혈중 납이 비흡연자들의 혈압에 미치는 영향

박윤숙,박상신,김태훈,이상윤,고영림,이은희,Pak, Yun-Suk,Park, Sang-Sin,Kim, Tae-Hun,Lee, Sang-Yoon,Kho, Young-Lim,Lee, Eun-Hee 한국환경보건학회 2012 한국환경보건학회지 Vol.38 No.4

Objective: The effect of lead on blood pressure remains controversial in spite of the numerous studies which have been conducted in the recent years. The aim of this study was to evaluate the effects of exposure to lead on blood pressure among non-smokers. Methods: In this cross sectional study, 1416 male and female non-smokers were enrolled, aged 20 years or older, from the Korean National Health and Nutrition Examination Survey 2008. Blood pressure, blood lead levels (BLLs), height, weight, and cotinine level were measured for all subjects. Results: Geometric mean BLLs of the participants was 2.20 ${\mu}g$/dl. BLLs were higher in the older, male, and lower education groups than the younger, female and higher education groups. After adjusting for age, sex, education and BMI through multiple regression analysis, a significant positive association between systolic blood pressure (p = 0.0357), diastolic blood pressure (p = 0.0111) and BLLs. Also, among the normal BMI group (18.5 kg/$m^2$ < BMI < 25 kg/$m^2$), we also found a significant positive association between diastolic blood pressure and BLLs (p = 0.0370). Conclusion: The present study showed that blood lead serves as a good predictor of blood pressure changes and that there was a statistically significant association between blood lead and blood pressure, especially diastolic blood pressure.

체중, 체질량지수, 체지방, 허리-둔부둘레비의 변화와 혈압 변화와의 상관관계

김은주 대한보건협회 1998 대한보건연구 Vol.24 No.2

연구목적 및 배경 ; 비만과 혈압상승과는 밀접한 관계가 있다. 비만과 혈압의 관련성이 알려지면서 혈압과 비만도를 나타내는 신체지수, 체지방량, 체지방분포도와의 관련성에 관한 연구가 활발히 진행되고 있으나 어떤 방법이 타당한지에 대해 논란이 꾸준히 제기되고 있다. 그동안 국내에서는 혈압과 비만간의 관련성에 대한 확인연구들이 부분적으로 시행되었으나 이들 위험요인에 대한 개입연구와 그 효과를 보는 연구는 거의 이루어진 바 없다. 이에 본 연구에서는 식이상담 및 운동처방의 개입을 통해 체중 및 비만과 관련된 여러지수의 변화와 혈압변화와의 상관성을 보고자 하였다. 연구방법 ; K구 보건소 건강증진센타를 내소한 K구 지역주민들 중 경증 고혈압자이면서 과체중인 자 32명의 여성을 대상으로 1997년 9월부터 1998년 5월까지 자료수집하였다. 이들을 대상으로 사전검사와 식이상담 및 체중감소 등을 위한 운동처방을 한 후 3∼5개월이 경과한 후에 추후검사를 하였다. 이에 따른 체중과 비만을 나타내는 몇 가지 수치의 변화와 혈압의 변화수치를 자료로 분석하였다. 연구결과 ; 수축기혈압의 변화는 체중(r=.55), 체질량지수(r=.55), 허리-둔부둘레비(r=.49)의 변화의 순으로 유의한 상관관계가 있었고, 연령과 체지방률의 변화와는 상관관계가 없었다. 이완기혈압의 변화도 체중(r=.46), 체질량지수(r=.44), 허리-둔부둘레비(r=.40)의 변화의 순으로 유의한 상관관계가 있었으나 수축기혈압에 비해 상대적으로, 상관성이 약했고, 연령과 체지방률의 변화와는 상관관계가 없었다. 수축기혈압의 변화에 영향을 미치는 주요변수로는 체중, 허리-둔부둘레비로 각각의 설명력은 31%, 4%였다. 또한 이완기혈압의 변화에 영향을 미치는 주요변수로는 체중, 체질량지수로 각각의 설명력은 21%, 5%였다. 결론 ; 혈압의 변화는 체중, 체질량지수, 허리-둔부둘레비의 변화와 상관성이 있었고, 체지방률의 변화는 상관성이 없었다. 즉, 체지방률에 따른 체지방량보다는 체중과 체지방분포도가 혈압과 밀접한 관계가 있음을 시사하였다. Background : It is known that obesity is closely related with blood pressure. Many studies are carrying out in the relation between several obesity indices, such as BMI, body fat, distribution of body fat, and hypertension, but diagnostic methods and criteria of obesity are in dispute. This study was done in order to investigate the relationship between change in several obesity indices and blood pressure according to applying exercise prescription and diet education. Method : From 32 mild hypertensive women with obesity who visit K Health Center in community, data were collected before and after the intervention of exercise prescription and diet education from September, 1997 to May, 1998. Results : The change in systolic blood pressure correlates with change in body weight(r=.55), BMI(r=.44), waist-hip ratio(r=.49). The change in diastolic blood pressure correlates with change in body weight(r=.46), BMI(r=.44), waist-hip ratio(r=.40), but a little decreased compared with systolic blood pressure. The important factors affecting the change in systolic blood pressure are body weight(R^2=.31) and waist-hip ratio(R^2=.04). Also in diastolic blood pressure, there are body weight(R^2=.21) and body mass index(R^2=.05). conclusion : The change in blood pressure is significantly correlated with change in body weight, BMI and waist-hip ratio but the change in body fat. Conclusively, blood pressure is more closely related with obesity level, fat distribution than quantity of body fat.

