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Open Access Publications from the University of California

Scholarly Works (4 results)

  • Thesis
  • Peer Reviewed
UC San Francisco Electronic Theses and Dissertations (2011)

Background. More women than men die of cardiovascular disease (CVD) in Korea. Of important concern to Korean women is the dramatically increasing mortality rate from coronary heart disease (CHD). Despite the significant burden of CHD in Korean women and its adverse impact on national public health, women have received little attention in cardiac research in Korea.

Purpose. The purposes of this study were to: (1) describe the prevalence of cardiovascular risk factors in Korean women, (2) estimate the 10-year risk for CHD, and (3) evaluate the proportion of women who need to be treated based on the American Heart Association (AHA) evidence-based guidelines for CVD prevention.

Methods. A cross-sectional design using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV was used. The sample was 3,301 asymptomatic women aged 20 years or older. Ten-year risk for CHD was estimated with the Framingham Risk Score. Korean women were classified into three risk subgroups. The proportion of women who were in need of treatment for each subgroup was presented.

Results. About 35% of Korean women had two or more major modifiable risk factors for CHD. Among Korean women free of CVD, 97.4% had a 10-year risk for CHD of < 10%, 2.4% had a risk of 10 to 20%, and 0.2% had a risk of > 20%. About 75% of Korean women in the high risk group were in need of lipid lowering treatment, but only 10.9% of them were receiving treatment.

Conclusions. Modifiable cardiovascular risk factors were highly prevalent among asymptomatic Korean women of all ages, and the clustering of risk factors was common. Ten-year risk for developing CHD risk in Korean women was comparable to that of women in the U.S. However, the proportion of Korean women who were not at AHA guideline goals was substantial. Furthermore, there was a significant treatment gap in Korean women. The findings of this study suggest that Korean women free of CVD need to be treated more intensively. Aggressive risk reduction efforts are urgently needed to prevent CHD in Korean women.

    Cover page: Cardiovascular Risk Factors and 10-year Risk for Coronary Heart Disease Among Korean Women
    • Article
    • Peer Reviewed
    UC Irvine Previously Published Works (2020)
    In Korea, a substantial proportion of long-term care insurance (LTCI) beneficiaries die within 1 year of seeking the benefit. This study was conducted to evaluate the pattern of medical care use and care cost during the last year of life among Korean LTCI beneficiaries between 2009 and 2013 using the national claims data. The National Health Insurances Senior (NHIS-Senior) cohort was used for this retrospective study. The participants were LTCI beneficiaries aged 65 or over as of 2008 who died between 2009 and 2013 (N = 30,433). Medical costs during the last year of life were highest for those who used both medical care services and long-term care (LTC) services and increased as death approached. About half of the participants were hospitalized at the time of death. The use of LTC services at the time of death increased from 13.0 to 22.8%, while those who died at home decreased from 34 to 20%. This study suggests that the use of LTC services did not reduce medical costs by substituting unnecessary inpatient hospitalization. Quality of dying should be considered one of the goals of older adult care, and provisions should be made for palliative care at home or LTC facilities.
      Cover page: Cost of Care and Pattern of Medical Care Use in the Last Year of Life among Long-Term Care Insurance Beneficiaries in South Korea: Using National Claims Data.
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2017)
      Patients with rheumatoid arthritis are at increased risk for cardiovascular disease. The prerequisites for reducing the risk of cardiovascular disease are adequate levels of knowledge and being aware of the risk. In this study, the levels of knowledge about cardiovascular disease among patients with rheumatoid arthritis and the perception were evaluated in relation to their actual 10-year risk of cardiovascular disease. This cross-sectional study of 200 patients with rheumatoid arthritis was conducted in a university-affiliated hospital in South Korea. The patients' actual risk of cardiovascular disease was estimated using the Framingham Risk Score. The most common risk factor was physical inactivity, with 77% of the patients not engaging in regular exercise. The patients lacked knowledge about the effects of physical inactivity and anti-inflammatory medication on the development of cardiovascular disease. Misperceptions about the risk of cardiovascular disease were common, i.e., 19.5% of the patients underestimated their risk and 41% overestimated. Hypertension, diabetes, obesity, and smoking were the most prevalent among the patients who underestimated their risk, and these same patients had the lowest level of knowledge about cardiovascular disease. This study demonstrated the rheumatoid arthritis patients' lack of knowledge about the effects of physical inactivity and anti-inflammatory medications on the development of cardiovascular disease, and their misperception of cardiovascular risk was common. As a preventive measure, educational programs about cardiovascular disease should be tailored specifically for patients with rheumatoid arthritis, and behavioral interventions, including routine exercise, should be made available at the time of diagnosis.
        Cover page: Knowledge and perception of cardiovascular disease risk among patients with rheumatoid arthritis
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2016)
        The purposes of this study were to compare the perceived and actual 10-year risk for cardiovascular disease (CVD) and to evaluate the influence of cardiovascular risk factors on perceived CVD risk in patients with rheumatoid arthritis (RA) in Korea. Additionally, the attainment of CVD prevention guideline goals by 3 levels of CVD risk (low, moderate, and high) was presented.For this cross-sectional study, data were collected from 208 patients with RA. Actual CVD risk was estimated with the Systematic Coronary Risk Evaluation (SCORE), and goal attainment was assessed based on the European League Against Rheumatism guidelines. Actual CVD risk and perceived risk were compared with cross-tabulation. Chi-square tests were used to evaluate differences in cardiovascular risk factors by perceived risk. Levels of goal attainment were presented in percentages.Among patients with RA, 13.9% were identified as being at high risk for CVD, whereas 39.9% were at moderate risk, and 46.2% were at low risk. The majority of those at high risk (96.6%) underestimated their risk for CVD. The use of antihypertensive or lipid-lowering medications and having a parental history of CVD significantly increased the likelihood that subjects with RA would perceive themselves as being at high risk for CVD. Diabetes, smoking, physical inactivity, and obesity did not affect perceived risk. A substantial proportion of the subjects with RA did not meet the prevention guideline goals.Patients with RA who are at increased risk of developing CVD must be managed as soon as possible to attain the guideline goals and, accordingly, lower their risk of future CVD.
          Cover page: Perceived and actual risk of cardiovascular disease in patients with rheumatoid arthritis in Korea
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