- 著者
- Hitonobu Tomoike Hiroyuki Yokoyama Yoko Sumita Sotaro Hanai Akiko Kada Tomonori Okamura Junichi Yoshikawa Yoshinori Doi Masatsugu Hori Chuwa Tei on behalf of the Scientific Committee of the JCS
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.79, no.5, pp.1058-1067, 2015-04-24 (Released:2015-04-24)
- 参考文献数
- 33
- 被引用文献数
- 18 19
Background:The geographic distribution of cardiovascular (CV) health-care services has not been assessed systematically.Methods and Results:Data of the Japanese Circulation Society (JCS) annual survey were provided to the JCS working group with the permission of the JCS Scientific Committee. The status of CV practice in 2010 was then assessed in 47 prefectures retrospectively, along with national census and gross domestic product (GDP) data. The surveyed indices included resources (hospitals, beds and cardiologists), burden (number of inpatients), and outcome (CV mortality and autopsy) in each prefecture, which correlated well with respective populations or GDP. Inequality of geographic distribution was evident for pediatrics among the 47 prefectures, according to Lorenz curve, Gini coefficient or the maximum/minimum ratio for each index. According to the Gini coefficients, only the number of inpatients (medical or acute myocardial infarction) and beds for the total number of general hospitals or the hospitals surveyed in the present JCS study were lower than expected with regard to GDP.Conclusions:Geographic disparity of CV resources or burden was larger in pediatrics than in CV medicine or surgery. Improvement of equality in CV practice with regard to appropriateness and quality are the coming challenges for the JCS. (Circ J 2015; 79: 1058–1067)
- 著者
- Shuichi TAKAGI Naoharu IWAI Ryoko YAMAUCHI Sunao KOJIMA Shinji YASUNO Takeshi BABA Masahiro TERASHIMA Yoshiaki TSUTSUMI Shoji SUZUKI Isao MORII Sotaro HANAI Koh ONO Shunroku BABA Hitonobu TOMOIKE Atsushi KAWAMURA Shunichi MIYAZAKI Hiroshi NONOGI Yoichi GOTO
- 出版者
- 日本高血圧学会
- 雑誌
- Hypertension Research (ISSN:09169636)
- 巻号頁・発行日
- vol.25, no.5, pp.677-681, 2002 (Released:2003-04-26)
- 参考文献数
- 28
- 被引用文献数
- 49 113
In epidemiological studies, moderate alcohol consumption has been consistently associated with a reduced risk of myocardial infarction (MI). About half of Japanese show an extremely high sensitivity to alcohol (ethanol), which is due to a missense mutation from glutamic acid (Glu) to lysine (Lys) at codon 487 in an isoenzyme of aldehyde dehydrogenase (ALDH2) with a low Km. We obtained a preliminary result that subjects homozygous for the Lys 487 allele had higher risk for myocardial infarction. The purpose of the present study was to assess this hypothesis by employing a larger cohort of subjects with MI. The experimental group consisted of 342 male subjects with demonstrated MI who were selected randomly from our outpatient clinic. As controls, we employed 1, 820 male subjects with no cardiovascular complications who were selected from the Suita Study. All subjects provided their written informed consent to participate in the genetic analyses. Subjects with MI were older and had higher body mass index, higher prevalence of diabetes mellitus, higher prevalence of smoking habit, higher prevalence of the Lys/Lys genotype (homozygous for Lys 487 allele), and lower high density lipoprotein (HDL) cholesterol level (HDL-C). The ALDH2 genotype affected the level of alcohol consumption, and HDL-C. Multiple logistic analyses indicated that the odds ratio of the Lys/Lys genotype to the Lys/Glu+Glu/Glu genotype was 1.56 (p =0.0359). Inclusion of HDL-C as one of the independent variables downplayed the importance of the ALDH2 genotype. This may indicate that the ALDH2 genotype affects MI via its effects on HDL-C. In conclusion, the ALDH2 Lys/Lys genotype is a risk factor for myocardial infarction in Japanese men due to its influence on HDL cholesterol level. (Hypertens Res 2002; 25: 677-681)