The J-curve between Diastolic Blood Pressure and Risk of All-cause and Cardiovascular Death

김희진,목예진,이선주,이선미,백정환,지선하 대한심장학회 2018 Korean Circulation Journal Vol.48 No.1

Background and Objectives The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. Methods We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. Results A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cas Background and Objectives The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. Methods We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. Results A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cases). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. Conclusion A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg. es). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. Conclusion A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg Background and Objectives The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. Methods We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. Results A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cas Background and Objectives The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. Methods We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. Results A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cases). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. Conclusion A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg. es). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. Conclusion A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg

한국성인에서 체지방, 혈중지질 농도와 혈압간의 상관관계

황수관,김남익,최건식 대한스포츠의학회 1997 대한스포츠의학회지 Vol.15 No.2

To investigate blood pressure and body fat, cholesterol, triglyceride concentration and relationship of each other in Korea adults, total 382(men 188 and women 196) aged between 20-69 years were chosen as subjects. The results are summarized as follows. 1. Body fat was increase with diastolic blood pressure from 60-69mmHg group to 110-130mmHg group in men and women. Body fat in women was always more than in men all range of blood pressure. 2. Triglyceride concentration was significantly increases with blood pressure in men. In women, triglyceride concentration was significantly increase over 90mmHg regarded as hypertension. 3. Total cholesterol had no relationship to blood pressure, but total/HDL cholesterol ratio tended to increase with blood pressure. Both men and women, high density lipoprotein cholesterol was decrease and low density lipoprotein cholesterol was increase with blood pressure. 4. The factor which had the best relationship to blood pressure was body fat in men and triglyceride in women. The total/HDL cholesterol ratio had higher correlation coefficient than HDL or LDL single value. From the above results it is speculated that body fat and triglyceride, cholesterol concentration responsible for hypertension. Especially high blood pressure has relation to body fat in men and triglyceride in women. And body fat, blood triglyceride, cholesterol concentration are concerned with each other, but the relationship is not high.

