Background The association between life-event stressors and low physical activity linked to the severity of coronary artery disease (CAD) is poorly understood. Therefore, this study aimed to determine the perceived stress status and physical activity level associated with the severity of CAD.
Methods The study was conducted among 423 patients with newly discovered CAD (both sexes, aged 35–65 years) confirmed by coronary angiography results. CAD severity was classified according to the Gensini score as severe or non-severe. The fasting blood glucose and lipid profiles were also investigated. Anthropometric and brachial blood pressure measurements were obtained. A structured questionnaire including participants’ characteristics, the Perceived Stress Scale (PSS-14), and the International Physical Activity Questionnaire were used via face-to-face interviews. Multivariable binary logistic regression was used to assess the predictors of CAD severity using IBM SPSS ver. 24.0 (IBM Corp., Armonk, NY, USA).
Results Most participants were classified as having severe CAD (63.8%). Adjusting for age, sex, smoking status, systolic blood pressure, body mass index, and history of hypertension, the severity of CAD increased by 9% for a onescore increase in the PSS (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.01–1.14; P=0.030). Moreover, sufficiently active (600–1,500 metabolic equivalents [METs]/wk) patients had lower odds of severe CAD (OR, 0.43; 95% CI, 0.23–0.72; P=0.027) than those with insufficient activity. However, no significant association was found between physical activity (≥1,500 METs/wk) and CAD severity.
Conclusion The odds of CAD severity significantly increased with increasing perceived stress score but decreased with sufficient physical activity.
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Background : The success rate of smoking cessation by patients with coronary artery disease is lower than expected and reportedly this rate increases once doctors intervene. The purpose of this study is to help doctors mediate their patients to quit smoking by investigating of smoking behavior following the diagnosis of coronary artery disease and promoting methods of smoking cessation with knowledge of factors influencing smoking cessation.
Methods : A total of 245 male coronary artery disease patients confirmed by coronary angiography in two university hospitals located in Seoul participated in the survey.
Results : The smoking cessation rate among the subjects for more than one year was 39.6%. More than 90% of the subjects were aware of the doctors warning about smoking, but no more than 6% of them heard how to actually stop smoking from their doctors. In the smoking cessation group the stress score was lower and the exercise performance rate was higher than the smoking group. Logistic regression analysis revealed the abstinence group succeeded in smoking cessation at higher rate than the drinking group (odds ratio 0.30; 95% confidence interval 0.14 to 0.65).
Conclusion : In recommending that a patient quit smoking, doctors should inform patients that drinking could be a detrimental factor and should promote a smoking cessation program including exercise and stress control. Doctors should educate patients that smoking cessation program will be more effective than sheer will power.
Background : Cardiovascular risk factors have been divided into 2 categories, modifiable risk factors, and nonmodifiable risk factors. Clustering of risk factors may increase the risk of CAD more than any of the factors alone and often related to each other. We conducted this study to examine clustering of modifiable risk factors, to analyse associated factors with the clustering of metabolic risk factors, and to evaluate the risk of CAD according to the number of cardiovascular risk factors.
Methods : The case series comprised of 166 patients with angiographically confirmed coronary artery disease, who were admitted to the Division of Cardiology of a Medical Center in Seoul. The controls were 137 persons composed of patients with normal coronary arteriogram or patients with normal myocardial SPECT for chest pain. We surveyed their life style habits, measured anthropometric variables, and analyzed biochemical markers among CAD patients and controls.
Results : Modifiable risk factors, smoking, hypertension, diabetes, hypercholesterolemia, and low HDL-C were clustering each others among middle-aged Korean. Clustering of metabolic risk factors, hypertension, diabetes, hyperchesterolemia, and low HDL-C were associated with white-collar group, low physical activity, non-exercise, high BMI(body mass index) and high WHR(waist-hip ratio). The odds ratios for CAD in men with 3, 4, more than 5 risk factors were 2.0(95% CI:0.9-4.5), 2.9(95% CI:1.2-6.7), and 12.2(95% CI:3.5-42.0) respectively, compared with men with less than 2 risk factors. The corresponding odds ratios in women were 3.4(95% CI:1.3-9.0), 4.1(95% CI:1.2-13.5), and 4.5(95% CI:1.0-21.5) respectively.
Conclusion : There findings show that modifiable cordiovascular risk factors cluster among middle-aged Korean. The more the cardivascular risk factors, the higher the CAD risk in men and not only for clustering cardiovascular risk factors but also for CAD risk.
Background : The waist/hip ratio is an useful index of abdominal obesity, but it includes two variables which may result in a false interpretation. The purpose of this study is to evaluate the usefulness of waist/height ratio as a predictor for the risk factors of coronary artery disease(CAD).
Methods : 1395 persons(818 men & 577 women) were selected as subjects who visited the Health Examination Center at Ewha Mokdong Hospital from October 1996 to March 1997. Waist circumference was measured at the level of umbilicus with standing position. Hip circumference was measured at the level of the largest circumference of the hip. We set the criteria of the risk factors as hypertension(systolic BP≥140mmHg and/or diastolic BP≥90mmHg), glucose intolerance(fasting blood glucose≥115mg/dl), hypertriglyceridemia(>160mg/dl), hypercholesterolemia(≥200mg/dl), and low HDL-cholesterol level(<35mg/dl). The morbidity index of CAD was calculated by the sum of the risk factor scores(one point per item if present).
Results : There was significant correlation between waist/height ratio, waist/hip ratio and body mass index(BMI)(p=0.0001). BMI had more strong correlation with waist/height ratio(r=0.81) than waist/hip ratio(r=0.48). According to the simple regression analysis, BMI, waist/hip ratio and waist/height ratio had significant correlation with all of the risk factors and the morbidity index. According to the multiple regression analysis, waist/height ratio had significant correlation with age, weight, height, systolic BP, triglyceride, cholesterol and HDL-cholesterol. The risk factor morbidity index of the groups with waist/height ratio over 0.45 was significantly more higher than the group of the lowest risk factor morbidity index(waist/height ratio under 0.4) in men(p=0.01). For women, 0.46 was the level which the risk factor morbidity index increased significantly(p<0.01).
Conclusion : Waist/height ratio can be a useful index of abdominal obesity. And it may be used as a more easier and better predictor of multiple CAD risk factors than waist/hip ratio. We can predict that waist/height ratio over 0.45 in men and over 0.46 in women may have more higher coronary artery disease risk.
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