- 著者
- Rie Hayashi Hiroyasu Iso Kazumasa Yamagishi Hiroshi Yatsuya Isao Saito Yoshihiro Kokubo Ehab S. Eshak Norie Sawada Shoichiro Tsugane for the Japan Public Health Center-Based (JPHC) Prospective Study Group
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-18-0842, (Released:2019-03-06)
- 参考文献数
- 43
- 被引用文献数
- 26
Background: Evidence from prospective cohort studies regarding the relationship between working hours and risk of cardiovascular disease is limited Methods and Results: The Japan Public Health Center-Based Prospective Study Cohort II involved 15,277 men aged 40–59 years at the baseline survey in 1993. Respondents were followed up until 2012. During the median 20 years of follow up (257,229 person-years), we observed 212 cases of acute myocardial infarction and 745 stroke events. Cox proportional hazards models adjusted for sociodemographic factors, cardiovascular risk factors, and occupation showed that multivariable-adjusted hazard ratios (HRs) associated with overtime work of ≥11h/day were: 1.63 (95% confidence interval [CI] 1.01–2.63) for acute myocardial infarction and 0.83 (95% CI 0.60–1.13) for total stroke, as compared with the reference group (working 7 to <9 h/day). In the multivariable model, increased risk of acute myocardial infarction associated with overtime work of ≥11 h/day was more evident among salaried employees (HR 2.11, 95% CI 1.03–4.35) and men aged 50–59 years (HR 2.60, 95% CI 1.42–4.77). Conclusions: Among middle-aged Japanese men, working overtime is associated with a higher risk of acute myocardial infarction.
- 著者
- Ahmed Arafa Yoshihiro Kokubo Keiko Shimamoto Rena Kashima Emi Watanabe Yukie Sakai Jiaqi Li Masayuki Teramoto Haytham A. Sheerah Kengo Kusano
- 出版者
- The Japanese Society for Hygiene
- 雑誌
- Environmental Health and Preventive Medicine (ISSN:1342078X)
- 巻号頁・発行日
- vol.27, pp.10, 2022 (Released:2022-03-04)
- 参考文献数
- 10
- 被引用文献数
- 12
Background: A protective role for physical activity against the development of atrial fibrillation (AF) has been suggested. Stair climbing is a readily available form of physical activity that many people practice. Herein, we investigated the association between stair climbing and the risk of AF in a Japanese population.Methods: In this prospective cohort study, we used data of 6,575 people registered in the Suita Study, aged 30–84 years, and had no history of AF. The frequency of stair climbing was assessed by a baseline questionnaire, while AF was diagnosed during the follow-up using a 12-lead ECG, health records, check-ups, and death certificates. We used the Cox regression to calculate the hazard ratios and 95% confidence intervals of AF incidence for climbing stairs in 20–39%, 40–59%, and ≥60% compared with <20% of the time.Results: Within 91,389 person-years of follow-up, 295 participants developed AF. The incidence of AF was distributed across the stair climbing groups <20%, 20–39%, 40–59%, and ≥60% as follows: 3.57, 3.27, 3.46, and 2.63/1,000 person-years, respectively. Stair climbing ≥60% of the time was associated with a reduced risk of AF after adjustment for age and sex 0.69 (0.49, 0.96). Further adjustment for lifestyle and medical history did not affect the results 0.69 (0.49, 0.98).Conclusion: Frequent stair climbing could protect from AF. From a preventive point of view, stair climbing could be a simple way to reduce AF risk at the population level.