Changes in the Saliva Cortisol Concentration and Blood Pressure of Patients with High Blood Pressure and Diabetes After Participating in Agro-healing Activities

장혜숙,유은하,정순진,김재순,김경미,류두영 인간식물환경학회 2019 인간식물환경학회지 Vol.22 No.5

This study was conducted to find out physical changes in the blood pressure and saliva cortisol of patients with high blood pressure and diabetes after participating in agro-healing activities. The saliva cortisol and blood pressure of 14 males and females aged 49.79±10.48 on average were measured after participating in agro-healing activities. The saliva collection system was used, and their satisfaction level for the program was also surveyed. Changes in the values before and after participating in the agro-healing activities were compared and analyzed. The cortisol concentration, a stress hormone, was reduced from 6.76nmol/L before the program to 4.86nmol/L after the program, down by 1.9nmol/L, which was a statistically significant difference (z=-3.170, p<.01). In addition, the cortisol concentration was gradually reduced through the entire program from Session 1 to Session 7. Changes in the blood pressure of subjects before and after participating in agro-healing activities were examined, and the total systolic and diastolic blood pressure continuously decreased after participating in agro-healing activities through the entire program from Session 1 to Session 7. Their systolic blood pressure was reduced statistically significantly (z=-1.947, p<.05). Also, participants' satisfaction was analyzed and it was found that more than 95% of participants answered 'satisfied' and 'very satisfied' with agro-healing activities. Therefore, these results indicate that agro-healing activities performed in the healing-farm had a positive impact on the cortisol concentration and blood pressure of patients with chronic diseases such as diabetes and high blood pressure. In addition, their high satisfaction for this program seemed to improve the psychological and physiological conditions of subjects.

Changes in the Saliva Cortisol Concentration and Blood Pressure of Patients with High Blood Pressure and Diabetes After Participating in Agro-healing Activities

Hye Sook Jang,Eunha Yoo,Sun-Jin Jeong,Jae Soon Kim,Gyung Mee Gim,Doo Young Ryu 인간식물환경학회 2019 인간식물환경학회지 Vol.22 No.5

This study was conducted to find out physical changes in the blood pressure and saliva cortisol of patients with high blood pressure and diabetes after participating in agro-healing activities. The saliva cortisol and blood pressure of 14 males and females aged 49.79±10.48 on average were measured after participating in agro-healing activities. The saliva collection system was used, and their satisfaction level for the program was also surveyed. Changes in the values before and after participating in the agro-healing activities were compared and analyzed. The cortisol concentration, a stress hormone, was reduced from 6.76nmol/L before the program to 4.86nmol/L after the program, down by 1.9nmol/L, which was a statistically significant difference (z=-3.170, p<.01). In addition, the cortisol concentration was gradually reduced through the entire program from Session 1 to Session 7. Changes in the blood pressure of subjects before and after participating in agro-healing activities were examined, and the total systolic and diastolic blood pressure continuously decreased after participating in agro-healing activities through the entire program from Session 1 to Session 7. Their systolic blood pressure was reduced statistically significantly (z=-1.947, p<.05). Also, participants satisfaction was analyzed and it was found that more than 95% of participants answered satisfied and very satisfied with agro-healing activities. Therefore, these results indicate that agro-healing activities performed in the healing-farm had a positive impact on the cortisol concentration and blood pressure of patients with chronic diseases such as diabetes and high blood pressure. In addition, their high satisfaction for this program seemed to improve the psychological and physiological conditions of subjects.

