1
|
Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
| |
Collapse
|
2
|
Fujiyoshi A, Kohsaka S, Hata J, Hara M, Kai H, Masuda D, Miyamatsu N, Nishio Y, Ogura M, Sata M, Sekiguchi K, Takeya Y, Tamura K, Wakatsuki A, Yoshida H, Fujioka Y, Fukazawa R, Hamada O, Higashiyama A, Kabayama M, Kanaoka K, Kawaguchi K, Kosaka S, Kunimura A, Miyazaki A, Nii M, Sawano M, Terauchi M, Yagi S, Akasaka T, Minamino T, Miura K, Node K. JCS 2023 Guideline on the Primary Prevention of Coronary Artery Disease. Circ J 2024; 88:763-842. [PMID: 38479862 DOI: 10.1253/circj.cj-23-0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Mitsuhiko Hara
- Department of Health and Nutrition, Wayo Women's University
| | - Hisashi Kai
- Department of Cardiology, Kurume Univeristy Medical Center
| | | | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science
| | - Yoshihiko Nishio
- Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Masatsune Ogura
- Department of General Medical Science, Chiba University School of Medicine
- Department of Metabolism and Endocrinology, Eastern Chiba Medical Center
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | | | - Yasushi Takeya
- Division of Helath Science, Osaka University Gradiate School of Medicine
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
| | | | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | - Yoshio Fujioka
- Division of Clinical Nutrition, Faculty of Nutrition, Kobe Gakuin University
| | | | - Osamu Hamada
- Department of General Internal Medicine, Takatsuki General Hospital
| | | | - Mai Kabayama
- Division of Health Sciences, Osaka University Graduate School of Medicine
| | - Koshiro Kanaoka
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
| | - Kenjiro Kawaguchi
- Division of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University
| | | | | | | | - Masaki Nii
- Department of Cardiology, Shizuoka Children's Hospital
| | - Mitsuaki Sawano
- Department of Cardiology, Keio University School of Medicine
- Yale New Haven Hospital Center for Outcomes Research and Evaluation
| | | | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Nishinomiya Watanabe Cardiovascular Cerebral Center
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Meidicine
| | - Katsuyuki Miura
- Department of Preventive Medicine, NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| |
Collapse
|
3
|
Yan S, Liu G, Chen X. Spatiotemporal distribution characteristics and influencing factors of the rate of cardiovascular hospitalization in Ganzhou city of China. Front Cardiovasc Med 2023; 10:1225878. [PMID: 38188258 PMCID: PMC10770874 DOI: 10.3389/fcvm.2023.1225878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Aims The objective of this study was to analyze hospitalization rates for cardiovascular diseases (CVD) in Ganzhou City, Jiangxi Province of China from 2015 to 2020 and to uncover the spatiotemporal distribution characteristics and influencing factors, and thus to provide reference for the prevention and control of CVD and public health resources planning. Methods The hospitalization data for CVDs from 2016 to 2020 was obtained from the First Affiliated Hospital of Gannan Medical University, and ArcGIS 10.8, SaTScan 9.5, and Matlab 20.0 were used to analyze the spatial autocorrelation, spatiotemporal scan statistics, and potential affecting factors of the hospitalization rates. Results The hospitalization rate for CVDs in Ganzhou City showed a slightly increasing trend from 2016 to 2020, with higher rates in winter and summer than that in spring and autumn, and the individuals aged 61 and above constitute a higher proportion compared to other age groups. Additionally, there was a positive correlation between hospitalization rates for CVDs and the counties and districts in Ganzhou City, with high-high aggregation areas mainly distributed in Nankang District, the western urban area of Ganzhou City. The spatial scan analysis identified three different types of significant aggregation areas: high-risk, low-risk, and middle-risk areas. The high-risk area was mainly centered around Zhanggong District or Shangyu County in the central and western regions, with a disease hospitalization rate 2-3 times higher than the rest areas. The study also found that environmental meteorological factors such as the annual average concentration of NO2, O3, average annual temperature, and annual maximum temperature diurnal range had a significant positive effect on hospitalization rates for CVDs in Ganzhou City, with O3 concentration and average annual temperature having significant positive indirect spatial spillover effects. Conclusion Winter and summer are the seasons with high hospitalization rate of cardiovascular diseases. County residents aged 61 and above are the higher-risk population that needs to pay more attention on for prevention and control of CVD in Ganzhou City, which exhibits significant spatiotemporal clustering. The urban areas of Zhanggong and Nankang in Ganzhou City are the key areas for prevention and control of CVD. The hospitalization rate of CVD in Ganzhou City is influenced by the aforementioned four environmental meteorological factors, with the annual maximum temperature diurnal range showing the most significant positive direct effect.
Collapse
Affiliation(s)
- Shanshan Yan
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
| | - Guoqiu Liu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiaoyuan Chen
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| |
Collapse
|
4
|
Fukumine Y, Nakamura K. Obesity and hypertension from a public health perspective in a small remote island of Okinawa, Japan. Hypertens Res 2023; 46:1850-1859. [PMID: 37188753 DOI: 10.1038/s41440-023-01293-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023]
Abstract
This study investigated the relationship between obesity and hypertension from a public health perspective in a small remote island of Okinawa where obesity is prevalent. A cross-sectional study was conducted in 456 residents aged ≥18 years in Yonaguni island who underwent an annual health check-up and the Yonaguni dietary survey in 2022. Each participant responded to our original questionnaire and provided further dietary survey data via the Yonaguni municipal government. The odds ratio for hypertension was calculated in the obese group, using a logistic regression model with the non-obese group serving as the reference. Hypertension was defined as a systolic blood pressure ≥140 mmHg, a diastolic blood pressure ≥90 mmHg measured on an automated sphygmomanometer, and/or taking anti-hypertensive agents, while obesity was defined as a body mass index ≥25 kg/m2. The proportion of hypertension associated with obesity among all hypertensive subjects was calculated. The prevalence of obesity and hypertension was 54.3% and 49.0% in the 208 male subjects and 32.3% and 43.6% in the 248 female subjects, respectively. The odds ratio for hypertension in the obese group was 3.73 (95% confidence interval, 1.93-7.20) for men and 4.13 (2.06-8.29) for women after adjusting for age, alcohol drinking habit, behavior for lowering salt intake, and smoking habit. Hypertension in 49.5% (95% confidence interval, 29.4%-63.9%) of males and 37.9% (22.6%-50.2%) of females was associated with obesity in this island. Some areas of Japan could be urgently required to address obesity for preventing cardiovascular disease. A community-based, cross-sectional study in 456 residents aged ≥18 years in Yonaguni island, Okinawa prefecture, Japan.
