Related Factors of Alcohol-Induced Blackout among University Student

Background@#Irresponsible alcohol consumption by university students in our country continues to increase regardless of the sex; it also causes various problems. The blackouts experienced by the students cause social issues, and increased rates of alcohol-based dementia and alcohol use disorder. Therefore, we aimed to investigate the factors related to alcohol-induced blackouts experienced by university students. @*Methods@#We used a structured questionnaire. Overall, 1,325 male and female attending four of the four-year universities in Gangwon-do were included in this study. Their living and drinking conditions, family’s drinking capacity, sleep, depression, anxiety and stress were investigated and the realtionship with the experience of blackout was investigated using the SPSS 24.0 statistical software. @*Results@#Based on the alcohol consumption habits, 360 male (42.3%) and 221 female (46.6%) experienced blackouts. Alcohol use disorder was found in Alcohol Use Disorder Identification Test - Korean revised version (AUDIT-K), 330 male (38.8%) and 265 female (55.9%). We found that the older male and female, the more they lived alone, the more frequently they drink alcohol in the family, the more they drink, and the more blackout experience, the more frequently they experience blackout (P40% of the university students experienced blackouts; female experienced blackouts more frequently than male. The blackouts were related to lifestyle, family drinking, problem drinking and depression in both male and female.

Understanding ‘Family’ for Family-Oriented Medical Care

The clinical philosophy of family medicine is to provide warm-hearted health care to every human being as opposed to the modern subspecialized carecalled “inhuman medicine.” One of the strategies to implement this philosophy is comprehensive care. Comprehensive care uses the biopsychosocialmodel approach to health problems. Comprehensive evaluation and management of biopsychosocial dimensions is unique to family medicine, andit is difficult to achieve through subspecialized care. Family-oriented health care is a specific tool to practice comprehensive care based on thebiopsychosocial approach. For family-oriented medical care, the family physician needs to understand “family” from two perspectives: structural anddevelopmental. From the structural perspective, family is a group of small entities called holons. From the developmental perspective, family is anentity that keeps changing and developing through the family life cycle and events. Family-oriented care, in these two contexts, tries to understandand address the communication and behavior patterns of the family members.

Associations between Family Function and Smartphone Addiction Proneness in Middle School Students

Background@#Smartphone usage time has been increasing every year causing smartphone addiction, also known as cell phone dependency. This study investigated and analyzed the effects of family characteristics on adolescent smartphone use. @*Methods@#The subjects were 908 middle school students in Gangneung whose legal guardians agreed to participate in the study. We investigated general characteristics, family structure, smartphone usage time of family members, using Korean Smartphone Addiction Proneness Scale (K-SAPS), Family APGAR, and Family Adaptability and Cohesion Evaluation Scale III (FACES III). The participants were classified into three groups according to the scores of the SAPS: addiction proneness, addiction tendency group, and normal user. @*Results@#The prevalence of the addiction proneness group was 47 (5.2%). The K-SAPS scores were higher in the following categories: female (P<0.001); more monthly allowance (P<0.05); lower academic performance (P<0.001); fewer hours of exercise (P<0.001); longer smartphone usage time (P<0.001); and younger owners of smartphones (P<0.05). In family characteristics, the K-SAPS scores were significantly higher in single parent families (P<0.05), longer smartphone usage time of mother and siblings (P<0.05), less time spent watching TV with family members (P<0.05), more exposure to smartphones in childhood (P<0.05), and less time spent with mother (P<0.05). The K-SAPS scores were significantly higher when family APGAR, family adaptability, and cohesion scores were lower (P<0.001). @*Conclusion@#This study indicated that the smartphone addiction in middle school students is closely related to smartphone usage of family members and family functions. Therefore, family behavior that can be corrected should be considered for counseling to prevent smartphone addiction.

Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing / 가정의학회지

This study investigated advantages and potential risks associated with drinking alcohol in Koreans based on the alcohol flush reaction. Our investigation reviewed published studies and examined moderate-drinking levels for Koreans based on modified National Institute on Alcohol Abuse and Alcoholism guidelines. Fourteen articles out of a total 198 publications were searched using PubMed, EMBASE, KoreaMed, and RISS (Research Information Sharing Service) databases and selected for review. Individuals without alcohol flush reaction (non-flushers) exhibited lower risks associated with insulin resistance, metabolic syndrome, and hyperhomocysteinemia and their 10-year cardiovascular disease risk when alcohol consumption was ≤8 drinks/wk. Conversely, risks associated with insulin resistance, metabolic syndrome, high blood pressure, prediabetes or type-2 diabetes, and high intraocular pressure and increases in carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels were present when >8 drinks were consumed. For individuals with flushing reaction (flushers), advantages were reported in relation to risks of hyperhomocysteinemia when alcohol consumption was ≤4 drinks/wk, whereas consumption of >4 drinks/wk increased the risk of insulin resistance, metabolic syndrome, high blood pressure, pre-diabetes or type-2 diabetes, high-risk colorectal adenoma, and high intraocular pressure and increased carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels. The moderate drinking level for Koreans is ≤8 drinks/wk for men aged ≤65 years and ≤4 drinks/wk for men aged over 65. For women, these limits should be half of those for men. Furthermore, individuals with flushing reaction should maintain an alcohol consumption level half of that for non-flushers.

Effect of Coffee Consumption on the Progression of Type 2 Diabetes Mellitus among Prediabetic Individuals / 가정의학회지

BACKGROUND: A previous large-scale cohort study investigated the relationship between coffee intake and the progression of diabetes mellitus in the United States. However, studies on the effects of coffee on diabetes are rare in South Korea. Therefore, this study assessed the amount and method of coffee intake in Koreans in order to determine if coffee intake has a prophylactic effect on diabetes progression. METHODS: This study included 3,497 prediabetic patients from a single medical institution, with glycated hemoglobin levels ranging from 5.7% to 6.4%. Cross-tabulation and Kaplan-Meier survival analyses were performed to compare patients with and without diabetes progression based on the frequency and method of coffee intake. Cox proportional hazard analysis was performed to correct for confounding variables. RESULTS: The observation period (mean+/-standard deviation) was 3.7+/-2.3 years. Kaplan-Meier survival analysis revealed that the risk of diabetes progression was lowest in patients who drank black coffee three or more times per day (P=0.036). However, correction for confounding variables in Cox proportional hazard analysis revealed that, while the risk was lower for the patients who typically consumed black coffee than for those who mixed creamer and sugar into their coffees, the difference was not significant. CONCLUSION: The results of this study suggest that drinking coffee without sugar and creamer at least three times daily has the greatest preventive effect on diabetes onset.

The Effects of Alcohol on Quality of Sleep / 가정의학회지

BACKGROUND: Alcohol is traditionally known to have a relaxing effect. However, persons who consume alcohol in excessive amounts suffer from poor sleep quality and patients with alcohol use disorders commonly report insomnia. In this study, we aimed to evaluate the effects of alcohol use on sleep quality. METHODS: A questionnaire-based cross-sectional survey was conducted with 234 men and 159 women who had visited a general hospital. We used structured questionnaires, including Alcohol Use Disorder Identification Test-Korean revised version (AUDIT-KR) and the Pittsburgh Sleep Quality Index-Korean version (PSQI-K). We analyzed the association between scores for all subcategories of the PSQI-K and the AUDIT-KR and then analyzed the correlation between AUDIT-KR and global PSQI-K scores. RESULTS: The global PSQI-K score for men was positively correlated with the AUDIT-KR score (P=0.008) after adjusting for age, chronic disease, tobacco use, exercise, depression, and anxiety. The AUDIT-KR score was significantly associated with subjective sleep quality (P=0.005), sleep duration (P=0.047), and sleep disturbance (P=0.048); it was not associated with sleep latency, sleep efficiency, or daytime dysfunction. Sleep disturbances due to snoring were significantly associated with total AUDIT-KR score (P=0.008). There was no correlation between the global PSQI-K and AUDIT-KR scores for women (P=0.333). However, daytime dysfunction showed a significant association with total AUDIT-KR score (P=0.048). CONCLUSION: Men with higher AUDIT-KR scores tended to suffer from poor sleep quality. AUDIT-KR scores showed significant correlations with subjective sleep quality, sleep duration, and sleep disturbances in men.