- 著者
- Yoshihiro Kokubo Makoto Watanabe Aya Higashiyama Yoko M Nakao Kengo Kusano Yoshihiro Miyamoto
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-17-0277, (Released:2017-05-25)
- 参考文献数
- 50
- 被引用文献数
- 79
Background:An atrial fibrillation (AF) risk score for a non-Western general population has not been established.Methods and Results:A total of 6,898 participants (30–79 years old) initially free of AF have been prospectively followed for incident AF since 1989. AF was diagnosed when AF or atrial flutter was present on ECG at a biannual health examination; was indicated as a current illness; or was in the medical records during follow-up. Cox proportional hazard ratios were analyzed after adjusting for cardiovascular risk factors at baseline. During the 95,180 person-years of follow-up, 311 incident AF events occurred. We developed a scoring system for each risk factor as follows: 0/−5, 3/0, 7/5, and 9/9 points for men/women in their 30 s–40 s, 50 s, 60 s, and 70 s, respectively; 2 points for systolic hypertension, overweight, excessive drinking, or coronary artery disease; 1 point for current smoking; −1 point for moderate non-high-density lipoprotein-cholesterol; 4 points for arrhythmia; and 8, 6, and 2 points for subjects with cardiac murmur in their 30 s–40 s, 50 s, and 60 s, respectively (C-statistic 0.749; 95% confidence interval, 0.724−0.774). Individuals with score ≤2, 10–11, or ≥16 points had, respectively, ≤1%, 9%, and 27% observed probability of developing AF in 10 years.Conclusions:We developed a 10-year risk score for incident AF using traditional risk factors that are easily obtained in routine outpatient clinics/health examinations without ECG.
- 著者
- Hiroshi Yatsuya Hiroyasu Iso Yuanying Li Kazumasa Yamagishi Yoshihiro Kokubo Isao Saito Norie Sawada Manami Inoue Shoichiro Tsugane
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-16-0081, (Released:2016-04-15)
- 参考文献数
- 41
- 被引用文献数
- 4 36
Background:Global risk assessment for the prevention of atherosclerotic cardiovascular diseases helps guide the intensity of behavioral and pharmacological interventions.Methods and Results:The Japan Public Health Center-based prospective (JPHC) Study Cohort II (age range: 40–69 years at baseline in 1993–1994, n=15,672) was used to derive the risk equations for coronary artery disease (CAD) and ischemic stroke incidence via hazard regression. The model discrimination was evaluated by the area under the receiver-operating curve (AUC), and model goodness-of-fit by the Grønnesby-Borgan chi-squared statistic. During a mean of 16.4 years of follow up, 192 incident CAD cases and 552 ischemic stroke cases occurred. Variables selected for the CAD equation were age, sex, current smoking, systolic blood pressure, antihypertensive medication use, diabetes, and high-density lipoprotein cholesterol (HDLC) and non-HDLC. The same variables, except non-HDLC, were selected for the ischemic stroke equation. The equations discriminated incidence reasonably well (AUC: 0.81 for CAD, 0.78 for ischemic stroke). The AUC of the equation applied externally to Cohort I (n=11,598) was also good: 0.77 and 0.76 for CAD and ischemic stroke, respectively. Risk calculator application and color charts to visualize estimated risk according to the combinations of risk factors were prepared.Conclusions:Risk equations were developed to estimate the 10-year probability of CAD and ischemic stroke in Japanese people, using variables that are routinely obtained.
- 著者
- Rie Hayashi Hiroyasu Iso Kazumasa Yamagishi Hiroshi Yatsuya Isao Saito Yoshihiro Kokubo Ehab S. Eshak Norie Sawada Shoichiro Tsugane for the Japan Public Health Center-Based (JPHC) Prospective Study Group
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.83, no.5, pp.1072-1079, 2019-04-25 (Released:2019-04-25)
- 参考文献数
- 43
- 被引用文献数
- 24 26
Background: Evidence from prospective cohort studies regarding the relationship between working hours and risk of cardiovascular disease is limited Methods and Results: The Japan Public Health Center-Based Prospective Study Cohort II involved 15,277 men aged 40–59 years at the baseline survey in 1993. Respondents were followed up until 2012. During the median 20 years of follow up (257,229 person-years), we observed 212 cases of acute myocardial infarction and 745 stroke events. Cox proportional hazards models adjusted for sociodemographic factors, cardiovascular risk factors, and occupation showed that multivariable-adjusted hazard ratios (HRs) associated with overtime work of ≥11h/day were: 1.63 (95% confidence interval [CI] 1.01–2.63) for acute myocardial infarction and 0.83 (95% CI 0.60–1.13) for total stroke, as compared with the reference group (working 7 to <9 h/day). In the multivariable model, increased risk of acute myocardial infarction associated with overtime work of ≥11 h/day was more evident among salaried employees (HR 2.11, 95% CI 1.03–4.35) and men aged 50–59 years (HR 2.60, 95% CI 1.42–4.77). Conclusions: Among middle-aged Japanese men, working overtime is associated with a higher risk of acute myocardial infarction.