Collapse
Affiliation(s)
- Yumeno Fukumine
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, 903-0215, Japan
| | - Koshi Nakamura
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, 903-0215, Japan.
| |
Collapse
|
5
|
Nooh F, Ali MI, Chernet A, Probst-Hensch N, Utzinger J. Prevalence and Risk Factors of Hypertension in Hargeisa, Somaliland: A Hospital-Based Cross-Sectional Study. Diseases 2023; 11:diseases11020062. [PMID: 37092444 PMCID: PMC10123622 DOI: 10.3390/diseases11020062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/25/2023] Open
Abstract
Hypertension is the leading risk factor for cardiovascular diseases and represents a major public health challenge worldwide. There is a paucity of information regarding the hypertension status of adults in Somaliland. We aimed to assess the magnitude of, and factors associated with, hypertension among adult patients seeking care at Hargeisa group hospital in Hargeisa city, Somaliland. We conducted a health facility-based cross-sectional study enrolling adult outpatients. We used the World Health Organization (WHO) STEPwise surveillance approach to obtain patient information. A total of 319 participants (54.2% males; mean age 40.4 ± 14.0 years) had complete data records. The prevalence of hypertension was 22.6% (95% confidence interval; 18.2-27.6%). The prevalence of hypertension increased with age and was higher in males (24.9%) than in females (19.9%). Age, cholesterolaemia and obesity were significantly associated with hypertension. Separate analyses for females and males revealed that obesity was significantly associated with hypertension in females but not in males. On the contrary, cholesterolaemia was significantly associated with hypertension in males but not in females. We found a high prevalence of hypertension and multiple risk factors for non-communicable diseases (NCDs) in outpatients seeking care in Hargeisa. Our findings emphasise the need for enhanced focus on the prevention and management of NCDs in Somaliland.
Collapse
Affiliation(s)
- Faisal Nooh
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
- College of Medicine & Health Sciences, University of Hargeisa, Hargeisa 25263, Somaliland
- College of Medicine & Health Sciences, Jigjiga University, Jigjiga 1020, Ethiopia
| | - Mohamed I Ali
- College of Medicine & Health Sciences, Jigjiga University, Jigjiga 1020, Ethiopia
| | - Afona Chernet
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| |
Collapse
|
6
|
Melak AD, Wondimsigegn D, Kifle ZD. Knowledge, Prevention Practice and Associated Factors of Stroke Among Hypertensive and Diabetic Patients - A Systematic Review. Risk Manag Healthc Policy 2021; 14:3295-3310. [PMID: 34408515 PMCID: PMC8364969 DOI: 10.2147/rmhp.s324960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/03/2021] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Because of the inadequate level of public awareness of the disease, the incidence of stroke has been sharply rising. Eventually, due to the prehospital delay, many stroke cases could not be eligible for thrombolysis thereby poor rehabilitative outcome has been tremendously increased. Thus, this study aimed to review the level of knowledge, prevention practice, and associated factors of stroke among hypertensive and diabetic patients. METHODS A systematic review of primarily published articles (2010-2020) related to knowledge and prevention practices of stroke was performed by searching online electronic databases like PubMed, Google Scholar, Refseek, Science direct, ResearchGate, and manual Google search by using the keywords and MeSH terms. Studies conducted on knowledge and prevention practices amongst hypertensive and/or diabetic patients were included. RESULTS Out of 531 searched studies, 42 articles were identified to be reviewed. The reported overall knowledge of stroke was ranging from 4.4% to 79%. Knowledge to the signs/symptoms of stroke was 23.6% to 87%. However, 15% to 77% of subjects were also reported that they did not know any sign of stroke. The range of risk factor knowledge was 10.5% to 86.6%. The reported level of stroke prevention practice was 2.4% to 72% but physical activity and weight reduction practice were relatively low. Inadequate level of knowledge and prevention practice of stroke was related to elderly, female gender, uneducated, unmarried, rural residents, economically low, comorbidity and unemployed individuals. CONCLUSION The current finding revealed that the level of knowledge and prevention practice of stroke was inadequate. Hence, the finding highlights health educational programs should be planned as an important avenue to enhance stroke awareness among the high-risk populations.
Collapse
Affiliation(s)
- Abreham Degu Melak
- University of Gondar, College of Medicine and Health Science, School of Pharmacy, Department of Pharmacology, Gondar, Ethiopia
| | - Dawit Wondimsigegn
- University of Gondar, College of Medicine and Health Science, School of Pharmacy, Department of Pharmaceutics and Social Pharmacy, Gondar, Ethiopia
| | - Zemene Demelash Kifle
- University of Gondar, College of Medicine and Health Science, School of Pharmacy, Department of Pharmacology, Gondar, Ethiopia
| |
Collapse
|
7
|
Lewis CR, Talboom JS, De Both MD, Schmidt AM, Naymik MA, Håberg AK, Rundek T, Levin BE, Hoscheidt S, Bolla Y, Brinton RD, Hay M, Barnes CA, Glisky E, Ryan L, Huentelman MJ. Smoking is associated with impaired verbal learning and memory performance in women more than men. Sci Rep 2021; 11:10248. [PMID: 33986309 PMCID: PMC8119711 DOI: 10.1038/s41598-021-88923-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/09/2021] [Indexed: 02/03/2023] Open
Abstract
Vascular contributions to cognitive impairment and dementia (VCID) include structural and functional blood vessel injuries linked to poor neurocognitive outcomes. Smoking might indirectly increase the likelihood of cognitive impairment by exacerbating vascular disease risks. Sex disparities in VCID have been reported, however, few studies have assessed the sex-specific relationships between smoking and memory performance and with contradictory results. We investigated the associations between sex, smoking, and cardiovascular disease with verbal learning and memory function. Using MindCrowd, an observational web-based cohort of ~ 70,000 people aged 18-85, we investigated whether sex modifies the relationship between smoking and cardiovascular disease with verbal memory performance. We found significant interactions in that smoking is associated with verbal learning performance more in women and cardiovascular disease more in men across a wide age range. These results suggest that smoking and cardiovascular disease may impact verbal learning and memory throughout adulthood differently for men and women.