Relationship between Neck Length, Sleep, and Cardiovascular Risk Factors / 가정의학회지

BACKGROUND: Neck circumference, as a predicator of obesity, is a well-known risk factor for obstructive sleep apnea and cardiovascular diseases. However, little research exists on neck length associated with these factors. This study explored the association of neck length with sleep and cardiovascular risk factors by measuring midline neck length (MNL) and lateral neck length (LNL). METHODS: We examined 240 patients aged 30 to 75 years who visited a health check-up center between January 2012 and July 2012. Patients with depressive disorder or sleep disturbance were excluded from this study. MNL from the upper margin of the hyoid bone to the jugular notch and LNL from the mandibular angle to the mid-portion of the ipsilateral clavicle were measured twice and were adjusted by height to determine their relationship with sleep and cardiovascular disease risk factors. RESULTS: Habitual snorers had shorter LNL height ratios (P = 0.011), MNL height ratios in men (P = 0.062), and MNL height ratios in women (P = 0.052). Those snoring bad enough to annoy others had shorter MNL height ratios in men (P = 0.083) and women (P = 0.035). Men with objective sleep apnea had longer distances from the mandible to the hyoid bone to the mandible (P = 0.057). Men with metabolic syndrome had significantly shorter LNL height ratios (P = 0.021), and women with diabetes, hyperlipidemia, and metabolic syndrome had shorter MNL height ratios (P < 0.05). CONCLUSION: This study shows that a short neck by measuring the MNL is probably associated with snoring. In addition, MNL is related to cardiovascular disease risk factors in women.

Inter-arm Differences in Simultaneous Blood Pressure Measurements in Ambulatory Patients without Cardiovascular Diseases / 가정의학회지

BACKGROUND: It has traditionally been known that there is normally a difference in blood pressure (BP) between the two arms; there is at least 20 mm Hg difference in the systolic blood pressure (SBP) and 10 mm Hg difference in the diastolic blood pressure (DBP). However, recent epidemiologic studies have shown that there are between-arm differences of 10 mm Hg. In women, 89.6% of patients had IAD in SBP of 10 mm Hg or IAD in DBP of > 10 mm Hg. Gangneung Asan Hospital clinical series of patients showed that the absolute IAD in SBP had a significant correlation with cardiovascular risk factors such as the 10-year Framingham cardiac risk scores and higher BP in men and higher BP in women. However, the absolute IAD in SBP and DBP had no significant correlation with the age, obesity, smoking, drinking, hyperlipidemia, diabetes, metabolic syndrome, and renal function. CONCLUSION: Our results showed that there were no significant between-arm differences in simultaneous BP measurements. It was also shown that most of the ambulatory patients without cardiovascular diseases had an IAD in SBP of < 10 mm Hg and an IAD in DBP of < 6 mm Hg.

