[show abstract][hide abstract] ABSTRACT: SummaryConcerns have been raised among clinicians and patients whether or not bisphosphonates increase the risk of atrial fibrillation.
In this large cohort study, increased risk of atrial fibrillation was not found to be associated with bisphosphonate. In fact,
bisphosphonate even showed a protective effect against cardiac arrhythmia compared to other osteoporosis medications.
IntroductionIncreased risk of atrial fibrillation among bisphosphonate users has been reported; however, the results from these studies
are controversial. The purpose of this study was to evaluate the risk of atrial fibrillation associated with bisphosphonate
use in older women.
MethodsWe used the Korean Health Insurance Review and Assessment Service claims database from May 1, 2005 to June 30, 2006. Retrospective
cohort analysis was conducted on women 65years or older with newly diagnosed cases of osteoporosis (ICD 10 code: M80, M81)
who had not previously taken any medications for osteoporosis. Bisphosphonate-exposed and non-exposed patients were followed
until they were either diagnosed with atrial fibrillation (ICD 10 code: I48) or until the end of the study. The Cox proportional
hazards model was used to calculate hazard ratios and the 95% confidence intervals.
ResultsAtrial fibrillation was reported in 626 of the 120,319 patients (0.52%) treated with bisphosphonates and 66 of 9,863 patients
(0.67%) treated with other osteoporosis medications. Overall hazard ratio for developing atrial fibrillation in the bisphosphonate-treated
group was 0.52 (95% CIs, 0.29–0.91). In patients with a medication possession ratio greater than 0.7, the hazard ratio was
lower (HR 0.41, 95% CIs 0.23–0.75). In the subgroup analysis, alendronate showed a statistically significant protective effect
against the risk of atrial fibrillation with a hazard ratio of 0.75 (95% CI, 0.58–0.97).
ConclusionAmong older Korean women with osteoporosis, bisphosphonate was found to have a protective effect against atrial fibrillation.
Osteoporosis International 04/2012; 23(1):247-254. · 4.04 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea.
In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score.
Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively.
Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.
Journal of preventive medicine and public health = Yebang Ŭihakhoe chi. 01/2012; 45(1):14-20.
[show abstract][hide abstract] ABSTRACT: The aim of this study was to investigate whether a medium to high degree of total physical activity and indoor physical activity were associated with reduced all-cause and cardiovascular mortality among elderly Korean women.
A prospective cohort study was done to evaluate the association between physical activity and mortality. The cohort was made up of elderly (≥ 65 years of age) subjects. Baseline information was collected with a self-administered questionnaire and linked to death certificates retrieved from a database. Cox proportional hazard models were used to estimate the hazard ratios (HRs) with 95% confidence interval (CI) levels.
Women who did not suffer from stroke, cancer, or ischemic heart disease were followed for a median of 8 years (n=5079). A total of 1798 all-cause deaths were recorded, of which 607 (33.8%) were due to cardiovascular disease. The group with the highest level of total physical activity and indoor physical activity was significantly associated to a reduced all-cause mortality (HR, 0.60; 95% CI, 0.51 to 0.71 and HR, 0.58; 95% CI, 0.50 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity. Additionally, the group with the highest level of total physical activity and indoor physical activity was significantly associated to a lower cardiovascular disease mortality (HR, 0.53; 95% CI, 0.40 to 0.71 and HR, 0.51; 95% CI, 0.39 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity.
Our study showed that regular indoor physical activity among elderly Korean women has healthy benefits.
Journal of preventive medicine and public health = Yebang Ŭihakhoe chi. 01/2012; 45(1):21-8.