순환계 : 일반연재 ; 일상활동혈압검사를 받은 환자들의 혈압분포

최소라 ( So-ra Choi ) 대한임상병리사협회 2011 임상생리검사학회 발표자료집 Vol.2011 No.-

배경(Background) 혈압은 변화가 많은 혈역학적 지표이므로 정확하고 재현성 있는 혈압측정이 고혈압의 진단과 치료에 있어서 매우 중요하다. 이에 대한 방법으로 일상활동혈압검사(ABPM)가 많이 활용되고 있는바, 실제 일상활동혈압검사를 받은 환자들을 대상으로 하여 일반적 특성과 혈압분포를 알아보고자 하였다. 방법(Methods) 2010~2011.7월까지 SMC를 내원하여 일상활동혈압검사(ABPM)를 받은 환자중 조건에 부합되는 587명을 연구대상으로 하였으며, 조사변수로는 연령, 성별, 체중, 신장, 주간 수축기 혈압(Awake systolic blood pressure; Awake SBP), 주간 이완기 혈압(Awake diastolic blood pressure; Awake DBP), 야간 수축기 혈압(Asleep systolic blood pressure; Asleep SBP), 야간 이완기 혈압(Asleep diastolic blood pressure; Asleep DBP)을 포함시켰다. 분석방법은 SPSS (version 12.0)을 이용하였고, 모든 조사자료는 빈도와 백분율로 제시하였다. 통계적 유의성은 α=0.05 수준에서 검정하였고, 이산변수는 χ²-test를 연속변수는 Student’s t-test를 이용하였다. 결과(Results) 대상자 587명(남 305 vs. 여 282)의 평균 연령은 53.4세(남 51.5 vs. 여 55.4), 평균 BMI는 24.1 kg/㎡(남 24.4 vs. 여 23.8)이었고, 주간 수축기 혈압(Awake SBP) 평균은 141.8 mmHg(남 142.8 vs. 여 140.8), 주간 이완기 혈압(Awake DBP) 평균은 90.3 mmHg(남 91.9 vs. 여 88.5), 야간 수축기 혈압(Asleep SBP) 평균은 131.7 mmHg(남 131.8 vs. 여 131.5), 야간 이완기 혈압(Asleep DBP) 평균은 81.9 mmHg(남 83.1 vs. 여 80.6)이었다. 고찰(Discussion) 본 연구는 특정 병원에서 검사를 받은 환자들을 대상으로 한정된 인원을 조사하였기 때문에 이 연구의 결과가 전체 일상활동혈압검사를 받은 환자들을 대표하기는 어렵다는 한계점이 있지만, 실제 검사된 자료를 가지고 통계적 특성을 분석해보았다는데 의의가 있다. 향후 대상자의 수와 범위를 크게 하여 분석하여 본다면 혈압에 대한 보다 대표성 있는 결과를 얻을 수 있을 것으로 기대한다. Objective : The aim of this study was to show the distribution of blood pressure in subject``s of ABPM. Methods : The study sample included 587 Korean men and women. Subjects, 20 years of age and older, were classified into 4 groups based on taking a daily average blood pressure: 1) systolic blood pressure (SBP) <125 mmHg and diastolic blood pressure (DBP) <80 mmHg (normal group), 2) 125 mmHg ≤ SBP or 80 mmHg ≤ DBP (Hypertension) 3) 140 mmHg ≤ SBP and 90 mmHg > DBP (Isolated systolic hypertension), and 4) 140 mmHg > SBP and 90 mmHg ≤ DBP (Isolated diastolic hypertension). Results : The prevalence of hypertension and isolated systolic hypertension and isolated diastolic hypertension were 87.4% (91.5% in men and 83.0% in women) and 12.6% (5.5% in men and 7.2% in women) and 8.5% (6.0% in men and 2.6% in women). The average of Awake SBP 141.8±12.9 mmHg (142.8±11.9 mmHg in men and 140.8±13.9 mmHg in women), Asleep SBP 131.7±14.8 mmHg (131.8±12.4 mmHg in men and 131.5±17.1 mmHg in women) and Awake DBP 90.3±10.2 mmHg (91.9±10.2 mmHg in men and 88.5±9.9 mmHg in women), Asleep DBP 81.9±10.8 mmHg (83.1±9.9 mmHg in men and 80.6±11.5 mmHg in women).