Differences in Blood Pressure Measurements Obtained Using an Automatic Oscillometric Sphygmomanometer Depending on Clothes-Wearing Status / 가정의학회지

BACKGROUND: According to the current guidelines for blood pressure monitoring, clinicians are recommended to measure blood pressure by completely exposing the upper arm. However, it is a common practice that blood pressure is measured with the cuff placed over the sleeve or with the sleeve rolled up. We therefore conducted this study to examine whether there are any differences in blood pressure measurements among the three different settings: the sleeve group, the rolled sleeve group, and the bare arm group. METHODS: We conducted the current study in 141 male and female adult patients who visited our clinical department. In these patients, we took repeatedly blood pressure measurements using the same automatic oscillometric device on three different settings. Then, we analyzed the results with the use of randomized block design analysis of variance. RESULTS: The mean values of systolic blood pressure (SBP) between the first reading and those of the second reading were 128.5 +/- 10.6 mm Hg in the sleeve group, 128.3 +/- 10.8 mm Hg in the rolled sleeve group, and 128.3 +/- 10.7 mm Hg in the bare arm group. These results indicate that there were no significant differences among the three groups (P = 0.32). In addition, the mean values of diastolic blood pressure (DBP) between the first reading and those of the second reading were 80.7 +/- 6.1 mm Hg in the sleeve group, 80.7 +/- 6.1 mm Hg in the rolled sleeve group, and 80.6 +/- 5.9 mm Hg in the bare arm group. These results indicate that there were no significant differences among the three groups (P = 0.77). In addition, based on the age, sex, past or current history of hypertension or diabetes mellitus, the thickness of sleeve, weight, a drinking history, and a smoking history, there were no significant differences in SBP and DBP among the three groups. CONCLUSION: There were no significant differences in blood pressure measurements between the three different settings (the sleeve group, the rolled sleeve group, and the bare arm group).

Brief Insight-enhancement Intervention among Patients with Alcohol Dependence

Patients' insight has a critical role in the recovery from problematic behavior. The aim of this study was to evaluate the effects of a brief intervention to promote insight among alcohol-dependent patients. A total of 41 alcohol-dependent patients (30 males, 11 females) in an insight-deficient state who had been admitted to a community-based alcohol treatment center, were randomized into two groups based on their admission order: an intervention group (IG) (n = 20) and a control group (CG) (n = 21). Patients in both the IG and CG participated in an identical treatment program with one exception: patients in the IG were required to undergo five sessions of brief individual intervention focusing on insight enhancement. Changes in insight state were assessed after the intervention. The IG exhibited significant (P < 0.05) changes in the distribution of insight level, while the CG did not exhibit any significant changes in the distribution of insight level. The insight score after intervention was significantly (P < 0.05) greater for the IG than the CG with adjustment for the baseline characteristics. The results suggest that a brief individual intervention focused on insight enhancement may be an effective tool to improve insight among alcohol-dependent patients.

Brief Insight-enhancement Intervention among Patients with Alcohol Dependence

Patients' insight has a critical role in the recovery from problematic behavior. The aim of this study was to evaluate the effects of a brief intervention to promote insight among alcohol-dependent patients. A total of 41 alcohol-dependent patients (30 males, 11 females) in an insight-deficient state who had been admitted to a community-based alcohol treatment center, were randomized into two groups based on their admission order: an intervention group (IG) (n = 20) and a control group (CG) (n = 21). Patients in both the IG and CG participated in an identical treatment program with one exception: patients in the IG were required to undergo five sessions of brief individual intervention focusing on insight enhancement. Changes in insight state were assessed after the intervention. The IG exhibited significant (P < 0.05) changes in the distribution of insight level, while the CG did not exhibit any significant changes in the distribution of insight level. The insight score after intervention was significantly (P < 0.05) greater for the IG than the CG with adjustment for the baseline characteristics. The results suggest that a brief individual intervention focused on insight enhancement may be an effective tool to improve insight among alcohol-dependent patients.

