著者
Naoki Nago Shizukiyo Ishikawa Tadao Goto Kazunori Kayaba
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.1012070204-1012070204, (Released:2010-12-11)
参考文献数
17
被引用文献数
28 66

Background: We investigated the relationship between low cholesterol and mortality and examined whether that relationship differs with respect to cause of death.Methods: A community-based prospective cohort study was conducted in 12 rural areas in Japan. The study subjects were 12 334 healthy adults aged 40 to 69 years who underwent a mass screening examination. Serum total cholesterol was measured by an enzymatic method. The outcome was total mortality, by sex and cause of death. Information regarding cause of death was obtained from death certificates, and the average follow-up period was 11.9 years.Results: As compared with a moderate cholesterol level (4.14–5.17 mmol/L), the age-adjusted hazard ratio (HR) of low cholesterol (<4.14 mmol/L) for mortality was 1.49 (95% confidence interval [CI]: 1.23–1.79) in men and 1.50 (1.10–2.04) in women. High cholesterol (≥6.21 mmol/L) was not a risk factor. This association was unchanged in analyses that excluded deaths due to liver disease, which yielded age-adjusted HRs of 1.38 (95% CI, 1.13–1.67) in men and 1.49 (1.09–2.04) in women. The multivariate-adjusted HRs and 95% CIs of the lowest cholesterol group for hemorrhagic stroke, heart failure (excluding myocardial infarction), and cancer mortality significantly higher than those of the moderate cholesterol group, for each cause of death.Conclusions: Low cholesterol was related to high mortality even after excluding deaths due to liver disease from the analysis. High cholesterol was not a risk factor for mortality.
著者
Naoki Nago Shizukiyo Ishikawa Tadao Goto Kazunori Kayaba
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.21, no.1, pp.67-74, 2011-01-05 (Released:2011-01-05)
参考文献数
17
被引用文献数
66 66 23

Background: We investigated the relationship between low cholesterol and mortality and examined whether that relationship differs with respect to cause of death.Methods: A community-based prospective cohort study was conducted in 12 rural areas in Japan. The study subjects were 12 334 healthy adults aged 40 to 69 years who underwent a mass screening examination. Serum total cholesterol was measured by an enzymatic method. The outcome was total mortality, by sex and cause of death. Information regarding cause of death was obtained from death certificates, and the average follow-up period was 11.9 years.Results: As compared with a moderate cholesterol level (4.14–5.17 mmol/L), the age-adjusted hazard ratio (HR) of low cholesterol (<4.14 mmol/L) for mortality was 1.49 (95% confidence interval [CI]: 1.23–1.79) in men and 1.50 (1.10–2.04) in women. High cholesterol (≥6.21 mmol/L) was not a risk factor. This association was unchanged in analyses that excluded deaths due to liver disease, which yielded age-adjusted HRs of 1.38 (95% CI, 1.13–1.67) in men and 1.49 (1.09–2.04) in women. The multivariate-adjusted HRs and 95% CIs of the lowest cholesterol group for hemorrhagic stroke, heart failure (excluding myocardial infarction), and cancer mortality significantly higher than those of the moderate cholesterol group, for each cause of death.Conclusions: Low cholesterol was related to high mortality even after excluding deaths due to liver disease from the analysis. High cholesterol was not a risk factor for mortality.
著者
Shizukiyo Ishikawa Kazunori Kayaba Tadao Gotoh Naoki Nago Yosikazu Nakamura Akizumi Tsutsumi Eiji Kajii
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.18, no.4, pp.144-150, 2008 (Released:2008-08-07)
参考文献数
37
被引用文献数
38 56

Background: Previous reports indicated that the incidence rate of stroke was higher in Japan than in Western countries, but the converse was true in the case of myocardial infarction (MI). However, few population-based studies on the incidence rates of stroke and MI have been conducted in Japan.Methods: The Jichi Medical School (JMS) Cohort Study is a multicenter population-based cohort study that was conducted in 12 districts in Japan. Baseline data were collected between April 1992 and July 1995. We examined samples from 4,869 men and 7,519 women, whose mean ages were 55.2 and 55.3 years, respectively. The incidence of stroke, stroke subtypes, and MI were monitored.Results: The mean follow-up duration was 10.7 years. A total of 229 strokes and 64 MIs occurred in men, and 221 strokes and 28 MIs occurred in women. The age-adjusted incidence rates (per 100,000 person-years) of stroke were 332 and 221 and those of MI were 84 and 31 in men and women, respectively. In the case of both sexes, the incidence rates of stroke and MI were the highest in the group of subjects aged > 70 years.Conclusion: We reported current data on the incidence rates of stroke and MI in Japan. The incidence rate of stroke remains high, considerably higher than that of MI, in both men and women. The incidence rates of both stroke and MI were higher in men than in women.
著者
Masatoshi Matsumoto Shizukiyo Ishikawa Kazunori Kayaba Tadao Gotoh Naoki Nago Akizumi Tsutsumi Eiji Kajii the Jichi Medical School (JMS) Cohort Study Group
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.19, no.2, pp.94-100, 2009-03-05 (Released:2009-03-19)
参考文献数
30
被引用文献数
8 16

Background: Risk charts that depict the absolute risk of myocardial infarction (MI) for each combination of risk factors in individuals are convenient and beneficial tools for primary prevention of ischemic heart disease. Although risk charts have been developed using data from North American and European cardiovascular cohort studies, there is no such chart derived from cardiovascular incidence data obtained from the Japanese population.Methods and Results: We calculated and constructed risk charts that estimate the 10-year absolute risk of MI by using data from the Jichi Medical School (JMS) Cohort Study—a prospective cohort study which followed 12 490 participants in 12 Japanese rural communities for an average of 10.9 years. We identified 92 cases of a clinically-certified MI event. Color-coded risk charts were created by calculating the absolute risk associated with the following conventional cardiovascular risk factors: age, sex, smoking status, diabetes status, systolic blood pressure, and serum total cholesterol.Conclusions: In health education and clinical practice, particularly in rural communities, these charts should prove useful in understanding the risks of MI, without the need for cumbersome calculations. In addition, they can be expected to provide benefits by improving existing risk factors in individuals.
著者
Shizukiyo Ishikawa Masatoshi Matsumoto Kazunori Kayaba Tadao Gotoh Naoki Nago Akizumi Tsutsumi Eiji Kajii the Jichi Medical School (JMS) Cohort Study Group
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.19, no.2, pp.101-106, 2009-03-05 (Released:2009-03-19)
参考文献数
36
被引用文献数
7 18

Background: Risk charts are used to estimate the risk of cardiovascular diseases; however, most have been developed in Western countries. In Japan, currently available risk charts are based on mortality data. Using data on cardiovascular disease incidence from the JMS Cohort Study, we developed charts that illustrated the risk of stroke.Methods and Results: The JMS Cohort Study is a community-based cohort study of cardiovascular disease. Baseline data were obtained between 1992 and 1995. In the present analysis, the participants were 12 276 subjects without a history of stroke; the follow-up period was 10.7 years. Color-coded risk charts were created by using Cox’s proportional hazards models to calculate 10-year absolute risks associated with sex, age, smoking status, diabetes status, and systolic blood pressure. The risks of stroke and cerebral infarction rose as age and systolic blood pressure increased. Although the risk of cerebral hemorrhage were generally lower than that of cerebral infarction, the patterns of association with risk factors were similar.Conclusion: These risk charts should prove useful for clinicians and other health professionals who are required to estimate an individual’s risk for stroke.