Background: Mortality from cardiovascular diseases in Asian populations is considerable. Menopause is a risk‐enhancing factor for cardiovascular disease, but it is unclear whether menopause is an independent risk factor for cardiovascular disease and mortality in Asian women. Methods and Results: A total of 1 159 405 postmenopausal women, who had participated in the health examinations of the Korean National Health Insurance Service in 2009, were analyzed, and their reproductive histories were taken. A multivariable Cox proportional hazard model assessed the hazard ratios (HRs) of myocardial infarction (MI), ischemic stroke, and all‐cause mortality, according to the history of premature menopause and age at menopause. After an average 10‐year follow‐up, there were 31 606, 45 052, and 77 680 new cases of MI, ischemic stroke, and all‐cause mortality, respectively. The women with premature menopause exhibited increased risks of MI (HR, 1.40 [95% CI, 1.31–1.50]), ischemic stroke (HR, 1.24 [95% CI, 1.17–1.31]), and all‐cause mortality (HR, 1.19 [95% CI, 1.14–1.24]) when compared with women with menopause aged ≥50 years. The highest risk was evident with menopause between the ages of 30 and 34 years (HR for MI, 1.52 [95% CI, 1.30–1.78]; HR for ischemic stroke, 1.29 [95% CI, 1.12–1.48]; HR for all‐cause mortality, 1.33 [95% CI, 1.20–1.47]) when compared with women with menopause aged ≥50 years. Conclusions: Earlier age at menopause was associated with increased risks for MI, ischemic stroke, and all‐cause mortality. Future guidelines and risk assessment tools should consider menopause as an independent risk factor of cardiovascular disease in Korean women.

Background: This study aimed to evaluate the association of hypertension with incident infective endocarditis (IE) by investigating the incidence of IE according to blood pressure levels using the National Health Insurance Service database. Methods: The data of 4 080 331 individuals linked to the health screening database in 2009 were retrieved (males, 55.08%; mean age, 47.12±14.13 years). From 2009 to 2018, the risk factors for the first episode of IE were investigated. Hypertension was categorized into normotension, prehypertension, hypertension, and hypertension with medication. The Cox proportional hazard model assessed the effect of blood pressure level during the health screening exam on incident IE. Results: During the 9-year follow-up, 812 (0.02%) participants were diagnosed with IE. The incidence rates of IE in the normotension, prehypertension, hypertension, and hypertension with medication groups were 0.9, 1.4, 2.6, and 6.0 per 100 000 person-years, respectively. Those with prehypertension, hypertension, and hypertension with medication were correlated with an increased risk of IE in a dose-response manner compared with the normotension group (hazard ratio, 1.33 [95% CI, 1.06–1.68]; hazard ratio, 1.98 [1.48–2.66]; hazard ratio, 2.56 [2.02–3.24], respectively, all P <0.001). Conclusions: In a large national cohort study with an average follow-up of 9 years, increased blood pressure was identified as a risk factor for incident IE in a dose-dependent manner. Hypertension increases the public health care burden by acting as a risk factor for rare infective heart diseases.

Fatty liver index (FLI) is a simple and useful index that evaluates non-alcoholic fatty liver disease (NAFLD), particularly in large epidemiologic studies. Heart failure (HF) is becoming a burden to public health as the global trend toward an aging society continues. Thus, we investigated the effect of FLI on the incidence of HF using large cohort data from the Korean National Health Insurance health database. Methods and Results: A total of 7,958,538 subjects aged over 19 years without baseline HF (men = 4,142,264 and women = 3,816,274) were included. Anthropometric and biochemical measurements were evaluated. FLI scores were calculated and FLI ≥ 60 was considered as having NAFLD. Hazard ratios (HRs) and 95% confidence intervals (CIs) for HF incidence were analysed using multivariable time-dependent Cox proportional hazard models. During a mean follow up of 8.26 years, 17,104 participants developed HF. The FLI components associated with the incidence of HF and FLI showed a causal relationship with HF; the FLI ≥ 60 group had a higher HR for HF (HR 1.493; 95% CIs 1.41–1.581) than the FLI < 30 group. Subgroup analysis showed that fatty liver (FLI ≥ 60) with age ≥ 65 years or women displayed higher HR for HF than fatty liver with age < 65 or men, respectively. An increase in FLI score significantly increased the HR for HF except for those with a FLI score change from <30 to 30–60. Conclusion: NAFLD defined by FLI and increase in FLI score were associated with the incidence of HF. Further detailed prospective studies are needed.