Paroxysmal Atrial Fibrillation Presenting as Acute Lower Limb Ischemia / 가정의학회지

An ischemic foot can be developed by acute arterial occlusion. Given proper treatment within critical time, the patient can avoid foot amputation and death. Early proper diagnosis and treatment by family physician at the initial clinical interviewing is important in saving the affected leg and the life. Thrombosis and embolism are the common causes of acute arterial occlusion. Thrombosis mostly arises from underlying cardiac disease such as arrhythmia, coronary artery disease and valvular heart disease while arterial occlusion by embolism can be shown on a narrowed artery related with systemic atherosclerosis. Because the treatment options depend on the underlying cause of the acute ischemic foot, it is important to identify the cause of acute ischemic foot. At this paper, we reported a case that the cause of acute ischemic foot of the patient proved paroxysmal atrial fibrillation after some diagnostic tests.

Radiological and Clinical Characteristics of a Military Outbreak of Pandemic H1N1 2009 Influenza Virus Infection

OBJECTIVE: To describe detailed clinical and radiological features of the pandemic H1N1 2009 influenza viral infection among healthy young males in a semi-closed institutionalized setting. MATERIALS AND METHODS: A total of 18 patients confirmed with the pandemic H1N1 2009 influenza virus infection from July 18 to July 30, 2009 were enrolled in this study. Each patient underwent an evaluation to determine detailed clinical and radiological features. RESULTS: All patients presented with high fever (> 38.0degrees C), with accompanying symptoms of cough, rhinorrhea, sore throat, myalgia and diarrhea, and increased C-reactive protein (CRP) values with no leukocytosis nor elevated erythrocyte sedimentation rate (ESR). All patients, including one patient who progressed into acute respiratory distress syndrome, were treated with oseltamivir phosphate and quickly recovered from their symptoms. Chest radiographs showed abnormalities of small nodules and lobar consolidation in only two out of 18 patients. However, six of 12 patients who underwent thin-section CT examinations showed abnormal findings for small ground-glass opacities (GGOs) in addition to poorly-defined nodules with upper lobe predominance. CONCLUSION: In a population of healthy young adults, elevated CRP with normal ESR and white blood cell levels combined with GGOs and nodules on thin-section CT scans may indicate early signs of infection by the pandemic H1N1 2009 influenza virus.

Secondary Hypertension / 가정의학회지

Hypertension is a major risk factor for the development of cardiovascular disease. The prevalence of secondary hypertension, 10% is known as a common cause of resistant hypertension. Development of diagnostic technology and the aging is likely to be increased of the prevalence. Secondary hypertension, if it is not appropriate etiologic treatment may sometimes be fatal, as well as to the proper treatment be treatable or curable hypertension. Secondary causes of hypertension include a greater prevalence of obstructive sleep apnea, renal parenchymal disease, renovascular disease and primary aldosteronism. Uncommon secondary causes include pheochromocytoma, Cushing's syndrome, hyperparathyroidism and thyroid disease. Clinical clues for secondary hypertension is onset of hypertension in persons younger than age 20 or older than age 50 without family history of hypertension, poor response to therapy, worsening of control in previously stable hypertensive patient, markedly elevated blood pressure or hypertension with severe end-organ damage, presence of abdominal bruit (renal artery stenosis), moon face and abdominal striae (Cushing's syndrome), paroxysmal headaches and palpitations (pheochromocytoma), pronounced hypokalemia due to low dose diuretic therapy (primary aldosteronism), acute renal failure or hypokalemia after initiation of angiotensin converting enzyme inhibitors or angiotensin II receptor blocker (renal artery stenosis), hypercalcemia (hyperparathyroidism), snoring and daytime somnolence (obstructive sleep apnea). A combination of a good history and physical examination, astute observation, and accurate interpretation of available data usually are helpful in the diagnosis of a specific causation. This article provides an overview of the range of secondary hypertension, including key clinical features, appropriate diagnostic approach and treatment for primary physician.

