Patterns of change in cardiovascular risks of Korean male workers: a 10-year cohort analysis using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) 2.0 database

Abstract

Objective: Health behaviour is one of the major determinants of cardiovascular diseases in working population. This study was tried to investigate the trend of cardiovascular health level, the relationship between continuous health behaviours, and changes in the risk of cardiovascular diseases of male workers by using a nationwide database.

Design: This study is a retrospective cohort study.

Setting and participants: The study analysed data of 57 837 male workers whose personal health examination data were continuously traced using Korea's National Health Insurance Service-National Sample Cohort 2.0 database.

Primary outcome measures: A 10-year trend for all cardiovascular risks and change for the risks according to the consistent performance of healthy behaviours.

Results: The results showed that the risk of being overweight (adjusted OR (aOR) 1.63, 95% CI 1.59 to 1.68) and obese (aOR 1.51, 95% CI 1.47 to 1.56) increased. The index of cardiovascular risk also increased for high fasting glucose (aOR 1.77, 95% CI 1.62 to 1.95) and high total cholesterol (aOR 1.68, 95% CI 1.60 to 1.76), respectively. The risks of high fasting glucose (aOR 2.09, 95% CI 1.40 to 3.13), high triglycerides (aOR 1.27, 95% CI 1.14 to 1.42) and high low-density lipoprotein cholesterol (aOR 1.38, 95% CI 1.14 to 1.66) were increased among high-risk smokers. Similarly, the risk of high total cholesterol (aOR 2.20, 95% CI 1.35 to 3.58) and high triglycerides (aOR 1.42, 95% CI 1.09 to 1.85) were increased among high-risk drinkers. In addition, the increase in the risk of being overweight (aOR 2.20, 95% CI 1.83 to 2.65) and obese (aOR 1.90, 95% CI 1.59 to 2.27) were analysed among who had not consistently exercised.

Conclusions: Since the pattern of change in the level of cardiovascular risk related to the continuous health behaviours of male workers was identified, the findings of the present study can be used as basic data to develop health promotion policies for the population.

Keywords: cardiac epidemiology; occupational & industrial medicine; public health.

Figure 1

Trends in health status among the participants (n=57 837). Overweight (BMI 23.00–24.99); Obesity (BMl≥25.00kg/m²); Abdominal obesity (WC≥90cm); Borderline BP (≥120/80 mmHg); High BP (≥140/90 mmHg); Prediabetes (100–125mg/dL); High FG (≥126 mg/dL); High TC (≥240 mg/dL); High TG (≥200 mg/dL), Low HDL-C (<40 mg/dL), and High LDL-C (≥160 mg/dL). *% prevalence rate among total number of cases in each cell, **p-value for trend <0.01. BMI, body mass index; BP, blood pressure; Fg, fasting glucose; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TC, total cholesterol; TG, triglycerides; WC, waist circumference

Figure 2

Annual changes in risks of obesity and high FG among the participants (n=53 837)*. Reference: normal range in each of the variables. *Adjusted for age, region, income. FG, fasting glucose.

Figure 3

Annual changes in risks of high FG and dyslipidaemia between high-risk smokers* and non-smokers† (n=6585)‡. Reference: normal range in each of the variables. *Has been a persistent smoker for 10 years. †Has been consistent non-smoker for 10 years. ‡Adjusted for age, region, income. FG, fasting glucose; LDL-C, low-density lipoprotein cholesterol; TG, triglyceride.

Figure 4

Annual changes in risks of high BP and dyslipidaemia between high risk drinkers* and non-drinkers† (n=1330)‡. Reference: normal range in each of the variables. *Persistent high-risk drinking for 10 years (twice or more per week, seven or more drinks per drinking on average). †Has been a consistent non-drinker for 10 years. ‡Adjusted for age. BP, blood pressure; TC, total cholesterol; TG, triglyceride.

Figure 5

Annual changes in risks of obesity between healthy exercisers and non-exercisers. Reference: normal range in each of the variables. *Adjusted for age, region, income. †,‡ Adjusted for age, income.