Collapse
Affiliation(s)
- C. R. Lewis
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - J. S. Talboom
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - M. D. De Both
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - A. M. Schmidt
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - M. A. Naymik
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - A. K. Håberg
- grid.5947.f0000 0001 1516 2393Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - T. Rundek
- grid.134563.60000 0001 2168 186XEvelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721 USA ,grid.26790.3a0000 0004 1936 8606Miami Clinical and Translational Science Institute, University of Miami, Miami, FL 33136 USA
| | - B. E. Levin
- grid.134563.60000 0001 2168 186XEvelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721 USA
| | - S. Hoscheidt
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - Y. Bolla
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - R. D. Brinton
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - M. Hay
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - C. A. Barnes
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - E. Glisky
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - L. Ryan
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - M. J. Huentelman
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| |
Collapse
|
8
|
Hsu JH, Chien IC, Lin CH. Increased risk of ischemic heart disease in patients with bipolar disorder: A population-based study. J Affect Disord 2021; 281:721-726. [PMID: 33223233 DOI: 10.1016/j.jad.2020.11.083] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/10/2020] [Accepted: 11/08/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study investigated the national prevalence and incidence of ischemic heart disease and associated factors among Taiwanese patients with bipolar disorder. METHODS We used a random sample of 766,427 subjects who were ≥18 years old from the National Health Research Institute database in 2005. Subjects with at least one primary diagnosis of bipolar disorder or ischemic heart disease were identified. We compared the prevalence and incidence of ischemic heart disease in bipolar patients and the general population in 2005 and the same cohort from 2006 to 2010. These associated factors with respect to ischemic heart disease among patients with bipolar disorder were also analyzed. RESULTS The prevalence of ischemic heart disease in patients with bipolar disorder was 1.69 times higher than in the general population (7.85% vs 4.67%; odds ratio 1.69; 95% confidence interval, 1.41-2.03) in 2005. The average annual incidence of ischemic heart disease in patients with bipolar disorder was also 1.60 times higher than in the general population (2.02% vs 1.24; risk ratio 1.60; 95% confidence interval, 1.36-1.90) from 2006 to 2010. The higher prevalence of ischemic heart disease among bipolar patients was associated with increased age, diabetes, hypertension, and antidepressant use. CONCLUSIONS Patients with bipolar disorder had a significantly higher prevalence and incidence of ischemic heart disease than the general population in both sexes, especially at younger ages. Among patients with bipolar disorder, older age, and hyperlipidemia were risk factors of ischemic heart disease.
Collapse
Affiliation(s)
- Jer-Hwa Hsu
- Chia-Yi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - I-Chia Chien
- Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei, Taiwan; National Yang-Ming University, Taipei, Taiwan.
| | - Ching-Heng Lin
- Taichung Veterans General Hospital, Taichung, Taiwan; National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
9
|
The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res 2020; 42:1235-1481. [PMID: 31375757 DOI: 10.1038/s41440-019-0284-9] [Citation(s) in RCA: 997] [Impact Index Per Article: 249.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
10
|
Sadeghi M, Daneshpour MS, Khodakarim S, Momenan AA, Akbarzadeh M, Soori H. Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study. Epidemiol Health 2020; 42:e2020009. [PMID: 32150674 PMCID: PMC7285426 DOI: 10.4178/epih.e2020009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 03/07/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers). METHODS In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders. RESULTS The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern. CONCLUSIONS The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.
Collapse
Affiliation(s)
- Masoumeh Sadeghi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam S Daneshpour
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Momenan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Akbarzadeh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Soori
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Kario K. Key Points of the 2019 Japanese Society of Hypertension Guidelines for the Management of Hypertension. Korean Circ J 2019; 49:1123-1135. [PMID: 31760704 PMCID: PMC6875598 DOI: 10.4070/kcj.2019.0246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/09/2019] [Indexed: 12/21/2022] Open
Abstract
The new 2019 Japanese Society of Hypertension (JSH) guidelines for the management of hypertension are now available; these update the previous guidelines published in 2014. The primary objective of the guideline is to provide all healthcare professionals with a standard management strategy and appropriate antihypertensive treatments to prevent hypertension-related target organ damage and cardiovascular events. The major changes in the new guideline relate to the definition of normal blood pressure (BP) and target BP. The terms 'normal BP' and 'high normal BP' used in the JSH 2014 guidelines are replaced with terms 'high normal BP' and 'elevated BP,' respectively. There was no change to the office BP diagnostic threshold for hypertension (140/90 mmHg). Recommended target office and home BP values for patients with hypertension aged <75 years and/or high-risk patients are <130/80 mmHg and <125/75 mmHg, respectively. Corresponding targets for elderly patients with hypertension (age≥75 years) are 140/90 and 135/85 mmHg, respectively. The goal is that these changes will contribute to reducing cardiovascular events, especially stroke and heart failure, in Japan. The dissemination of the JSH 2019 guidelines and implementation of a home BP-based approach by all general practitioners in Japan might be facilitated by digital hypertension management using health information technology.
