Self-reported diet management, dietary quality, and blood pressure control in Korean adults with hypertension

Objectives: Hypertension control is a major public health concern. Daily preventive practices of the affected individual are essential for controlling blood pressure (BP). We investigated the association of diet management practice, dietary quality, and BP control among Korean adults with known hypertension. Methods: We included 4107 participants aged 40-79 years who reported physician-diagnosed hypertension in the Korea National Health and Nutrition Examination Survey 2013-2016. Dietary management practice was defined by self-report, and dietary intakes were assessed by a 24-h dietary recall. Dietary quality and adherence were evaluated based on the Korean Healthy Eating Index (KHEI) using food and nutrient intakes assessed by a 24-h dietary recall. BP control was defined as systolic/diastolic BP < 140/90 mmHg. Results: While the prevalence of dietary management was higher in women than men, BP control rate was not different by sex. Dietary management practice had no significant association with BP control in both men and women. Only in men, dietary quality was positively associated with BP control (OR: 1.10 per KHEI 10 score increase, 95% CI: 1.00-1.20, p-value = 0.04). Men who had a highly adherent diet seemed to have a higher possibility of BP control, but there was no statistical significance (OR: 1.54, 95% CI: 0.84-2.81, p-value = 0.16). Conclusions: A high-quality diet was positively associated with BP control in Korean men aware of their hypertension. Our findings highlight the beneficial impact of dietary management as a means for achieving blood pressure control.ope

Perceived Discrimination, Depression, and the Role of Perceived Social Support as an Effect Modifier in Korean Young Adults

OBJECTIVES: The relationships among discrimination, social support, and mental health have mostly been studied in minorities, and relevant studies in the general population are lacking. We aimed to investigate associations between discrimination and depressive symptoms in Korean non-minority young adults, considering the role of social support. METHODS: In total, 372 participants who completed the psychological examinations conducted in the third wave of the Jangseong High School Cohort study were included. We used the Everyday Discrimination Scale to evaluate perceived discrimination and the Beck Depression Inventory-II to measure depressive symptoms. Social support was measured by the Multidimensional Scale of Perceived Social Support. Multivariate linear regression was conducted to investigate associations between discrimination and depression, along with the effect modification of social support. We stratified the population by gender to investigate gender differences. RESULTS: Perceived discrimination was significantly associated with depressive symptoms (β=0.736, p&lt;0.001), and social support was negatively associated with depression (β=-0.245, p&lt;0.001). In men, support from friends was the most influential factor (β=-0.631, p=0.011), but no significant effect modification was found. In women, support from family was the most influential factor (β=-0.440, p=0.010), and women with higher familial support showed a significantly diminished association between discrimination and depression, unlike those with lower family support. CONCLUSIONS: Discrimination perceived by individuals can lead to depressive symptoms in Korean young adults, and this relationship can may differ by gender and social support status.ope

Anxiety and COVID-19 Related Stressors Among Healthcare Workers Who Performed Shift Work at Four COVID-19 Dedicated Hospitals in Korea

Objective: To assess the relationship between anxiety and shift work of healthcare workers (HCWs) during COVID-19 pandemic. Methods: From four COVID-19-dedicated hospitals in Korea, 381 HCWs were analyzed to estimate anxiety in relation to four COVID-19 job stressors and the impact of shift work on this relationship. Anxiety was measured with a generalized anxiety disorder 7-item scale. Multiple logistic regression models were utilized after stratification by sex, occupation, and shift work, after adjusting for a number of variables. Results: Anxiety prevalence was 32%. Among female nurses or nursing assistants who performed shift work, anxiety risk was significantly associated with three COVID-19 related job stressors: contact with confirmed cases or patients, dealing with unpleasant patients, and discomfort from wearing protective equipment. Conclusions: Special attention is required for mental health of HCWs working shifts during the COVID-19 pandemic.ope

Mental Health and Psychological Intervention Amid COVID-19 Outbreak: Perspectives from South Korea

ope

Exploring the associations between cardiovascular health measured with the CANHEART model and early cognitive impairment in a middle-aged population in Korea

