018, age-standardized mortality rates significantly declined for all diseases of circulatory system, total heart diseases, hypertensive heart diseases, and cerebrovascular diseases. Age-standardized mortality rates for ischemic heart diseases and myocardial infarction peaked in the early 2000s then decreased thereafter. However, agestandardized mortality rate for heart failure rapidly increased, especially in recent years. 
		                        		
		                        			Conclusions
		                        			CVD mortality in Korea has remarkably decreased over the last 36 years.However, the recent rise in the absolute number of deaths from heart diseases, especially from heart failure, calls for attention in prevention and management of CVD and its sequelae.
		                        		
		                        		
		                        		
		                        	
5.Korea Heart Disease Fact Sheet 2020:Analysis of Nationwide Data
Hyeok-Hee LEE ; So Mi JEMMA CHO ; Hokyou LEE ; Jongmin BAEK ; Jang-Ho BAE ; Wook-Jin CHUNG ; Hyeon Chang KIM
Korean Circulation Journal 2021;51(6):495-503
		                        		
		                        			Background and Objectives:
		                        			Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. To provide an overview of the temporal trends in the burden of CVD, the Korean Society of Cardiology has published the Korea Heart Disease Fact Sheet in 2020. 
		                        		
		                        			Methods:
		                        			We analyzed anonymized data of the Causes of Death Statistics, National Health Insurance Claims Database, and Korea National Health and Nutrition Examination Survey to assess mortality, hospitalizations, and risk factors for CVD. 
		                        		
		                        			Results:
		                        			The CVD mortality decreased until 2010, then steadily increased up to 123 per 100,000 persons in 2018. Since 2002, the number and rate of CVD hospitalization have continued to grow. In 2018, approximately 12.1 million Korean adults had hypertension, 4.3 million had diabetes, 8.7 million had hypercholesterolemia, 14.9 million had obesity, and 8.8 million were currently smoking. The number of risk factors increased markedly with older age; 58.4% of adults age ≥70 years had ≥2 risk factors. 
		                        		
		                        			Conclusions
		                        			CVD mortality and hospitalization have gradually increased in the last decade, and a substantially high proportion of adults were carrying more than 1 cardiovascular risk factor in 2018. With the rapid population aging, a continued increase in CVD appears inevitable in Korea. Concerted and sustained approaches are essential to achieve early prevention and reduce the burden of CVD.
		                        		
		                        		
		                        		
		                        	
6.Thirty-six Year Trends in Mortality from Diseases of Circulatory System in Korea
Jongmin BAEK ; Hokyou LEE ; Hyeok-Hee LEE ; Ji Eun HEO ; So Mi Jemma CHO ; Hyeon Chang KIM
Korean Circulation Journal 2021;51(4):320-332
		                        		
		                        			Background and Objectives:
		                        			Understanding the trends in cardiovascular disease (CVD) mortality is important for developing burden reduction strategies. Based on the Cause of Death Statistics, we examined the changing patterns of CVD mortality in Korea between 1983 and 2018. 
		                        		
		                        			Methods:
		                        			Causes of death were coded according to the International Classification of Disease, 10th revision. Deaths from all diseases of circulatory system (I00-I99) and the following 6 subcategories were analyzed: total heart diseases (I00-I13 and I20-I51), hypertensive heart diseases (I10-I13), ischemic heart diseases (I20-I25), myocardial infarction (I21-I23), heart failure (I50), and cerebrovascular diseases (I60-I69). Crude, age-standardized, and age-stratified rates were calculated to assess temporal trends in CVD mortality. 
		                        		
		                        			Results:
		                        			The number of deaths and crude mortality rate for all diseases of circulatory system increased recently mainly due to the population ageing. Specifically, total heart diseases showed increasing trend, whereas cerebrovascular diseases showed decreasing trend. Between 1983 and 2018, age-standardized mortality rates significantly declined for all diseases of circulatory system, total heart diseases, hypertensive heart diseases, and cerebrovascular diseases. Age-standardized mortality rates for ischemic heart diseases and myocardial infarction peaked in the early 2000s then decreased thereafter. However, agestandardized mortality rate for heart failure rapidly increased, especially in recent years. 
		                        		