Collapse
Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
| |
Collapse
|
12
|
Survival to Age 90 in Men: The Tromsø Study 1974-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16112028. [PMID: 31174416 PMCID: PMC6603911 DOI: 10.3390/ijerph16112028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 12/26/2022]
Abstract
The 738 oldest men who participated in the first survey of the population-based Tromsø Study (Tromsø 1) in Norway in 1974 have now had the chance to reach the age of 90 years. The men were also invited to subsequent surveys (Tromsø 2–7, 1979–2016) and have been followed up for all-cause deaths. This study sought to investigate what could be learned from how these men have fared. The men were born in 1925–1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, and 10.8 for never, former, and current smokers, respectively. Significant effects on survival were also found for physical inactivity, low income, being unmarried, high blood pressure, and high cholesterol. For men with 0–4 of these risk factors, the percentages reaching 90 years were 33.3, 24.9, 12.4, 14.4, and 1.5, respectively. Quitting smoking and increasing physical activity before 55 years of age improved survival significantly. Men should refrain from smoking and increase their physical activity, especially those with low income, those who are unmarried, and those with high blood pressure and high cholesterol.
Collapse
|
13
|
Cardiovascular risk and blood pressure lowering treatment among elderly individuals: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan. J Hypertens 2019; 36:410-418. [PMID: 28877077 DOI: 10.1097/hjh.0000000000001555] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There is little evidence to support an increased risk of blood pressure (BP) elevation among elderly individuals receiving antihypertensive drug treatment. METHODS To clarify the impact on BP level and residual cardiovascular risk in treated elderly individuals, we analysed individual participant data of 26 133 residents aged 60-89 years from seven Japanese general populations and cross-classified participants by age category, 60-74 (young-old) versus 75-89 years (old-old), and by usage of antihypertensive medication at baseline survey (1980-1995). RESULTS During a median follow-up period of 12.7 years, 2451 cardiovascular deaths were observed. Multivariable-adjusted hazard ratios of cardiovascular mortality in treated participants compared with untreated participants were 1.30 [95% confidence intervals, 1.16-1.46) and 1.35 (95% confidence interval, 1.16-1.56) in young-old and old-old participants, respectively. Irrespective of antihypertensive medication, the risk increase of total cardiovascular and stroke mortality with elevation of BP was significant among young-old (P ≤ 0.0013), but not significant among old-old participants (P ≥ 0.061). CONCLUSION Although impact on BP was more evident among young-old than old-old individuals, clinicians who prescribe antihypertensive medication to elderly patients should consider that such patients require further monitoring.
Collapse
|
14
|
Hozawa A, Hirata T, Yatsuya H, Murakami Y, Kuriyama S, Tsuji I, Sugiyama D, Satoh A, Tanaka-Mizuno S, Miura K, Ueshima H, Okamura T. Association Between Body Mass Index and All-Cause Death in Japanese Population: Pooled Individual Participant Data Analysis of 13 Cohort Studies. J Epidemiol 2018; 29:457-463. [PMID: 30393269 PMCID: PMC6859077 DOI: 10.2188/jea.je20180124] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We sought to investigate the optimal values of BMI for the lowest risk of all-cause death and whether the optimal BMI differs according to smoking status in large-scale pooled analysis of 13 Japanese cohorts. METHODS Data from 179,987 participants of 13 well-qualified cohort studies conducted throughout Japan were used for our analysis. A cohort-stratified Cox proportional hazard model was used. P values for interactions were calculated based on the cross product of BMI and age, sex, or smoking status. RESULTS In the entire study population, all-cause mortality risk was lowest when the BMI was 22.0-24.9 kg/m2. This was also the case for selected healthy participants (never smoked, baseline total cholesterol level ≥4.1 mmol/L; the first 5 years of follow-up data were excluded). No effect modification of age, sex, or smoking status was observed. Regardless of their BMI, never smokers always had a lower all-cause mortality risk than did current smokers even with an ideal BMI in terms of mortality risk. CONCLUSION A BMI of 22-24.9 kg/m2 correlated with the lowest risk of mortality, regardless of whether all participants or selected healthy participants were analyzed. The fact that smoking was more strongly associated with mortality than obesity emphasizes the urgency for effective anti-smoking programs.
Collapse
Affiliation(s)
- Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization
| | - Takumi Hirata
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine
| | | | - Shinichi Kuriyama
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization.,Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University
| | - Ichiro Tsuji
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization.,Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Daisuke Sugiyama
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Atsushi Satoh
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University
| | | | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| |
Collapse
|
15
|
Kinoshita M, Yokote K, Arai H, Iida M, Ishigaki Y, Ishibashi S, Umemoto S, Egusa G, Ohmura H, Okamura T, Kihara S, Koba S, Saito I, Shoji T, Daida H, Tsukamoto K, Deguchi J, Dohi S, Dobashi K, Hamaguchi H, Hara M, Hiro T, Biro S, Fujioka Y, Maruyama C, Miyamoto Y, Murakami Y, Yokode M, Yoshida H, Rakugi H, Wakatsuki A, Yamashita S. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017. J Atheroscler Thromb 2018; 25:846-984. [PMID: 30135334 PMCID: PMC6143773 DOI: 10.5551/jat.gl2017] [Citation(s) in RCA: 497] [Impact Index Per Article: 82.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Koutaro Yokote
- Department of Diabetes, Metabolism and Endocrinology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Yasushi Ishigaki
- Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Seiji Umemoto
- Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Hirotoshi Ohmura
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Shinji Kihara
- Biomedical Informatics, Osaka University, Osaka, Japan
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Isao Saito
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Kazuhisa Tsukamoto
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama, Japan
| | - Seitaro Dohi
- Chief Health Management Department, Mitsui Chemicals Inc., Tokyo, Japan
| | - Kazushige Dobashi
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine, Kanagawa, Japan
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University, Hyogo, Japan
| | - Chizuko Maruyama
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University, Tokyo, Japan
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Masayuki Yokode
- Department of Clinical Innovative Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akihiko Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan
| | - Shizuya Yamashita
- Department of Community Medicine, Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Rinku General Medical Center, Osaka, Japan
| | | |
Collapse
|
16
|
Ukawa S, Tamakoshi A, Murakami Y, Kiyohara Y, Yamada M, Nagai M, Satoh A, Miura K, Ueshima H, Okamura T, EPOCH-JAPAN Research Group. Pooled Analysis of the Associations between Body Mass Index, Total Cholesterol, and Liver Cancer-related Mortality in Japan. Asian Pac J Cancer Prev 2018; 19:2089-2095. [PMID: 30139206 PMCID: PMC6171377 DOI: 10.22034/apjcp.2018.19.8.2089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: We employed a large-scale pooled analysis to investigate the association of liver cancer-related
mortality with being overweight/obese and total cholesterol (TC) levels, since limited and inconsistent data on these
associations exist in Japan. Methods: A total of 59,332 participants (23,853 men and 35,479 women) from 12 cohorts
without a history of cancer who were followed for a median of 14.3 years were analyzed. A sex-specific stratified
Cox proportional hazards model adjusted for age and other potential confounders was used to calculate hazard ratios
(HRs) and 95% confidence intervals (CI) for liver cancer-related mortality. Results: A total of 447 participants
(266 men and 181 women) died of liver cancer within the follow-up period. Individuals classified as having a high
BMI (≥25.0 kg/m2) and low TC levels (<160 mg/dL) had a significantly increased risk for liver cancer-related
mortality (HR 7.05, 95% CI 4.41–11.26 in men; HR 8.07, 95% CI 4.76–13.67 in women) when compared with those
in the intermediate BMI (18.5–24.9 kg/m2) and TC (160–219 mg/dL) categories. These associations remained after
limiting the follow-up duration to >5 years. Conclusion: Being overweight/obese, combined with low TC levels, was
strongly associated with liver cancer-related mortality in the EPOCH-JAPAN.
