Cardiovascular Prevention and Pharmacotherapy

Original Article

The distribution of artificial intelligence–derived retinal cardiovascular risk scores and conventional risk factors in two Korean health screening cohorts: a descriptive study: Jungkyung Cho, Jaewon Seo, Junseok Park, Dongjin Nam, Tae Hyun Park, Sahil Thakur, Tyler Hyungtaek Rim, Beom-hee Choi, Miso Jang; Cardiovasc Prev Pharmacother. 2025;7(3):73-84. Published online July 28, 2025; DOI: https://doi.org/10.36011/cpp.2025.7.e14

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Abstract PDF Supplementary Material: Background
Although retinal imaging–based artificial intelligence (AI) tools have recently been introduced for cardiovascular disease (CVD) risk assessment, little is known about the distribution of these AI-derived scores across the full age spectrum or their associations with traditional cardiometabolic risk factors at different ages.
Methods
We analyzed data from 138,745 participants who underwent routine health examinations at two health screening centers in Seoul, Korea. The AI-based retinal CVD risk score (Dr.Noon CVD), as well as anthropometric, hemodynamic, and metabolic indices and cardiometabolic disease status, were compared across ages 16 to 96 years. In a subgroup of 13,182 individuals who underwent coronary artery calcium scoring (CACS) by cardiac computed tomography, we evaluated the performance of the Dr.Noon CVD score in detecting CACS using receiver operating characteristic curve analysis.
Results
Mean Dr.Noon CVD scores rose steadily with age from 14.2±2.9 (<30 years) to 46.3±6.5 (≥70 years), closely mirroring the increase in traditional cardiovascular risk factors with age. Additional analysis using CACS demonstrated that the Dr.Noon CVD score achieved an area under the curve of 0.80 (95% confidence interval, 0.80–0.81) for detecting any coronary calcification, defined as CACS >0, and an area under the curve of 0.82 (95% confidence interval, 0.81–0.83) for identifying significant calcification burden, defined as CACS >100.
Conclusions
Dr.Noon CVD scores were consistently correlated with age, conventional risk factors, and CACS, suggesting a potential role in broad-based cardiovascular risk stratification and in guiding personalized prevention strategies.

Review Article

Stroke mechanisms and prevention in intracranial atherosclerosis: Sang Hee Ha, Bum Joon Kim; Cardiovasc Prev Pharmacother. 2025;7(3):94-101. Published online July 22, 2025; DOI: https://doi.org/10.36011/cpp.2025.7.e10

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Abstract PDF: Intracranial atherosclerosis (ICAS) is a leading cause of ischemic stroke worldwide, with a particularly high prevalence among Asian populations. While early research primarily attributed this to systemic risk factors such as metabolic syndrome, more recent studies highlighted the importance of local factors, including vascular geometry and hemodynamic stress. The pathophysiology of ICAS-related stroke is multifactorial and encompasses in situ thrombotic occlusion, artery-to-artery embolism, hemodynamic compromise, and perforator branch occlusion. A thorough understanding of these mechanisms is essential for precise risk stratification and the development of targeted preventive strategies. Despite advancements in imaging techniques and pharmacological therapies, ICAS continues to present significant clinical challenges. This review synthesizes current knowledge on stroke mechanisms associated with ICAS and discusses emerging evidence for both primary and secondary prevention, including antithrombotic strategies, risk factor modification, and novel imaging approaches such as high-resolution vessel wall magnetic resonance imaging.

Original Article

Association between reproductive aging and hypertension among Korean women: Eunji Kim, Youngrong Lee, Hyeon Chang Kim; Cardiovasc Prev Pharmacother. 2022;4(1):34-41. Published online January 19, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e2

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Abstract PDF Supplementary Material: Background
Although postmenopausal women are well known to have a high prevalence of hypertension, it is unclear whether menopause itself increases blood pressure independently from the known risk factors of hypertension. This study sought to determine whether an association exists between reproductive aging, analyzed as a gradual transition, and an increased risk of hypertension among Korean women.
Methods
This cross-sectional study used baseline data from 5,456 women aged 30 to 64 years who participated in the Cardiovascular and Metabolic Diseases Etiology Research Center study in Korea from 2013 to 2018. The participants’ stage of reproductive aging was assessed by a questionnaire and categorized as premenopause, perimenopause, and postmenopause. Multiple logistic regression models were used to analyze the association between menopausal status and hypertension after adjusting for age, education level, marital status, employment, household income, smoking, drinking, physical activity, body mass index, and hormone replacement therapy use.
Results
The prevalence of hypertension increased with reproductive aging: 9.8% in premenopause, 25.2% in perimenopause, and 27.7% in postmenopause. The adjusted odds ratio (95% confidence interval) for having hypertension was 1.70 (1.07–2.72) for perimenopausal women and 1.14 (0.88–1.48) for postmenopausal women, compared to premenopausal women.
Conclusions
Our study shows that perimenopausal women are at high risk of developing hypertension. Since the menopausal transition may last months or years, blood pressure monitoring and early interventions are crucial for not only postmenopausal women, but also those in the transition.

Special Article

Geriatric Considerations in the Management of Elderly Patients with Cardiovascular Diseases: Doo Soo Jeon; Cardiovasc Prev Pharmacother. 2021;3(2):38-46. Published online April 30, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e6

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Abstract PDF

Cardiovascular disease (CVD) is the most frequently diagnosed disease as well as the leading cause of death in the elderly. It usually results from long-term effects of cardiovascular risk factors as well as the aging process itself. Elderly people commonly have geriatric syndrome, which is an age-specific problem that is complicated by the presence of cardiovascular, cognitive, and physical dysfunction and is accompanied by many other chronic diseases. While caring for the elderly, in addition to CVD, various inherent problems must be considered. The patient-centered approach, instead of evidence-based guidelines that are designed for young adult patients, is the most important concept when it comes to elderly patients with CVD and multiple comorbidities. This approach should be used to maintain the functionality, independence, quality of life, and dignity of these patients.

Citations

Citations to this article as recorded by

Assessment of Quality of Life in Patients With Cardiovascular Disease Using the SF-36, MacNew, and EQ-5D-5L Questionnaires
Aikaterini Chatzinikolaou, Stergios Tzikas, Maria Lavdaniti
Cureus.2021;[Epub] CrossRef

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