Clinical Application of Family-Centered Health Care / 가정의학회지

For practicing comprehensive approach to health problems, family physicians should see both biomedical aspects and psychosocial aspects of each patient at the same time. Family physicians can hypothesize and intervene effectively the psychosocial aspects of patients through family-centered health care. Genogram, family life cycle, family's resources for stressful life events, and adaptability and cohesiveness of patients' family are the four eyes of family physicians, those enable family physicians to see the family of patients in their health care practice. Family-centered health care in family practice can be achieved by applications of family-related questions to routine health care practice, approaches to the family dynamics in patients with red flags, and family conferences for inpatients and patients with more difficult problems. Family-centered health care is the core practice of comprehensive approach to health problems and an important identity of family medicine.

A Case of Successful Correction of Subclavian Steal Syndrome by Percutaneus Transluminal Angioplasty with Stenting Who Found Incidentally Significant Interarm Blood Pressure Difference / 가정의학회지

A case of successful correction of subclavian steal syndrome by percutaneous transluminal angioplasty with stenting in a male patient who found incidentally significant interarm blood pressure difference. Small difference in blood pressure (BP) between two arms is a relatively common. Significant interarm BP difference is a potential marker of peripheral vascular disease such as subclavian artery stenosis and a predictor of cardiovascular disease. The subclavian steal syndrome is a condition that results from stenosis of subclavian artery proximal to the vertebral artery. The resulting symptoms are vertebrobasilar insufficiency symptoms due to reversal of blood flow from the contralateral vertebral and basilar artery into the ipsilateral upper extremity vessels and arm ischemic symptoms. Stenotic lesion of subclavian artery has traditionally been treated surgically. However recent trends are undergoing a paradigm shift from open surgery to endovascular approach. We report a patient with subclavian steal syndrome who found incidentally 35 mmHg interarm systolic BP difference. It was successfully treated by percutaneus transradial angioplasty with stenting on stenotic lesion of the subclavian artery.

Infective Endocarditis Not Easily Diagnosed in Primary Care

BACKGROUND: Despite the use of antibiotics and cardiac surgery, infective endocarditis, remains a life-threatening disease. Unfortunately, diagnosis and treatment may be delayed. This is due, in part, to the vague and, at times, baffling clinical picture of this disease and to the frequency with which antibiotics were administered prior to obtaining a microbiological diagnosis. We conducted this study to improve the suspicion index from difficult diagnostic process of this serious disease. METHODS: We retrospectively reviewed the medical records of 39 patients admitted to the Gangneung Asan Hospital in Gangwon-do with infective endocarditis from December 1996 to July 2004. We evaluated initial chief complaints and presumed diagnosis on first visit to medical care facilities, duration of referral from primary care to our hospital, the time period to confirm the diagnosis, treatment modality, and survival rate. RESULTS: Among the total, 23 out of 39 patients fulfilled the criteria for definite infective endocarditis, whereas the others (16 patients) were for possible group in Duke criteria. In 79.5%, infective endocarditis was the first clinical presentation without medical history of any cardiac disease. Most frequent initial presenting symptoms and signs were fever and chills (56.4%), abnormal neurologic deficit (12.8%), and myalgia (7.6%). The most common initial diagnosis at first medical facilities was common cold. The mean duration of referral from primary care to our hospital was 9.5 days. The mean duration of symptoms before the definite diagnosis was 20.3 days. The most frequent etiologic microorganisms were streptococcus and staphylococcus. Blood culture negative infective endocarditis was found in 35.9% of cases. Almost all patients were treated with 3rd generation cephalosporins. Among the total, 71.6% patients were treated with medical treatment only, and 28.2% patients required surgical intervention. The mortality rate was 20.5% with the major cause of death being sepsis. CONCLUSION: Since the symptoms and signs of infective endocarditis are nonspecific, it is difficult to suspect and reach to correct diagnosis of infective endocarditis in primary care, requiring prolonged duration of 3 weeks to reach diagnosis. The consequences can result in higher rate of systemic complications and mortality.