- 著者
- Ahmed Arafa Rena Kashima Yoshihiro Kokubo Masayuki Teramoto Yukie Sakai Saya Nosaka Haruna Kawachi Keiko Shimamoto Chisa Matsumoto Qi Gao Chisato Izumi
- 出版者
- The Japanese Society for Hygiene
- 雑誌
- Environmental Health and Preventive Medicine (ISSN:1342078X)
- 巻号頁・発行日
- vol.28, pp.26, 2023 (Released:2023-05-03)
- 参考文献数
- 63
- 被引用文献数
- 1
Background: Alcohol consumption is a modifiable lifestyle, but its role in heart failure (HF) development is controversial. Herein, we investigated the prospective association between alcohol consumption and HF risk.Methods: A total of 2,712 participants (1,149 men and 1,563 women) from the Suita Study were followed up every two years. Cox regression was applied to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of HF risk for heavy drinking (≥46 g/day in men or ≥23 g/day in women) and never drinking compared to light drinking (<23 g/day in men or <11.5 g/day in women). Then, we combined the results of the Suita Study with those from other eligible prospective cohort studies in a meta-analysis using the random-effects model.Results: In the Suita Study, within a median follow-up period of 8 years, 319 HF cases (162 in men and 157 in women) were detected. In men, but not women, never and heavy drinking carried a higher risk of HF than light drinking: HRs (95% CIs) = 1.65 (1.00, 2.73) and 2.14 (1.26, 3.66), respectively. Alike, the meta-analysis showed a higher risk of HF among heavy drinkers: HR (95% CI) = 1.37 (1.15, 1.62) and abstainers: HR (95% CI) = 1.18 (1.02, 1.37).Conclusion: We indicated a J-shaped association between alcohol consumption and HF risk among Japanese men. The results of the meta-analysis came in line with the Suita Study. Heavy-drinking men should be targeted for lifestyle modification interventions.
- 著者
- Ahmed Arafa Yoshihiro Kokubo Rena Kashima Chisa Matsumoto Masayuki Teramoto Kengo Kusano
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0464, (Released:2023-09-22)
- 参考文献数
- 35
- 被引用文献数
- 1
Background: Atrial fibrillation (AF) is the most diagnosed arrhythmia in clinical settings. The fatty liver index (FLI) is a marker of liver steatosis with potential cardiovascular implications. This study investigated whether FLI could predict the risk of AF.Methods and Results: We used data from the Suita Study, a Japanese population-based prospective cohort study. A total of 2,346 men and 3,543 women, aged 30–84 years, without prevalent AF were included and followed up. The diagnosis of AF was established during follow-up using electrocardiograms, hospital records, and death certificates. FLI was assessed during a baseline health checkup. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for incident AF per FLI quintile and log-transformed FLI. Within a median 14.5 years of follow-up, 142 men and 105 women developed AF. Compared with women in the third (middle) FLI quintile, women in the first (lowest), fourth, and fifth (highest) quintiles showed a higher risk of AF, with multivariable-adjusted HRs of 2.37 (95% CI 1.06–5.31), 2.60 (95% CI 1.30–5.17), and 2.04 (95% CI 1.00–4.18), respectively. No corresponding associations were observed in men. The change in log-transformed FLI was not associated with the risk of AF in either sex.Conclusions: A U-shaped association between FLI and AF risk was detected in Japanese women. FLI could be a screening tool to detect women at high risk of developing AF.