Objectives: Both cardiovascular health (CVH) and inflammation are associated with cognition, and inflammation is also associated with CVH. However, limited information has been reported on these factors in the Korean population. The objective of our study was to investigate the influence of inflammation on the association between CVH and cognition using a cross-sectional design. Methods: Data were obtained from the Cardiovascular and Metabolic Diseases Etiology Research Center baseline study. Participants who completed fasting serum analysis, questionnaires, and cognitive function tests were included in the analysis, whereas those with a history of autoimmune disease were excluded. The CVH in Ambulatory Care Research Team health index metrics, including smoking, physical activity, healthy diet, obesity, history of hypertension, and diabetes, were used to assess CVH. Cognitive function was evaluated with the Korean version of the Mini-Mental State Estimation for Dementia Screening. Inflammatory status was assessed based on a high-sensitivity C-reactive protein (hs-CRP) test. Results: Among 2,622 total participants (mean age, 57.2 years; 1,792 women), 13%, 58%, and 29% had poor, intermediate, and ideal CVH, respectively. Logistic regression analysis demonstrated that CVH was significantly associated with cognitive function only in women. A stratified analysis showed that cognitive impairment due to CVH was not associated with hs-CRP levels. When the same analyses were conducted for each CVH component, the only component affecting the association was hypertension history in men. Conclusions: CVH is not significantly associated with cognitive decline in the middle-aged Korean population. Inflammation did not play a significant modifying role in this relationship.ope

Posttraumatic stress disorder symptoms and television viewing patterns in the Nurses' Health Study II: A longitudinal analysis

INTRODUCTION: The relation between TV viewing and posttraumatic stress disorder (PTSD) is controversial; prior work focused exclusively on whether TV viewing of disaster events constitutes a traumatic stressor that causes PTSD. This study evaluates a possible bidirectional relation between PTSD and TV viewing in community-dwelling women. METHODS: Data are from the PTSD subsample of the Nurses' Health II study, an ongoing prospective study of women aged 24-42 years at enrollment and who have been followed biennially (N = 50,020). Trauma exposure and PTSD symptoms (including date of onset) were assessed via the Brief Trauma Questionnaire and the Short Screening Scale for DSM-IV PTSD. Average TV viewing was reported at 5 times over 18 years of follow-up. Linear mixed models assessed differences in TV viewing patterns by trauma/PTSD status. Among women with trauma/PTSD onset during follow-up (N = 14,374), linear spline mixed models assessed differences in TV viewing patterns before and after PTSD onset. RESULTS: Women with high PTSD symptoms reported more TV viewing (hours/wk) compared to trauma-unexposed women at all follow-up assessments (β = 0.14, SE = 0.01, p < .001). Among the women who experienced trauma during follow-up, significant increases in TV viewing (hours/day) prior to onset of high PTSD symptom levels were evident (β = 0.15, SE = 0.02, p < .001). CONCLUSIONS: TV viewing following trauma exposure may be a marker of vulnerability for developing PTSD and also a consequence of having PTSD. High TV viewing levels may be linked with ineffective coping strategies or social isolation, which increase risk of developing PTSD.ope

Association between menstrual cycle irregularity and suicidal ideation among Korean women: Results from the Korea national health and nutrition examination survey (2010-2012)

Background: We aimed to evaluate the association between menstrual cycle irregularity and suicidal ideation in Korean women. Methods: Data on 5,606 women from the 2010-2012 Korea National Health and Nutrition Examination Survey, a population-based cross-sectional study, were included. Menstrual cycle irregularity, suicidal ideation, current occupational status, age at menarche, education level, household income, and marital status were assessed through questionnaires with trained interviewers. A multivariate logistic regression analysis was performed after adjusting for age, socioeconomic status, smoking and drinking status, age at menarche, comorbid diseases, and physical activity. Results: In the multivariate-adjusted models, we found significant associations between menstrual cycle irregularity and suicidal ideation (odds ratio [OR], 95% confidence interval [CI] = 1.44 [1.14-1.82]). This association was particularly noticeable in women aged 12 to 29 years (OR [95% CI] = 1.45 [1.04-2.03]), in those who had menarche at a relatively early age (aged 8-13 years) (OR [95% CI] = 1.60 [1.15-2.23]), and in those who were currently employed (OR [95% CI] = 1.46 [1.05-2.04]). Limitations: Suicidal ideation was evaluated based on the participants' self-reports, and were therefore subjective in nature. Additionally, due to the cross-sectional design and use of retrospective data, causal relationships could not be drawn. Conclusion: Women with irregular menstrual cycles were 1.42 times more likely to have suicidal ideation than those with regular cycles. More attention should be paid to menstrual cycle irregularity when attempting to improve levels of suicidal ideation.ope

Use of sedative-hypnotics and the risk of Alzheimer's dementia: A retrospective cohort study