		                        			Conclusions
		                        			CVD mortality in Korea has remarkably decreased over the last 36 years.However, the recent rise in the absolute number of deaths from heart diseases, especially from heart failure, calls for attention in prevention and management of CVD and its sequelae.
		                        		
		                        		
		                        		
		                        	
7.Korea Heart Disease Fact Sheet 2020:Analysis of Nationwide Data
Hyeok-Hee LEE ; So Mi JEMMA CHO ; Hokyou LEE ; Jongmin BAEK ; Jang-Ho BAE ; Wook-Jin CHUNG ; Hyeon Chang KIM
Korean Circulation Journal 2021;51(6):495-503
		                        		
		                        			Background and Objectives:
		                        			Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. To provide an overview of the temporal trends in the burden of CVD, the Korean Society of Cardiology has published the Korea Heart Disease Fact Sheet in 2020. 
		                        		
		                        			Methods:
		                        			We analyzed anonymized data of the Causes of Death Statistics, National Health Insurance Claims Database, and Korea National Health and Nutrition Examination Survey to assess mortality, hospitalizations, and risk factors for CVD. 
		                        		
		                        			Results:
		                        			The CVD mortality decreased until 2010, then steadily increased up to 123 per 100,000 persons in 2018. Since 2002, the number and rate of CVD hospitalization have continued to grow. In 2018, approximately 12.1 million Korean adults had hypertension, 4.3 million had diabetes, 8.7 million had hypercholesterolemia, 14.9 million had obesity, and 8.8 million were currently smoking. The number of risk factors increased markedly with older age; 58.4% of adults age ≥70 years had ≥2 risk factors. 
		                        		
		                        			Conclusions
		                        			CVD mortality and hospitalization have gradually increased in the last decade, and a substantially high proportion of adults were carrying more than 1 cardiovascular risk factor in 2018. With the rapid population aging, a continued increase in CVD appears inevitable in Korea. Concerted and sustained approaches are essential to achieve early prevention and reduce the burden of CVD.
		                        		
		                        		
		                        		
		                        	
8.Dyslipidemia Fact Sheets in Korea 2020: an Analysis of Nationwide Population-based Data
So Mi Jemma CHO ; Hokyou LEE ; Hyeok-Hee LEE ; Jongmin BAEK ; Ji Eun HEO ; Hyung Joon JOO ; Soon Jun HONG ; Hyeon Chang KIM ;
Journal of Lipid and Atherosclerosis 2021;10(2):202-209
		                        		
		                        			Objective:
		                        			The Korean Society of Lipid and Atherosclerosis (KSoLA) has published the Dyslipidemia Fact Sheets in Korea 2020 to provide an overview of magnitude and management status of dyslipidemia and their recent trends therein. 
		                        		
		                        			Methods:
		                        			The Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 2007–2018 Korea National Health and Nutrition Examination Survey (KNHANES) and the 2002–2018 National Health Insurance Big Data (NHI-BD). 
		                        		
		                        			Results:
		                        			Between 2007 and 2018, the crude prevalence of hypercholesterolemia increased from 9.0% to 20.7%. During the same period, its management rate also improved yet remained unsatisfactory. In 2018, the prevalence of dyslipidemia was 45.6% in men and 31.3% in women, which increased with older age and presence of metabolic abnormalities.Indeed, the number of people diagnosed with dyslipidemia has increased nearly 8-fold from 1.5 million in 2002 to 11.6 million in 2018; alongside, the number of people receiving pharmacological treatment for dyslipidemia has also risen. Of the 7.7 million people treated for dyslipidemia in 2018, statin accounted for the majority (91.8%) of lipid-lowering drug prescriptions, followed by ezetimibe (14.6%), fibrate (8.5%), and omega-3 acid (5.9%). The most frequently used combination therapy was statin plus ezetimibe, accounting for 72% of dual therapy prescriptions. 
		                        		