Collapse
Affiliation(s)
- Shigekazu Ukawa
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.,Research Unit of Advanced Interdisciplinary Care Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Nakamura K, Watanabe M, Okuda N, Yoshita K, Kabayama M, Torii S, Kuribayashi T, Itai K, Kamide K, Miura K, Okayama A. The Influence of the Japanese Nationwide Cardiovascular Prevention System Health Guidance on Smoking Cessation Among Smokers: A Propensity Score Matching Analysis. J Atheroscler Thromb 2018; 25:323-334. [PMID: 29199202 PMCID: PMC5906185 DOI: 10.5551/jat.42051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim: We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers. Methods: The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling (“supported”) and those who had not received counseling (“unsupported”). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index. Results: In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was + 2.64% (95% confidence interval: + 1.51% to + 3.77%) for males and + 3.11% (−1.85% to +8.07%) for females. The ATE of single counseling was +0.61% (−1.17% to +2.38%) for males and −1.06% (−5.96% to +3.85%) for females. Conclusions: In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.
Collapse
Affiliation(s)
- Koshi Nakamura
- Department of Public Health, Hokkaido University Faculty of Medicine
| | - Makoto Watanabe
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Art and Science
| | - Katsushi Yoshita
- Department of Food Science and Nutrition, Graduate School of Human Life Science, Osaka City University
| | - Mai Kabayama
- Division of Health Science, Osaka University Graduate School of Medicine
| | - Sayuki Torii
- Department of Public Health, Shiga University of Medical Science
| | | | | | - Kei Kamide
- Division of Health Science, Osaka University Graduate School of Medicine
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | | |
Collapse
|
18
|
Zhou G, Liu H, He M, Yue M, Gong P, Wu F, Li X, Pang Y, Yang X, Ma J, Liu M, Li J, Zhang X. Smoking, leisure-time exercise and frequency of self-reported common cold among the general population in northeastern China: a cross-sectional study. BMC Public Health 2018; 18:294. [PMID: 29486739 PMCID: PMC6389261 DOI: 10.1186/s12889-018-5203-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 02/22/2018] [Indexed: 11/24/2022] Open
Abstract
Background Physical activity (PA) and smoking have been reported to be associated with the duration and severity of common cold symptoms. However, few studies have addressed the associations between the frequency of leisure-time exercise, cigarette smoking status and the frequency of the common cold in a cold area. This study was designed to investigate these issues in northeastern China. Methods This cross-sectional study included individuals who participated in a regular health examination conducted in Jilin Province, China. Information on episodes of the common cold, the frequency of leisure-time exercise and cigarette smoking status in the past year were collected by self-administered health questionnaires. Ordinal logistic regression models were used to analyse the associations between the frequency of leisure-time exercise, cigarette smoking status and the retrospective frequency of common cold. Results A total of 1413 employees participated in the study, with an average age of 38.92 ± 9.04 years and 44.4% of them were male. Of all participants, 80.8% reported having experienced the common cold in the past year. After adjustment, the risk of suffering from the common cold more than once (odds ratios (ORs), 1.59; 95% confidence interval (CI), 1.27–1.99) in passive smokers was 1.59 times as high as that in non-smokers. Nevertheless, the results of the adjusted analysis showed no statistically significant relation between current smoking and the frequency of the common cold. A high frequency of leisure-time exercise (≥3 days/week) was associated with a 26% reduced risk of having at least one episode of the common cold (OR, 0.74; 95% CI, 0.55–0.98) compared with a low frequency group (< 4 days/month). For current and passive smokers, the protective effect of a high frequency of leisure-time exercise appears not to be obvious (current smokers: OR, 0.68; 95% CI, 0.33–1.43; passive smokers: OR, 1.15; 95% CI, 0.69–1.93). Conclusion Passive smoking was associated with a higher risk of having self-reported common cold at least once, while a high frequency of leisure-time exercise was related to a lower risk of reporting more than one episode of the disease in Chinese.