- 著者
- Ahmed Arafa Yoshihiro Kokubo Rena Kashima Masayuki Teramoto Yukie Sakai Saya Nosaka Keiko Shimamoto Haruna Kawachi Chisa Matsumoto Kengo Kusano
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-22-0378, (Released:2022-10-25)
- 参考文献数
- 38
- 被引用文献数
- 1
Background: The incidence and prevalence of atrial fibrillation (AF) are increasing. The white blood cell (WBC) count is an indicator of systemic inflammation and is related to increased cardiovascular disease risk. Using data from the Suita Study, we investigated the association between WBC count and AF risk in the general Japanese population.Methods and Results: This prospective cohort study included 6,884 people, aged 30–84 years, with no baseline AF. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for AF incidence by WBC count quintile. Within a median follow-up period of 14.6 years, 312 AF cases were diagnosed. Compared with the lowest WBC count quintile, the highest quintile was associated with an increased AF risk (HR 1.57; 95% CI 1.07–2.29). The association was more pronounced among women than men (HR 2.16 [95% CI 1.10–4.26] and 1.55 [95% CI 0.99–2.44], respectively; P interaction=0.07), and among current than non-smokers (HR 4.66 [95% CI 1.89–11.50] and 1.61 [95% CI 1.01–2.57], respectively; P interaction=0.20). For each 1.0×109-cells/L increment in WBC count, AF risk increased by 9% in men (9% in non-smokers, 10% in current smokers) and 20% in women (13% in non-smokers, 32% in current smokers).Conclusions: A higher WBC count was positively associated with an elevated AF risk in the general Japanese population, especially in women who smoked.
- 著者
- Michikazu Nakai Makoto Watanabe Yoshihiro Kokubo Kunihiro Nishimura Aya Higashiyama Misa Takegami Yoko M Nakao Tomonori Okamura Yoshihiro Miyamoto
- 出版者
- Japan Atherosclerosis Society
- 雑誌
- Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
- 巻号頁・発行日
- pp.48843, (Released:2020-02-06)
- 参考文献数
- 41
- 被引用文献数
- 29
Aim: To construct a risk prediction model for cardiovascular disease (CVD) based on the Suita study, an urban Japanese cohort study, and compare its accuracy against the Framingham CVD risk score (FRS) model. Methods: After excluding participants with missing data or those who lost to follow-up, this study consisted of 3,080 men and 3,470 women participants aged 30–79 years without CVD at baseline in 1989–1999. The main outcome of this study was incidence of CVD, defined as the incidence of stroke or coronary heart disease. Multivariable Cox proportional hazards models with stepwise selection were used to develop the prediction model. To assess model performance, concordance statistics (C-statistics) and their 95% confidence intervals (CIs) were calculated using a bootstrap procedure. A calibration test was also conducted. Results: During a median follow-up period of 16.9 years, 351 men and 241 women developed CVD. We formulated risk models with and without electrocardiogram (ECG) data that included age, sex, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, diabetes mellitus, smoking, and urinary protein as risk factors. The C-statistics of the Suita CVD risk models with ECG data (0.782; 95% CI, 0.766–0.799) and without ECG data (0.781; 95% CI, 0.765–0.797) were significantly higher than that of the FRS model (0.768; 95% CI, 0.750–0.785). Conclusions: The Suita CVD risk model is feasible to use and improves predictability of the incidence of CVD relative to the FRS model in Japan.
- 著者
- Hiroshi Yatsuya Kazumasa Yamagishi Yuanying Li Isao Saito Yoshihiro Kokubo Isao Muraki Manami Inoue Shoichiro Tsugane Hiroyasu Iso Norie Sawada
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- pp.JE20220364, (Released:2023-07-15)
- 参考文献数
- 34
Background: Associations of major risk factors for stroke with total and each type of stroke as well as subtypes of ischemic stroke and their population attributable fractions had not been examined comprehensively.Methods: Participants of the Japan Public Health Center-based prospective (JPHC) Study Cohort II without histories of cardiovascular disease and cancer (n=14,797) were followed from 1993 through 2012. Associations of current smoking, hypertension, diabetes, overweight (body mass index ≥ 25 kg/m2), non-high-density lipoprotein cholesterol (non-HDLC) categories, low HDLC (< 40 mg/dL), urine protein, and history of arrhythmia were examined in a mutually-adjusted Cox regression model that included age and sex. Population attributable fraction (PAF) was estimated using the hazard ratios and the prevalence of risk factors among cases.Results: Subjects with hypertension were 1.63 to 1.84 times more likely to develop any type of stroke. Diabetes, low HDLC, current smoking, overweight, urine protein, and arrhythmia were associated with risk of overall and ischemic stroke. Hypertension and urine protein were associated with risk of intracerebral hemorrhage while current smoking, hypertension, and low non-HDLC were associated with subarachnoid hemorrhage. Hypertension alone accounted for more than a quarter of stroke incidence, followed by current smoking and diabetes. High non-HDLC, current smoking, low HDLC, and overweight contributed mostly to large-artery occlusive stroke. Arrhythmia explained 13.2% of embolic stroke. Combined PAFs of all the modifiable risk factors for total, ischemic and large-artery occlusive strokes were 36.7 and 44.5% and 61.5%, respectively.Conclusion: Although there are differences according to the subtypes, hypertension could be regarded as the most crucial target for preventing strokes in Japan.