황구침법(黃丘鍼法)을 이용한 고혈압 환자의 혈압강하 효과에 대한 증례보고

한창현 ( Chang Hyun Han ),황치원 ( Chi Won Hwang ),신미숙 ( Min Suk Shin ),신선화 ( Seon Hwa Shin ),최선미 ( Sun Mi Choi ) 대한경락경혈학회 2006 Korean Journal of Acupuncture Vol.23 No.3

Objectives: The aim of the study was to investigate the antihypertensive effect of Hwang-gu Acupuncture in hypertensive patients. Methods: We measured the blood pressure of the patients who were admitted in the Oriental Medical Clinic of Brother from 25th November 2005 to 27th March 2006. We included the patients only in case of the systolic blood pressure was over 140mmHg or diastolic blood pressure was over 90mmHg, Twenty two patients were treated by Hwang-gu Acupuncture. In order to evaluate the effect of the Hwang-gu Acupuncture, the blood pressure was measured before and after Acupuncture procedure total 4 times, 10times. Results: There were a significant decrease in the systolic blood pressure and significant decrease in the diastolic blood pressure by Hwang-gu Acupuncture 4 times. The effect of Hwang-gu Acupuncture by measurement time on blood pressure were follows: In a systolic blood pressure was gradually deceased significantly from 1st to 4th but diastolic blood pressure was significantly decreased after 2nd and 4th only. Conclusions: These results suggest that Hwang-gu Acupuncture is effective in decreasing the systolic and diastolic blood pressure.

Pharmacokinetic/pharmacodynamic Modeling of the Cardiovascular Effects of Beta Blockers in Humans

백인환,Min-hyuk Yun,윤휘열,권광일 대한약학회 2008 Archives of Pharmacal Research Vol.31 No.6

Pharmacokinetic-pharmacodynamic (PK/PD) analysis is useful study in clinical pharmacology, also PK/PD modeling is major tools for PK/PD analysis. In this study, we sought to characterize the relationship between the cardiovascular effects and plasma concentrations of the beta blocker drugs carvedilol and atenolol using PK/PD modeling in healthy humans. One group received oral doses of atenolol (50 mg) and the other group received oral doses of carvedilol (25 mg). Subsequently, blood samples were taken, and the effects of the drugs on blood pressure were determined. Plasma concentrations of drugs were measured by HPLC, and PK/PD modeling performed by applied biophase model, plasma drug concentrations were linked to the observed systolic blood pressure (SBP) and diastolic blood pressure (DBP) via an effect compartment. The model parameters were estimated using the ADAPT II program. In PK/PD analysis, it was observed the time delay between plasma concentration and effect and the time delay between SBP and DBP. The two time delays were properly explained by PD parameter “Keo” in applied biophase model. As conclusion, the biophase PK/PD model described the relationship between the plasma concentrations of the drugs and the cardiovascular effects, including the time delay between systolic blood pressure and diastolic blood pressure.

Pharmacokinetic/pharmacodynamic Modeling of the Cardiovascular Effects of Beta Blockers in Humans

Baek, In-Hwan,Yun, Min-Hyuk,Yun, Hwi-Yeol,Kwon, Kwang-Il 대한약학회 2008 Archives of Pharmacal Research Vol.31 No.6

Pharmacokinetic-pharmacodynamic (PK/PD) analysis is useful study in clinical pharmacology, also PK/PD modeling is major tools for PK/PD analysis. In this study, we sought to characterize the relationship between the cardiovascular effects and plasma concentrations of the beta blocker drugs carvedilol and atenolol using PK/PD modeling in healthy humans. One group received oral doses of atenolol (50 mg) and the other group received oral doses of carvedilol (25 mg). Subsequently, blood samples were taken, and the effects of the drugs on blood pressure were determined. Plasma concentrations of drugs were measured by HPLC, and PK/PD modeling performed by applied biophase model, plasma drug concentrations were linked to the observed systolic blood pressure (SBP) and diastolic blood pressure (DBP) via an effect compartment. The model parameters were estimated using the ADAPT II program. In PK/PD analysis, it was observed the time delay between plasma concentration and effect and the time delay between SBP and DBP. The two time delays were properly explained by PD parameter "$K_{eo}$" in applied biophase model. As conclusion, the biophase PK/PD model described the relationship between the plasma concentrations of the drugs and the cardiovascular effects, including the time delay between systolic blood pressure and diastolic blood pressure.