Collapse
Affiliation(s)
- Ge Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Mengjia Yue
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ping Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Fangyuan Wu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xuanxuan Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yingxin Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiaodi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Juan Ma
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Meitian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Jinghua Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| |
Collapse
|
19
|
Lee PN, Forey BA, Thornton AJ, Coombs KJ. The relationship of cigarette smoking in Japan to lung cancer, COPD, ischemic heart disease and stroke: A systematic review. F1000Res 2018; 7:204. [PMID: 30800285 PMCID: PMC6367657 DOI: 10.12688/f1000research.14002.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2018] [Indexed: 02/06/2023] Open
Abstract
Background: To present up-to-date meta-analyses of evidence from Japan relating smoking to major smoking-related diseases. Methods: We restricted attention to lung cancer, chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and stroke, considering relative risks (RRs) for current and ex-smokers relative to never smokers. Evidence by amount smoked and time quit was also considered. For IHD and stroke only, studies had to provide age-adjusted RRs, with age-specific results considered. For each disease we extended earlier published databases to include more recent studies. Meta-analyses were conducted, with random-effects RRs and tests of heterogeneity presented. Results: Of 40 studies, 26 reported results for lung cancer and 7 to 9 for each other disease. For current smoking, RRs (95%CIs) were lung cancer 3.59 (3.25-3.96), COPD 3.57 (2.72-4.70), IHD 2.21 (1.96-2.50) and stroke 1.40 (1.25-1.57). Ex-smoking RRs were lower. Data for lung cancer and IHD showed a clear tendency for RRs to rise with increasing amount smoked and decrease with increasing time quit. Dose-response data were unavailable for COPD and unclear for stroke, where the association was weaker. Conclusions: Compared to studies in other Asian and Western countries, current smoking RRs were quite similar for IHD and stroke. The comparison is not clear for COPD, where the Japanese data, mainly from cross-sectional studies, is limited. For lung cancer, the RRs are similar to those in other Asian countries, but substantially lower than in Western countries. Explanations for this are unclear, but less accurate reporting of smoking by Japanese may contribute to the difference.
Collapse
Affiliation(s)
- Peter N. Lee
- P.N. Lee Statistics and Computing Ltd., Sutton, SM2 5DA, UK
| | | | | | | |
Collapse
|
20
|
Tsuji M, Kanda H, Hayakawa T, Mori Y, Ito T, Hidaka T, Kakamu T, Kumagai T, Osaki Y, Kawazoe M, Sato S, Fukushima T. Nicotine cut-off value in human hair as a tool to distinguish active from passive smokers: A cross-sectional study in Japanese men. Cancer Biomark 2017; 20:41-48. [PMID: 28759953 DOI: 10.3233/cbm-170004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Nicotine concentration in hair is a useful marker of tobacco exposure. Detection of nicotine in the hair of non-smokers indicates passive smoking. Accurate measurement of nicotine among active and passive smokers can help in smoking cessation programs or programs designed to prevent secondhand smoke exposure. OBJECTIVE To establish, using high-performance liquid chromatography-ultraviolet detection (HPLC/UV), a hair nicotine cut-off value to distinguish active from passive smokers. METHODS Hair samples were collected from randomly chosen Japanese men (n= 192) between 2009 and 2011. Nicotine and cotinine levels in hair were measured using HPLC/UV with column-switching. T-tests and chi-square tests were performed to compare active and passive smokers, while receiver operating characteristic curves were used to evaluate the effectiveness of the cut-off value. RESULTS There were 69 active smokers and 123 passive smokers. The nicotine and cotinine concentrations in hair were significantly higher in active than in passive smokers (p< 0.01). The area under the curve for nicotine was 0.92. A hair nicotine cut-off value of 5.68 ng/mg, with a sensitivity of 94.2% and specificity of 87.0%, was identified as the optimal cut-off value for separating active from passive smokers. CONCLUSION Nicotine and cotinine concentrations in hair clearly distinguished active from passive smokers.
Collapse
Affiliation(s)
- Masayoshi Tsuji
- Department of Preventive Medicine & Public Health, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan.,Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Hideyuki Kanda
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Takehito Hayakawa
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Yayoi Mori
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Teruna Ito
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Tomoo Hidaka
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Takeyasu Kakamu
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Tomohiro Kumagai
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Yoneatsu Osaki
- Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Miki Kawazoe
- Department of Preventive Medicine & Public Health, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
| | - Sei Sato
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Tetsuhito Fukushima
- Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| |
Collapse
|
21
|
Lubin JH, Couper D, Lutsey PL, Yatsuya H. Synergistic and Non-synergistic Associations for Cigarette Smoking and Non-tobacco Risk Factors for Cardiovascular Disease Incidence in the Atherosclerosis Risk In Communities (ARIC) Study. Nicotine Tob Res 2017; 19:826-835. [PMID: 27651477 PMCID: PMC5896551 DOI: 10.1093/ntr/ntw235] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 09/19/2016] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Cigarette smoking, various metabolic and lipid-related factors and hypertension are well-recognized cardiovascular disease (CVD) risk factors. Since smoking affects many of these factors, use of a single imprecise smoking metric, for example, ever or never smoked, may allow residual confounding and explain inconsistencies in current assessments of interactions. METHODS Using a comprehensive model in pack-years and cigarettes/day for the complex smoking-related relative risk (RR) of CVD to reduce residual confounding, we evaluated interactions with non-tobacco risk factors, including additive (non-synergistic) and multiplicative (synergistic) forms. Data were from the prospective Atherosclerosis Risk in Communities (ARIC) Study from four areas of the United States recruited in 1987-1989 with follow-up through 2008. Analyses included 14 127 participants, 207 693 person-years and 2857 CVD events. RESULTS Analyses revealed distinct interactions with smoking: including statistical consistency with additive (body mass index [BMI], waist to hip ratio [WHR], diabetes mellitus [DM], glucose, insulin, high density lipoproteins [HDL] and HDL(2)); and multiplicative (hypertension, total cholesterol [TC], low density lipoproteins [LDLs], apolipoprotein B [apoB], TC to HDL ratio and HDL(3)) associations, as well as indeterminate (apolipoprotein A-I [apoA-I] and triglycerides) associations. CONCLUSIONS The forms of the interactions were revealing but require confirmation. Improved understanding of joint associations may help clarify the public health burden of smoking for CVD, links between etiologic factors and biological mechanisms, and the consequences of joint exposures, whereby synergistic associations highlight joint effects and non-synergistic associations suggest distinct contributions. IMPLICATIONS Joint associations for cigarette smoking and non-tobacco risk factors were distinct, revealing synergistic/multiplicative (hypertension, TC, LDL, apoB, TC/HDL, HDL(3)), non-synergistic/additive (BMI, WHR, DM, glucose, insulin, HDL, HDL(2)) and indeterminate (apoA-I and TRIG) associations. If confirmed, these results may help better define the public health burden of smoking on CVD risk and identify links between etiologic factors and biologic mechanisms, where synergistic associations highlight joint impacts and non-synergistic associations suggest distinct contributions from each factor.