- 著者
- Ahmed Arafa Yoshihiro Kokubo Haytham A. Sheerah Yukie Sakai Emi Watanabe Jiaqi Li Kyoko Honda-Kohmo Masayuki Teramoto Rena Kashima Masatoshi Koga
- 出版者
- Japan Atherosclerosis Society
- 雑誌
- Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
- 巻号頁・発行日
- pp.63191, (Released:2021-11-20)
- 参考文献数
- 55
- 被引用文献数
- 12
Aim: Weight change could have many health outcomes. This study aimed to investigate the association between weight change and mortality risk due to total cardiovascular disease (CVD), ischemic heart disease (IHD), and stroke among Japanese. Methods: We used Suita Study data from 4,746 people aged 30-79 years in this prospective cohort study. Weight change was defined as the difference between baseline weight and weight at age 20. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of total CVD, IHD, and stroke mortality for 1) participants with a weight change (>10, 5 to 10, -5 to -10, and <-10 kg) compared to those with stable weight (-4.9 to 4.9 kg) and 2) participants who moved from one body mass index category (underweight, normal weight, or overweight) to another compared to those with normal weight at age 20 and baseline. Results: Within a median follow-up period of 19.9 years, the numbers of total CVD, IHD, and stroke mortality were 268, 132, and 79, respectively. Weight loss of >10 kg was associated with the increased risk of total CVD mortality 2.07 (1.29, 3.32) and stroke mortality 3.02 (1.40, 6.52). Moving from normal weight at age 20 to underweight at baseline was associated with the increased risk of total CVD, IHD, and stroke mortality: 1.76 (1.12, 2.77), 2.10 (1.13, 3.92), and 2.25 (1.05, 4.83), respectively. Conclusion: Weight loss, especially when moving from normal to underweight, was associated with the increased risk of CVD mortality.
- 著者
- Kunihiro Nishimura Tomonori Okamura Makoto Watanabe Michikazu Nakai Misa Takegami Aya Higashiyama Yoshihiro Kokubo Akira Okayama Yoshihiro Miyamoto
- 出版者
- Japan Atherosclerosis Society
- 雑誌
- Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
- 巻号頁・発行日
- vol.21, no.8, pp.784-798, 2014-08-26 (Released:2014-08-26)
- 参考文献数
- 57
- 被引用文献数
- 132 151
Aim: The Framingham risk score (FRS) is one of the standard tools used to predict the incidence of coronary heart disease (CHD). No previous study has investigated its efficacy for a Japanese population cohort. The purpose of this study was to develop new coronary prediction algorithms for the Japanese population in the manner of the FRS, and to compare them with the original FRS. Methods: Our coronary prediction algorithms for Japanese were based on a large population-based cohort study (Suita study). The study population comprised 5,521 healthy Japanese. They were followed-up for 11.8 years on average, and 213 cases of CHD were observed. Multiple Cox proportional hazard model by stepwise selection was used to construct the prediction model. Results: Our coronary prediction algorithms for Japanese patients were based on a large populationbased cohort study (the Suita study). A multiple Cox proportional hazard model by stepwise selection was used to construct the prediction model. The C-statistics showed that the new model had better accuracy than the original and recalibrated Framingham scores. The net reclassification improvement (NRI) by the Suita score with the inclusion of CKD was 41.2% (P<0.001) compared with the original FRS. The recalibration of the FRS slightly improved the efficiency of the prediction, but it was still worse than the Suita score with the CKD model. The calibration analysis suggested that the original FRS and the recalibrated FRS overestimated the risk of CHD in the Japanese population. The Suita score with CKD more accurately predicted the risk of CHD. Conclusion: The FRS and recalibrated FRS overestimated the 10-year risk of CHD for the Japanese population. A predictive score including CKD as a coronary risk factor for the Japanese population was more accurate for predicting CHD than the original Framingham risk scores in terms of the C-statics and NRI.
