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TRANSCRIPT
d'~,~~,~~~'U,~~,~~~JOURNAL OF NURSING SCIENCE
11~21 'UtJlJ~1 l-Jm"H'Il-J-Ll-J~lt1iJ2546Vol. 21 NO.1 January-April' 2003
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A study of hea/th-behevior and cardiovascular riskin middle adults in Bangkoknoi district.
VenusLeelahakul, Usaporn Chavalitnitikul,Pairoj Leelahpkul, Supanee Puthadejakum,
Nitaya Pasunant.
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JOURNAL OF NURSING SCIENCE Vol. 21 NO.1 January-April 2003 57
Abstract: Cardiovascular diseases continue to be the leading cause of morbidity and mortality
among adults in Thailand. Studies of health behavior and cardiovascular risks are benefit for pri-
mary prevention. The objective of this study was to investigate the health behavior and cardiovas-
cular risks in 194 adults, 51 men and 143 women in Bangkoknoi district, Bangkok, aged between
35 and 59. The health behavior and cardiovascular risks were assessed by use of a health style
questionnaire and the Framingham Risk Assessment Scoring. The resulting data showed their
lack of exercise, poor eating, stress, alcohol consumption or drug abuse and cigarette smoking
habits were 86.6,65.0,45.9,14.5 and 10.9 respectively; in women were 90.2, 64.3, 45.5,9.1 and
5.6% whereas the corresponding figure in men were 76.5, 66.7, 47.0, 29.4 and 25.4%, respec-
tively. The prevalences of their cardiovascular risk factors namely hypercholesterolemia, low level
of HDL-cholesterol, hypertension, obesity, diabetes mellitus and cigarette smoking were 74.2,
78.4,44.8,26.8, 10.8 and 7.7 %, respectively; in women were 77.7,76.9,25.9,49.7,7.7 and 5.6%
whereas the corresponding figure in menwere 64.7, 82.3, 29.4, 31.4 and 25.4%, respectively. The
mean of absolute risk estimates of their 10 year total coronary heart disease risk was 6.03 ~
0.37%; in men was 8.61? 0.68 % whereas that in women was 5.10?0.37%. The relative risk for
coronary heart disease in men was 2 whereas that in women was 1.7. The conclusion of this study
shows the major cardiovascular risks ofthe adults in Bangkoknoi district are hypercholesterolemia,
hypertension, smoking and diabetes mellitus. The proper health practices should be recommended
in order to improve their cardiovascular risk profiles
Key words: health behavior/cardiovascular risk/middle adult
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JOURNAL OF NURSING SCIENCE Vol. 21 NO.1 January-April 2003 59
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JOURNAL OF NURSING SCIENCE Vol. 21 NO.1 January-April 2003 61
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1. Report of WHO study group. Epidemiology
and prevention of cardiovascular disease in
elderly people. WHO Tech Rep Ser 1995 : 1-
67.
2. Rice DP, Hodgson TA, Kqpstein AN. The eco-
nomic costs of illness: replication and update.
Health care finance review, 1985: 7: 61-80.
3. American Heart Association, 2001 Heart and
Stroke Statistical Update. Texas: American
Heart Association, 2000:21-31.(Available at
http://www .america nhea rt.org)
4. World health statistics annual 1990. Geneva,
World health organiza~ion, 1991.
5. Sindhvananda K, Kachacheewa U. Epidemi-
ology of heart disease in Thailand. In : Lochaya
S, Pongpanich B, Sakornpant P, eds. Cardio-
vascular disease. 2nd ed. Bangkok: The Heart
Association of Thailand, 1993: 9-22.
6. ~')'W'ii!l~tl'll1,)~1H'l1fi1'j'ru~'lI~hrn'W'i:mJ1mltl:;~ ,llj;.J'W~1fi1'j'ru~'lI~11!mJ~~m:;YJ'j',)'1~1fi1'j'CW~'lI., ,~Ci~~1fi1'j'ru~'lI'V'u'1.2540. nNl'VlY1"1: !l'lr1n1'j', ,~'1l~'j'1:;,x'VlVl1'j'~1'W~n,2542.
7. Grundy SM, Pasternak R, Greenland P., et al.
Assessment of Cardiovascular Risk by Use of
Multiple-Risk-Factor Assessment Equations: A
Statement for Healthcare Professionals form
the American Heart Ass.ociation and the
JOURNAL OF NURSING SCIENCE Vol. 21 NO.1 January-April 2003 67
American Collage of Cardiology. Circulation
1999; 100 C13: 1481-92.
8. 4''WVlfbYlru 'lllh:::1l1'J11ru. nU'l1'Wn11~11'J~~ ~~ rn 'W:::~"lJ1l1Vi'fl'W1~U"lJ'fl'llh:::'ll1n11VlU~bUn11
~'fllJm~bb'Cl:::lJI1'J~11'1n1U~'Jlh:::bVlPl.rlf'l~ 1ViA
2534-5. nN bVlVi'1 : ~'111j'Wfj4'U1:::lJlJ~1fi11ru~"lJ,, ,2539.
9. Report of WHO study group. Tobacco or
Health: A Global Status Report, Geneva, Swit-
zerland: World Health Organization (WHO):
1997.
10. ~TVi1 "'1lJ1~1nru, L'llrl-nU rln=BlJI, ~l?Ilh:::~'1f'l, ~ ,b'flm1'llbnlJlt)'Cl~.rlrur11'fl1vn1Vh~v.Jl?I:~11'fl1"'11" ~",~n. 'J11~11'fl1"'11. 2535 ; 22 : 31-6.
11. Valentin F, Gotto AM. Risk reduction. Circula-
tion. 2000 ; 102: IV-94-IV-102.
12. Powell KE, Thompson PO, Caspersen CJ, &
Kendrick JS. Physical activity and incident of
coronary heart disease. Annual Review of
Public Health 1987; 8: 251-87.
13. Fletcher GF. How to implement physical
activity in primary and secondary prevention:
a statement for healthcare professionals from
the Task Force on Risk Reduction, American
Heart Association. Circulation. 1997; 96: 355-
357.
14. Marmot M & Brunner E. Alcohol and cardio-
vascular disease: the status of the U-shaped
curve. British Medica Journal 1991; 303 : 565-
8.
15. Grillette ECD, Blumenthal JA, Babyak M, Jaing
W, Waugh RA, Frid OJ, et al. Effect of mental
stress on myocardial ischemia during daily
life. JAMA 1997; 277: 1521-6.
16. The Association of Joint National Committee
(JNC-V). The fifth Report of the Joint National
Committee on Detection, Evaluation and Treat-
ment of High Blood Pressure (JNC-V). Arch
Intern Med. 1993; 153: 154-183.
17. Science press briefing. Lipid research clinics
coronary primary prevention trial results. Nutr
Today 1984; 1: 20-25.
18. Stemler J, Vaccaro 0, Neaton JD. For the Mul-
tiple Risk Factor Intervention Research Group.
Diabetes, other risk factor and 12 year cardio-
vascular mortality for men screened in the
Multiple Risk Factor Trial. Diabetes Care 1993;
16: 434-44.
19. Robinson JG. & Leon AS. The prevention of
cardiovascular disease: emphasis on secon-
dary prevention. Med Clin N Am. 1994; 78:
69-98.
20. Krieger DR, Landsberg L. Mechanisms in
obesity-related hypertension: role of insulin
and catecholamines. Am J Hypertens. 1988;
1: 84-90.
21. Wilson PWF, D'Agostino RB, Belanger AM, et
al. Prediction of Coronary Heart Disease
Using RiskFactorCategories. Circulation 1998;
97:1837-1847.
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