The usefulness of wrist/height ratio as a predictor for the risk factors of coronary artery disease

BACKGROUND: The waist/hip ratio in an useful index of abodominal 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: 1,395 persons(818 men & 577 women) were selected as subjects who visited the Health Examination Center at Ewha Mokdong Hospital from October 1998 to March 1997. Waist circumference was measured at the level of umblicus with standing position. Hip circumference was measured at the level of the largest circumference of the hip. We set the criteria if the risk factors as hypertension(systolic BP > OR = 140mmHg and/or diastolic BP > OR = 90mmHg), glucose intolence (fastng blood glucose > OR = 115mg/dl) hypertriglyceridemia(>160mg/dl), hypercholesterolemia(> OR = 200mg/dl), and low HDL-cholesterol level(<35mg/dl). The morbidity index of CAD was calculated by the sim if 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). CONCLUSIONS: 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.

Drug Use and Its Related Factors of the Elderly in a Rural and Urban area

BACKGROUND: The purpose of study was to analyze the demographic and health-behavioral factors that influence drug use in elderly population. METHODS: The 506 individuals aged more than 60 year old residing in the area of Seoul and Kyung-Ki Do were interviewed with structured questionnaire from July 1st to August 15th, 1997. RESULTS: Of the 506 participants, 63.5% reported of taking at least one type of drug currently. Westerns medication group was 72.8% , oriental medication group was 12.8%, and combined medication group was 14.4%. Western medication was reported to have been taken primarily for 'curative' purpose whereas the oriental medication was taken primarily for 'preventive' purpose. The most frequently used drugs were analgesics(33.0%), antihypertensives (26.4%), and digestives(18.1%). 52.8% of the participants were taking two to five drug, and 49.7% were taking drugs which doctors recommended and 27.8% were on self-medication. Only 17.2% of drug users knew the names of the drugs being taken, and 8.1% reported having experienced adverse effects. Epidemiologic factors revealed higher rate of drug use for urban residents(67.9%), and ones living without their spouses(70.9%)(p<0.05). Medicines for 'preventive' purpose such as eutrophics were found to be used more frequently by those who lived in urban(21.7%) rather than rural(13.0%) area, with higher education and higher income(p<0.05). Behavioral characteristics revealed higher rate of drug use for those with low self-confidence in health and more frequent utilization of medical institution (p<0.05). The rate of drug use was higher for non-smokers and for those who do not drink alcohol, however it was not significant. For 'preventive' drug use, factor such as self-confidence in health and past medical history do not seem to have statistical influence. CONCLUSION: Factors such as urban residents, low self-confidence in health, and frequent utilization of medical institution have significant effect on drug use in elderly population.