Hypertension is one of the leading chronic diseases globally and a major contributor to cardiovascular morbidity and mortality. Despite advances in pharmacological therapy, medication alone remains limited in achieving optimal control. This review synthesizes recent hypertension management guidelines, including those from the European Society of Cardiology (ESC, 2024), American Heart Association/American College of Cardiology (AHA/ACC, 2025), Taiwan Society of Cardiology/Hypertension Society (2022), and Korean Society of Hypertension (KSH, 2018). All guidelines consistently emphasize sodium restriction, weight reduction, regular exercise, moderation of alcohol intake, smoking cessation, and adoption of healthy dietary patterns such as the Dietary Approaches to Stop Hypertension, Mediterranean, or culturally adapted diets. The ESC 2024 guideline elevates lifestyle modification to Class I, Level A, specifying targets for sodium (<2 g/day) and potassium (≥3.5 g/day). The AHA/ACC 2025 guideline provides quantitative estimates, reporting approximately 1/1 mm Hg blood pressure reduction per kilogram of weight loss, and incorporates newer strategies such as glucagon-like peptide-1 receptor agonists and bariatric surgery when lifestyle measures alone are insufficient. Taiwan’s 2022 guideline frames recommendations under the S-ABCDE (sodium restriction, alcohol limitation, body weight reduction, cigarette cessation, diet adaptation, exercise adoption) mnemonic and uniquely includes genetic factors such as ALDH2 polymorphisms. The KSH 2018 guideline emphasizes salt restriction (<6 g/day), maintaining a body mass index <25 kg/m2, and adherence to traditional Korean diets. Lifestyle modification remains the cornerstone of hypertension prevention and management, particularly in primary care. Future directions should focus on integrating these approaches with pharmacotherapy, digital health strategies, and personalized prescriptions.

Background: The impact of weight or weight changes on kidney function remains a matter of debate. This study aimed to investigate the association between weight fluctuation and the incidence of end-stage renal disease (ESRD) using data from the Korean National Health Insurance Corporation health checkups (2009–2015).Methods: The study included 2,310,667 participants (1,546,749 men and 763,918 women), aged ≥40 years. Weight fluctuation was assessed using the average real variability (ARV) of weight and categorized into quartiles (Q1–Q4). Hazard ratios (HRs) and 95% confidence intervals for ESRD incidence were calculated using multivariable Cox proportional hazards models.Results: After adjustment for comorbidities, increased body mass index was associated with a decreased HR for ESRD. The highest quartile of weight variability (ARV Q4) demonstrated a higher probability and HR for ESRD compared to the lower variability quartiles (Q1–Q3). Among men, individuals with sustained weight, and those with weight gain, the ARV Q4 group showed significantly increased HRs for ESRD (HR of 1.372, 1.222, and 1.49, respectively). Furthermore, irrespective of changes in creatinine levels, all ARV Q4 groups exhibited increased HRs for ESRD (HR of 1.342, 1.472, and 1.299, respectively).Conclusions: High weight fluctuation (ARV Q4) was associated with an increased incidence of ESRD in the general Korean population, with notable significance in men and in groups with sustained or increased weight. Clinically, individuals in the ARV Q4 category should be considered at risk for ESRD, and early interventions should be pursued for this population.

Objectives: The relationship between tooth loss and glycemic control status in diabetes is inconclusive. Material and Methods: Using data from the 2014–2018 Korean National Health and Nutrition Examination Survey (KNHANES), 2146 adults with diabetes aged ≥ 40 years were categorized by number of remaining teeth (0–19, 20–27, and ≥ 28). Uncontrolled diabetes and poorer glycemic control were defined as HbA1c ≥ 6.5% and ≥ 7.0%, respectively. Multivariable logistic regression models calculated the odds ratio (OR) for uncontrolled diabetes and poorer glycemic control according to the number of remaining teeth. Results: No significant association was observed in men. In women, fewer remaining teeth were associated with higher odds of uncontrolled diabetes (per 1‐tooth increase OR 0.961, 95% CI 0.937–0.986; p = 0.002), and compared with ≥ 28 teeth, OR were higher in the 0–19 teeth (OR 2.500, 95% CI 1.535–4.074) and the 20–27 teeth (OR 1.679, 95% CI 1.073–2.629) (all p = 0.002). Furthermore, among women, the associations persisted in both 40–59 years (per 1‐tooth increase OR 0.878, 95% CI 0.780–0.988; p = 0.030) and ≥ 60 years (per 1‐tooth increase OR 0.965, 95% CI 0.939–0.992; p = 0.011). Among women aged ≥ 60 years, those with 0–19 teeth had higher odds of uncontrolled diabetes (OR 1.994, 95% CI 1.041–3.818; p = 0.029) and poorer glycemic control (OR 2.498, 95% CI 1.321–4.723; p = 0.008) compared with those with ≥ 28 teeth. Conclusions: Fewer remaining teeth were associated with poorer glycemic control among women with diabetes, independent of periodontitis. This association was most pronounced in women aged ≥ 60 years. Large cohort studies are warranted to clarify causality and to evaluate the roles of periodontitis and dental caries in this relationship.