		                        			Conclusion
		                        			Dyslipidemia continues to impose a substantial disease burden in Korea. Both healthcare practitioners and patients need to actively adopt guideline-recommended lifestyle modification and pharmacological treatment for comprehensive, timely, and sustained management.
		                        		
		                        		
		                        		
		                        	
9.Comparison and Implication of the Contemporary Blood Pressure Guidelines on Korean Population
So Mi Jemma CHO ; Hokyou LEE ; Hyeon Chang KIM
Korean Circulation Journal 2020;50(6):485-498
		                        		
		                        			 Background and Objectives:
		                        			This study compared the potential impacts of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 Korean Society of Hypertension (KSH) guidelines on prevalence of hypertension, recommended antihypertensive treatment, and achievement of target blood pressure (BP) in Korean population. 
		                        		
		                        			Methods:
		                        			We analyzed the 2007–2017 Korea National Health and Nutrition Examination Survey data to calculate guideline-specific hypertension prevalence and treatment implications on 59,767 adults aged 20 years or older by sex and age. 
		                        		
		                        			Results:
		                        			The prevalence of hypertension was markedly higher 46.3% by the ACC/AHA guideline due to the lowered BP cutoff than 25.9% by the KSH guideline; the increase was most pronounced in young adults. Yet, there was only a marginal 1.6% increase in the percentage of adults suggested pharmacological approach by the ACC/AHA guideline, but selectively in the older subgroups. Overall, 45.6% of Korean adults treated for hypertension failed to meet BP goal according to the KSH guideline; the underachievement extended to 61.7% of participants according to the ACC/AHA guideline. 
		                        		
		                        			Conclusions
		                        			The lowered BP threshold, 130/80 mmHg, by the 2017 ACC/AHA guideline, in conjuncture with 10-year risk calculation largely driven by age, would increase pharmacological treatment preferentially in very old individuals, while increasing prevalence and uncontrolled rate mostly in younger subgroups. Adoption of lower BP cutoff to the KSH guideline would require validated cardiovascular disease risk assessment tools accounting for risk distributions specific to Korean population. 
		                        		
		                        		
		                        		
		                        	
10.Association of social network size and composition with physical activity in Korean middle-aged adults
Moon Su KWAK ; So Mi Jemma CHO ; Jee-Seon SHIM ; Dae Jung KIM ; Yoosik YOUM ; Hyeon Chang KIM
Epidemiology and Health 2020;42(1):e2020070-
		                        		
		                        			OBJECTIVES:
		                        			Physical activity (PA) is an established protective factor for many chronic diseases. Numerous studies have established positive relationships between social networks and PA. Accordingly, this study examined the relationship between social network structures (specifically the network size and the number and proportion of same-sex alters) and self-reported PA in Korean middle-age adults, where the term “alter” refers to a respondent’s social network members. 
		                        		
		                        			METHODS:
		                        			We analyzed 8,092 participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. We assessed the association between each network structure variable and PA level using a linear regression model. Then, we employed logistic regression to evaluate associations between social network structure and adherence to guideline-recommended exercise levels. Socio-demographic factors and health status measures were used as covariates. 
		                        		
		                        			RESULTS:
		                        			In both sexes, the social network size and proportion of same-sex network members showed positive relationships with total and moderate-to-vigorous PA. Notably, female participants with a greater number of kin were more likely to satisfy the recommended amount of total PA. 
		                        		
		                        			CONCLUSIONS
		                        			These findings suggest that large scale, same-sex intervention programs can help to achieve recommended PA regimens.
		                        		
		                        		
		                        		
		                        	
            
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