Journal List > J Korean Acad Nurs > v.29(6) > 1062598

Oh and Seo: Development of Structural Equation Model for Causal Relationships Among the Risk Factors of Arteriosclerosis

Abstract

The purpose of this study was to clarify the dynamic relationships among risk factors of arteriosclerosis and to develop and examine a model which could explain this relationship clearly. Data were collected from medical records of 400 male clients who visited a university hospital located in Inchon for physical examinations, from May 1996 to December 1996. Data were analyzed using the LISREL (Linear Structural Relationship) 8 program. To test the fitness of the hypothesized model, chi-square, RMSR (root mean square residual), GFI (goodness of fit index), CN (critical number) and Q-plot were used. Most of the fitness measurements, except the chi-square showed that the hypothesized model complimented the real data. According to the results, there were trends that obesity and hyperlipidemia were prevalent in heavier smokers, higher alcohol intakers, and groups who excercised less. Also, hypertension was more prevalent in older age, higher alcohol intaker, and higher serum lipid level groups. In contrast to the hypothesis, alcohol intake did not significantly affect serum lipid levels. This might be due to the serum lipid measurements (total cholesterol and trigryceride) used in this study to estimate hyperlipidemia. The direct effect of smoking on hypertension was not significant. However, the total effect of smoking on the hypertension was significant since indirect effects of smoking on hypertension, such as obesity and hyperlipidemia, were significant. The total effect of obesity on hypertension was significant since the indirect effect of obesity on hypertension via hyperlipidemia was significant, although the direct effect of smoking on hypertension was not significant. The degree of explaining hyperlipidemia with smoking, exercise, and obesity was high (60%), however, the degree of explaining obesity with age, smoking, alcohol intake, and exercise was very low (7%). On the basis of these results, high risk factors of arteriosclerosis such as hypertension, hyperlipidemia, or obesity are either directly or indirectly correlated each other. Therefore, it is difficult to predict outcomes for increasing or decreasing the risk factors by simply modulating a factor. Smoking, alcohol, and exercise both directly and indirectly affected major risk factors of arteriosclerosis. Therefore, correcting these variables is required to decrease risk factors. Finally, the relationship among other risk factors which have been known to be related with arteriosclerosis (diet, stress or hereditary) should be clarified in further studies.

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