The Role of Alcoholics' Insight in Abstinence from Alcohol in Male Korean Alcohol Dependents

This study was performed to examine the relationship between the abstinence results of alcohol dependents after discharge and the level of insight at the time of discharge. 117 male Korean alcohol dependents discharged from a community-based alcohol treatment center were followed up to determine the initial months of abstinence on a successive basis (IMA), total months of abstinence during 12-month period (TMA), and complete abstinence for one full year after discharge. Analyses of abstinence results with adjustment for the differences in baseline characteristics were performed for subjects' insight levels (poor, fair and good). The mean IMA of patients with good insight was significantly (p<0.01) longer than that of patients with poor insight and TMA of patients with good insight was significantly (p<0.001) longer than that of others. Using patients with good insight as the reference, patients with poor insight showed an adjusted odds ratio (OR) of 0.07 (95% confidence interval [CI]=0.01-0.75, p<0.05) for complete abstinence for one full year after discharge and patients with fair insight, adjusted OR of 0.17 (95% CI=0.03-0.81, p<0.05). These results suggest that alcohol dependents' insight could be regarded as a factor related with abstinence.

Relationship of Left Ventricular Mass to Obesity in Normotensive Adults

BACKGROUND: Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for cardiovascular morbidity and mortality. The combination of hypertension and obesity are well known to act as risk factors of left ventricular hypertrophy in a number of studies, but it is unclear whether obesity itself stimulates LVH independently. Therefore, we investigated the relationship of left ventricular mass to body size in normotensive adults. METHODS: A population sample of 240 normotensive (systolic BP < 140 mmHg and diastolic BP < 90 mmHg) adults (139 men and 101 women) was examined by echocardiography. We excluded adults with history of hypertension, thyroid diseases, diabetes mellitus and other cardiac diseases. Left ventricular mass normalized for height(2.7) was used in the analyses and left ventricular hypertrophy was defined as a value of 50 g/m(2.7) men or 47 g/m(2.7) in women. RESULTS: Left ventricular mass significantly and positively correlated with body mass index. On univariate correlation analysis after adjusting for age, the body mass index was associated with LV mass/height(2.7) (LVMI: Left Ventricular Mass Index) in males and body mass index, waist circumference, hip circumference and waist/hip circumference ratio were associated with LVMI in females. Left ventricular hypertrophy was more frequent in overweight (33.3%) and obese (39.4%) groups than in lean group (15.9%). CONCLUSION: Left ventricular mass was strongly related to obesity in normotensive adults, especially in females. Obesity may be an independent risk factor for left ventricular hypertrophy.

Relationship of Left Ventricular Mass to Obesity in Normotensive Adults

BACKGROUND: Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for cardiovascular morbidity and mortality. The combination of hypertension and obesity are well known to act as risk factors of left ventricular hypertrophy in a number of studies, but it is unclear whether obesity itself stimulates LVH independently. Therefore, we investigated the relationship of left ventricular mass to body size in normotensive adults. METHODS: A population sample of 240 normotensive (systolic BP < 140 mmHg and diastolic BP < 90 mmHg) adults (139 men and 101 women) was examined by echocardiography. We excluded adults with history of hypertension, thyroid diseases, diabetes mellitus and other cardiac diseases. Left ventricular mass normalized for height(2.7) was used in the analyses and left ventricular hypertrophy was defined as a value of 50 g/m(2.7) men or 47 g/m(2.7) in women. RESULTS: Left ventricular mass significantly and positively correlated with body mass index. On univariate correlation analysis after adjusting for age, the body mass index was associated with LV mass/height(2.7) (LVMI: Left Ventricular Mass Index) in males and body mass index, waist circumference, hip circumference and waist/hip circumference ratio were associated with LVMI in females. Left ventricular hypertrophy was more frequent in overweight (33.3%) and obese (39.4%) groups than in lean group (15.9%). CONCLUSION: Left ventricular mass was strongly related to obesity in normotensive adults, especially in females. Obesity may be an independent risk factor for left ventricular hypertrophy.