- 著者
- Takahiro Yoshizaki Junko Ishihara Ayaka Kotemori Junpei Yamamoto Yoshihiro Kokubo Isao Saito Hiroshi Yatsuya Kazumasa Yamagishi Norie Sawada Motoki Iwasaki Hiroyasu Iso Shoichiro Tsugane the JPHC Study Group
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- pp.JE20180130, (Released:2019-01-12)
- 参考文献数
- 27
- 被引用文献数
- 9
Background: Few studies have investigated the effects of Okinawan vegetable consumption on the risk of incident stroke and coronary heart disease. This study aimed to examine associations of vegetable, fruit, and Okinawan vegetable consumption with risk of incident stroke and coronary heart disease in the Japanese population of Okinawa.Methods: Study design was a prospective cohort study. During 1995-1998, a validated food frequency questionnaire was administered in two study areas to 16,498 participants aged 45-74 years. In 217,467 person-years of follow-up until the end of 2012, a total of 839 stroke cases and 197 coronary heart disease cases were identified.Results: No statistically significant association between total Okinawan vegetable consumption and risk of stroke and coronary heart disease was obtained: the multivariable adjusted hazard ratios for the highest versus lowest tertile of consumption were 1.09 (95% confidence interval, 0.93-1.29; p for trend = 0.289) in model 2. Total vegetable and fruit and specific Okinawan vegetable consumption were also not statistically significantly associated with risk of cardiovascular outcomes.Conclusions: This study demonstrated that consumption of total vegetable and fruit, total Okinawan vegetables, and specific Okinawan vegetables in Japanese residents of Okinawa was not associated with risk of incident stroke and coronary heart disease.
- 著者
- Jiaqi Li Yoshihiro Kokubo Ahmed Arafa Haytham A. Sheerah Makoto Watanabe Yoko M. Nakao Kyoko Honda-Kohmo Rena Kashima Yukie Sakai Emi Watanabe Masayuki Teramoto Tomoharu Dohi Masatoshi Koga
- 出版者
- Japan Atherosclerosis Society
- 雑誌
- Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
- 巻号頁・発行日
- pp.63317, (Released:2022-01-15)
- 参考文献数
- 25
- 被引用文献数
- 6
Aims: This study aimed to investigate the association of mild hypertensive retinopathy with cardiovascular disease (CVD) risk. Methods: A total of 7,027 residents aged 30–79 years without a history of CVD participated in the annual health checkups and retinal photography assessments. Retinal microvascular abnormalities were graded using the standard protocols and classified according to the Keith–Wagener–Barker classification. Mild hypertensive retinopathy was defined as grades 1 and 2. Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for total CVD and its subtypes according to the presence and absence of mild hypertensive retinopathy. Results: During a median follow-up of 17 years, 351 incident stroke and 247 coronary heart disease (CHD) cases were diagnosed. After adjustment for traditional cardiovascular risk factors, mild hypertensive retinopathy was positively associated with risk of CVD (multivariable HR=1.24; 95% CI, 1.04–1.49) and stroke (1.28; 1.01–1.62) but not with risk of CHD (1.19; 0.89–1.58). Generalized arteriolar narrowing and enhanced arteriolar wall reflex were positively associated with CVD risk, the multivariable HR (95% CI) was 1.24 (1.00– 1.54)and 1.33 (1.02–1.74), respectively. Moreover, mild hypertensive retinopathy was positively associated with stroke risk in normotensive participants. Conclusion: Mild hypertensive retinopathy was positively associated with CVD and stroke risk in the urban Japanese population. Especially, generalized arteriolar narrowing and enhanced arteriolar wall reflex were positively associated with CVD risk. These findings suggested that retinal photography could be helpful for cardiovascular risk stratification in the primary cardiovascular prevention.
