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Clinical Utility of Novel Biomarkers in the Prediction of Coronary Heart Disease
김현창 대한심장학회 2012 Korean Circulation Journal Vol.42 No.4
Coronary heart disease (CHD) is a significant cause of morbidity and mortality worldwide. Many risk prediction models have been developed in an effort to assist clinicians in risk assessment and the prevention of CHD. However, it is unclear whether the existing CHD prediction tools can improve clinical performance, and recently, there has been a lot of effort being made to improve the accuracy of the prediction models. A large number of novel biomarkers have been identified to be associated with cardiovascular risk, and studied with the goal of improving the accuracy and clinical utility of CHD risk prediction. Yet, controversy still remains with regard to the utility of novel biomarkers in CHD risk assessment, and in finding the best statistical methods to assess the incremental value of the biomarkers. This article discusses the statistical approaches that can be used to evaluate the predictive values of new biomarkers, and reviews the clinical utility of novel biomarkers in CHD prediction, specifically in the Korean population.
Noncommunicable Diseases: Current Status of Major Modifiable Risk Factors in Korea
김현창,오선민 대한예방의학회 2013 예방의학회지 Vol.46 No.4
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.
Korea hypertension fact sheet 2018
김현창,Myeong Chan Cho 대한고혈압학회 2019 Clinical Hypertension Vol.25 No.1
Background: The Korea Hypertension Fact Sheet 2018 aims to overview the magnitude and management status of hypertension, and their trends in Korea. Methods: The Hypertension Epidemiology Research Group analyzed the 1998–2016 Korea National Health and Nutrition Examination Survey data and the 2002–2016 Korea National Health Insurance Big Data. Results: The population average of systolic/diastolic blood pressure was 118/77 mmHg among Korean adults (age 30+) in 2016, showing little change in recent 10 years. However, the number of people with hypertension increased steadily, exceeding 11 million. The number of people diagnosed with hypertension increased from 3 million in 2002 to 8.9 million in 2016. The number of people using antihypertensive medication increased from 2.5 million in 2002 to 8.2 million in 2016. However, only 5.7 million people are being treated constantly. Hypertension awareness, treatment, and control rates increased fast until 2007, but showed a plateau thereafter. More than half of the young hypertensive patients (30–49 years) did not know about and treat for their hypertension. Among patients prescribed antihypertensive medications, 45% was elderly people over the age of 65 years, 57% used anti-diabetic or cholesterollowering medications, and 60% were prescribed two or more class of antihypertensive medications simultaneously. Conclusions: In Korea, the level of hypertension management has considerably improved over the last 20 years. In order to achieve further improvement in hypertension management status, we need to find the vulnerable subgroups and develop subgroup-specific intervention strategies. It is also becoming more important to manage hypertensive patients at older age and those with concurrent chronic diseases.