Collapse
Affiliation(s)
- Jay H Lubin
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, US National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - David Couper
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Kutsukake-cho, Japan
| |
Collapse
|
22
|
Zhang W, Iso H, Murakami Y, Miura K, Nagai M, Sugiyama D, Ueshima H, Okamura T. Serum Uric Acid and Mortality Form Cardiovascular Disease: EPOCH-JAPAN Study. J Atheroscler Thromb 2017; 23:1365-1366. [PMID: 27904050 PMCID: PMC5221499 DOI: 10.5551/jat.er31591] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Wen Zhang
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Hirakawa Y, Ninomiya T, Kiyohara Y, Murakami Y, Saitoh S, Nakagawa H, Okayama A, Tamakoshi A, Sakata K, Miura K, Ueshima H, Okamura T. Age-specific impact of diabetes mellitus on the risk of cardiovascular mortality: An overview from the evidence for Cardiovascular Prevention from Observational Cohorts in the Japan Research Group (EPOCH-JAPAN). J Epidemiol 2017; 27:123-129. [PMID: 28142033 PMCID: PMC5350618 DOI: 10.1016/j.je.2016.04.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 04/19/2016] [Indexed: 11/18/2022] Open
Abstract
Background Diabetes mellitus is a strong risk factor for cardiovascular disease. However, the age-specific association of diabetes with cardiovascular risk, especially in the elderly, remains unclear in non-Western populations. Methods A pooled analysis was conducted using 8 cohort studies (mean follow-up period, 10.3 years) in Japan, combining the data from 38,854 individual participants without history of cardiovascular disease. In all, 1867 of the participants had diabetes, defined based on the 1998 World Health Organization criteria. The association between diabetes and the risk of death from cardiovascular disease, coronary heart disease (CHD), and stroke was estimated using a stratified Cox model, accounting for variability of baseline hazard functions among cohorts. Results During the follow-up, 1376 subjects died of cardiovascular disease (including 268 of coronary heart disease and 621 of stroke). Diabetes was associated with an increased risk of cardiovascular death after multivariable adjustment (hazard ratio [HR] 1.62; 95% confidence interval [CI], 1.35–1.94). Similarly, diabetes was a risk factor for CHD (HR 2.13; 95% CI, 1.47–3.09) and stroke (HR 1.40; 95% CI, 1.05–1.85). In the age-stratified analysis of the risk of cardiovascular death, the relative effects of diabetes were consistent across age groups (p for heterogeneity = 0.18), whereas the excess absolute risks of diabetes were greater in participants in their 70s and 80s than in younger subjects. Conclusions The management of diabetes is important to reduce the risk of death from cardiovascular disease, not only in midlife but also in late life, in the Japanese population. We conducted meta-analysis of individual data from 8 Japanese cohorts (n = 38,854). Diabetes raised cardiovascular mortality in Japan. Impact of diabetes on cardiovascular death was similar across 10-year age groups.
Collapse
Affiliation(s)
- Yoichiro Hirakawa
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Division of Research Management, Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yutaka Kiyohara
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Shigeyuki Saitoh
- Department of Nursing, Sapporo Medical University School of Health Sciences, Sapporo, Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Akiko Tamakoshi
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Katsuyuki Miura
- Department of Public Health, Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| |
Collapse
|
24
|
Gu L, Zhou J, Tan J, Yang J, Shen T, Jiang H, Tang Q. Association of TLR8 gene rs3764880 polymorphisms with susceptibility and lipid metabolism- and inflammation response-related quantitative traits of ischemic stroke in southern Chinese Han male population. J Neurol Sci 2016; 370:94-99. [DOI: 10.1016/j.jns.2016.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 07/21/2016] [Accepted: 08/09/2016] [Indexed: 10/21/2022]
|
25
|
Hatanaka Y, Shimokata K, Osugi S, Kaneko N. Impact of drinking and smoking habits on cerebrovascular disease risk among male employees. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2016; 58:155-163. [PMID: 27488512 DOI: 10.1539/sangyoeisei.b15024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We aimed to analyze the impact of drinking and smoking behavior on the risk of developing cerebrovascular diseases among male employees aged 20-46 years. Twenty years of follow-up data of male employees enrolled in the DENSO Health Insurance Program were used for analyses. SUBJECTS AND METHODS Of 29,048 male employees aged 20-46 years who were enrolled in the insurance program in 1994, 25,084 (86.4%) employees underwent annual health check-ups until 2003 without missing an appointment. Of these 25,084 employees, the data of 11,784 (40.6%) employees who self-reported drinking and smoking habits were used for analyses. The hazard ratio and 95% confidence intervals (CIs) for developing cerebrovascular disease in 2004-2013 were calculated in four risk groups categorized as per drinking and smoking behavior in the young group who were in their 20s and the middle-aged group who were in their 30s-40s in 1994. Based on their drinking behavior, participants were categorized into two groups: "not drinking or drinking sometimes" and "drinking every day." Based on their smoking behavior, participants were also categorized into two groups: "not smoking for 10 years" and "smoking for 10 years." RESULTS A Cox's proportional hazard model revealed that after controlling for body mass index, systolic blood pressure, triglycerides, total cholesterol, fasting plasma glucose, and age, the hazard ratios for "smoking and drinking every day" were 3.82 (95% CI: 1.40-10.41) in the young group and 2.31 (95% CI: 1.27-4.17) in the middle-aged group. DISCUSSION Male employees who had been drinking and smoking for 10 years had a higher risk of developing cerebrovascular diseases. To prevent cerebrovascular diseases among male employees, it may be effective to offer behavior change interventions for both drinking and smoking habits, regardless of the age group.