- 著者
- Aya Higashiyama Ichiro Wakabayashi Tomonori Okamura Yoshihiro Kokubo Makoto Watanabe Misa Takegami Kyoko Honda-Kohmo Akira Okayama Yoshihiro Miyamoto
- 出版者
- Japan Atherosclerosis Society
- 雑誌
- Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
- 巻号頁・発行日
- pp.62730, (Released:2021-05-28)
- 参考文献数
- 29
- 被引用文献数
- 18
Aim: A prospective cohort study in a Japanese urban general population was performed to investigate whether triglyceride (TG) and its related indices were associated with the risk for the incidence of ischemic cardiovascular disease (CVD) after the adjustment for low-density lipoprotein cholesterol (LDL-C) in Asian community dwellers. Methods: A 15.1-year prospective cohort study was performed in 6,684 Japanese community dwellers aged 30–79 years without a history of CVD and whose fasting TG levels were <400 mg/dL. After adjusting for covariates, including LDL-C, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of the deciles (D) of TG and those of 1-standard deviation (SD) increment of log-transformed TG (1-SD of TG) according to LDL-C level (≥ 140 and <140 mg/dL) for ischemic CVD incidence were estimated. The multivariable-adjusted HRs and 95%CIs of the quintiles (Q) of TG, TG/HDL-C, and the cardiometabolic index (CMI) for ischemic CVD were also estimated. Results: In 101,230 person-years, 464 ischemic CVD cases occurred. For D10 of TG, the HR (95%CI) was 1.56 (1.05–2.32), and for 1-SD of TG, it was 1.30 (1.00–1.70) in participants with LDL-C <140 mg/dL and 1.07 (0.77–1.50) in those with LDL-C ≥ 140 mg/dL. For Q5 of the CMI, the multivariable-adjusted HR was higher than those of TG and TG/HDL-C. Conclusions: Fasting TG was an independent predictor for ischemic CVD incidence after adjusting for LDL-C in Japanese community dwellers with TG <400 mg/dL. Among TG, TG/HDL-C, and the CMI, the CMI could be the most powerful predictor for ischemic CVD.
- 著者
- Takako Sugisawa Ichiro Kishimoto Yoshihiro Kokubo Hisashi Makino Yoshihiro Miyamoto Yasunao Yoshimasa
- 出版者
- The Japan Endocrine Society
- 雑誌
- Endocrine Journal (ISSN:09188959)
- 巻号頁・発行日
- vol.57, no.8, pp.727-733, 2010 (Released:2010-09-02)
- 参考文献数
- 23
- 被引用文献数
- 23 32
The inverse association between plasma B-type natriuretic peptide (BNP) levels and body mass index (BMI) has been reported in Western populations. Here we analyzed the relationship between plasma BNP and obesity in a general urban Japanese population. We recruited 1,759 subjects without atrial fibrillation or history of ischemic heart disease aged 38-95 years (mean age ± standard deviation 64.5 ± 10.9 years, 56.1% women, mean BMI 22.8 ± 3.1 kg/m2) from the participants in the Suita Study between August 2002 and December 2003. In multivariable regression analyses adjusted for age, systolic blood pressure, pulse rate, serum creatinine, left ventricular hypertrophy in ECG, the inverse relationships between BNP levels and BMI (kg/m2) was found in both sexes (both p<0.001). Multivariable-adjusted mean plasma BNP levels in the group of BMI<18.5, 18.5≤BMI< 22, 22≤BMI<25, and 25≤BMI were 23.4, 17.9, 14.0 and 13.0 pg/mL, respectively (trend p<0.001). The negative association of body fat (percentage and mass), skin fold thickness, or waist circumference with BNP levels was observed the negative associations in both sexes (p<0.01). Among the obesity indices, body fat mass is most tightly associated with BNP. In conclusion, plasma BNP was inversely associated with obesityrelated markers such as body fat mass, skinfold thickness and waist circumferences after adjusted for relevant covariates in a Japanese population.