There has been a growing interest in the relationship between sedative-hypnotics use and the risk of Alzheimer's dementia (AD) risk. This study aimed to evaluate the risk of AD associated with the use of sedative-hypnotics. A retrospective cohort study was conducted with randomly selected 5% samples from ≥50 years old beneficiaries of National Health Insurance Service (NHIS) of Korea from January 2002 to December 2015. The exposure to sedative-hypnotics was defined when prescribed over 30 defined daily dose (DDD) after January 2004 and it was categorized by prescribed dosage, types and half-lives of benzodiazepines. Time-dependent Cox regression model with a lag period of 5-years was used to evaluate the association between use of sedative-hypnotics and the risk of subsequent AD. Sensitivity analysis was performed for restricting sedative-hypnotics only when prescribed with insomnia. A total of 268,170 subjects were identified and subjects exposed to sedative-hypnotics showed a higher risk of AD (HR: 1.79; 95% CI: 1.72-1.86) than those who were not. There was an increased risk of AD among subjects exposed to benzodiazepines or zolpidem (HR: 1.75; 95% CI: 1.67-1.82) and antidepressants or low-dose antipsychotics (HR: 1.63; 95% CI: 1.42-1.87). The risk of AD was increased regardless of dose of sedative-hypnotics and half-life among benzodiazepines, especially in exposure to more than 360 DDD of sedative-hypnotics (HR: 1.78; 95% CI: 1.60-1.99) and the long-acting benzodiazepine (HR:1.77; 95% CI: 1.65-1.89)ope

Posttraumatic stress disorder, cardiovascular disease outcomes and the modifying role of socioeconomic status

Introduction: Substantial evidence indicates that post-traumatic stress disorder (PTSD) is associated with an increased incidence of cardiovascular disease (CVD), and differential PTSD-CVD association by socioeconomic status had been suggested. However, there are inadequate evidence on differential association. This study investigated sociodemographic heterogeneity in the association between PTSD and CVD. Methods: A total of 53,749 patients diagnosed with PTSD in 2004-2018 were recruited from Korean National Health Insurance Database. Date of first diagnosis of PTSD was set as an index date. We recruited 3 controls per each patient, matched by age and sex (N = 161,247). Monthly insurance premiums were used as a surrogate variable for socioeconomic status. Cox proportional hazard model was used to estimate the hazard of incident coronary artery disease, incident stroke, and cardiovascular mortality. We stratified participants by age, sex, and insurance premium to test heterogeneities in the association. Results: PTSD was associated with increased risk for coronary artery disease, hemorrhagic stroke, and cardiovascular mortality. Elevation in risk of cardiovascular disease was more prominent in younger individuals. PTSD increased the risk of coronary artery disease and ischemic stroke more in individuals with lower SES, especially in men. Limitations: Insurance premium might not fully represent socioeconomic status of individual. Misclassification or misdiagnosis of PTSD by might have introduced biases. Conclusions: PTSD was associated with increased incidence of CVD, particularly in male patients with low SES. For PTSD patients with lower SES, preventive measures against cardiovascular disease would be able to decrease the disease burden of cardiovascular comorbidity in PTSD.ope

Impact of COVID-19 on mental health according to prior depression status: A mental health survey of community prospective cohort data

Objective: We aimed to investigate the mental health impact of COVID-19 on a demographically well-characterized population cohort by gender and previous depression status. Methods: Among people who participated in a community cohort study between 2013 and 2018 with previous depression measurement, a total of 1928 people without quarantine experience (680 men and 1249 women) were included after responding to an online survey in March 2020. In the 2020 survey, people were queried about daily needs supply, social support, risk perception, change during the COVID-19 pandemic, as well as mental health indices measuring loneliness, anxiety symptoms, post-traumatic stress disorder (PTSD), and depression. Separate analyses by gender were conducted to assess the association between COVID-19-related experiences and each mental health index, using multivariable logistic regressions with additional adjustment and stratification with pre-existing depression status. Results: We could not observe significant gender differences for depression, anxiety, PTSD, and loneliness at 55 days after the start of the COVID-19 outbreak. Most external support, including daily needs supply and social support, protected men and women from experiencing severe anxiety (for life supply, OR = 0.92 (95%CI 0.88-0.97) (men) and OR = 0.95 (95% CI 0.91-0.99) (women); for social support, OR = 0.92(both for men and women, p < 0.01)). The results were similar for depression and PTSD. External support showed a larger reduction in the likelihoods for anxiety and depression during the COVID-19 pandemic among people with pre-existing depression compared to previously healthy people, and it was more prominent in men. Conclusion: COVID-19 significantly affected the mental health of both men and women in the early period of the pandemic. Having enough supply of daily needs and social support seems important, especially for people with previous depression.ope