Collapse
|
26
|
Gu L, Zhou J, Tan J, Su L, Wei Q, Jiang H, Liang B, Tang Q. TLR7 rs2897827 Polymorphism Affects TLR7 Gene mRNA Expression and Serum Apolipoprotein A1 Level of Ischemic Stroke Patients in a Chinese Han Population. J Mol Neurosci 2016; 59:397-403. [PMID: 27427388 DOI: 10.1007/s12031-016-0773-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 05/25/2016] [Indexed: 01/27/2023]
Abstract
Stroke is a multi-factorial disorder that has become the leading cause of death and disability worldwide. Previous studies reported that TLR7 mRNA expression is associated with poor outcome of ischemic stroke (IS). This study aimed to assess whether TLR7 mRNA expression affects IS occurrence, as well as the association of TLR7 rs2897827 with susceptibility to IS and TLR7 mRNA expression and serum apolipoprotein and lipid levels in a Chinese Han population. A total of 816 stroke patients and 816 healthy controls were included in this study. mRNA expression was determined by quantitative real-time PCR. The Sequenom MassARRAY iPLEX platform was used to genotype the TLR7 rs2897827 polymorphism. TLR7 mRNA expression of the IS cases was statistically significantly higher than that of the controls in the male or female group (male, P = 0.014; female, P = 0.025). In the male IS cases, TLR7 mRNA expression of the T allele carriers was statistically significantly higher than that of the C allele carriers (P = 0.018). However, a significant difference was not observed in the female cases (P = 0.545). In either the male or female group, the distribution of genotype or allele had no statistical significance (P > 0.050). The ApoA1 level of the T carriers was statistically significantly higher than the C carriers in males (t = -2.383, P = 0.020); however, the ApoB and lipid levels were not associated with rs2897827 (P > 0.050). In female patients, no significant difference was observed between different genotypic/allelic carriers in serum apolipoprotein and lipid levels (all P > 0.050). The expression of the TLR7 gene may affect IS occurrence. TLR7 gene rs2897827 may influence TLR7 mRNA expression and the plasma ApoA1 level in male IS patients.
Collapse
Affiliation(s)
- Lian Gu
- First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Jinying Zhou
- First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Jinjing Tan
- First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Li Su
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Qiugui Wei
- First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Haiyun Jiang
- First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Baoyun Liang
- First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Qianli Tang
- You Jiang Medical University for Nationalities, 98 Chengxiang Road, Baise, Guangxi, 533000, China.
| |
Collapse
|
27
|
Zhang W, Iso H, Murakami Y, Miura K, Nagai M, Sugiyama D, Ueshima H, Okamura T. Serum Uric Acid and Mortality Form Cardiovascular Disease: EPOCH-JAPAN Study. J Atheroscler Thromb 2016; 23:692-703. [PMID: 26887218 DOI: 10.5551/jat.31591] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM To investigate the relationship between serum uric acid levels and cardiovascular disease in Asians. METHODS We examined the above relationship using the data of Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN Study). The data of 36,313 subjects (15,628 men and 20,685 women aged 35-89 years without histories of stroke, coronary heart disease, or cancer at baseline) were used for the analyses. Sex-specific hazard ratios (HRs) of mortality from cardiovascular disease were estimated according to the quintiles of serum uric acid using Cox hazard models stratified by cohorts. RESULTS During 441,771 person-years of follow-up, we documented 1,288 cardiovascular deaths. A J- or U-shaped relationship between serum uric acid level and cardiovascular disease mortality was observed. Compared with the lowest quintile of serum uric acid levels, the highest quintile was associated with an increased cardiovascular disease mortality in men [HR: 1.28; 95% confidence interval (CI): 1.01-1.63] and women (HR: 1.51; 95% CI: 1.14-1.99). However, there was no significant association with mortality from stroke, coronary heart disease or heart failure in both men and women. CONCLUSION This large pooled analysis in Japan suggested a J- or U-shaped relationship between serum uric acid levels and cardiovascular mortality. The highest quintile of serum uric acid levels was associated with increased cardiovascular disease mortality in both Japanese men and women.
Collapse
Affiliation(s)
- Wen Zhang
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Li Y, Iso H, Cui R, Murakami Y, Yatsuya H, Miura K, Nagasawa SY, Ueshima H, Okamura T. Serum γ-glutamyltransferase and Mortality due to Cardiovascular Disease in Japanese Men and Women. J Atheroscler Thromb 2016; 23:792-9. [PMID: 26875518 DOI: 10.5551/jat.32698] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
AIM Whether the association between serum γ-glutamyltransferase (γ-GTP) levels and total cardiovascular disease (CVD) mortality is independent of alcohol drinking in East Asian populations is not well known. We conducted a pooled analysis of Japanese men and women that enabled an analysis restricted to never-drinkers. METHODS A total of 15,987 men and 25,053 women aged 40-79 years, pooled from seven cohort studies throughout Japan, were followed-up to examine sex-specific relationship between serum γ-GTP levels and total CVD mortality. Cox regression model was used that was adjusted for age, smoking status, body mass index, and systolic blood pressure and serum triglyceride, total cholesterol, aspartate aminotransferase, and alanine aminotransferase levels. RESULTS During an average follow-up of 8.7 years, we documented 361 and 340 deaths from total CVD, 146 and 168 from stroke, and 101 and 53 from coronary heart disease (CHD) for men and women, respectively. Among the never-drinkers, hazard ratios (HRs) for mortality for one standard deviation of log-γ-GTP for men were 1.89 (1.00-3.58) for stroke, 1.04 (0.57-1.90) for CHD, and 1.43 (1.04-1.96) for total CVD. For women, HRs were 1.28 (1.06-1.54), 1.81 (1.34-2.44), and 1.30 (1.14-1.49), respectively. CONCLUSION γ-GTP may be a risk factor for total CVD mortality independent of alcohol drinking status in Japanese men and women.
Collapse
Affiliation(s)
- Yuanying Li
- Department of Public Health, Fujita Health University School of Medicine
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Smoking increases the risk of all-cause and cardiovascular mortality in patients with chronic kidney disease. Kidney Int 2015. [DOI: 10.1038/ki.2015.212] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
30
|
Association of GWAS-supported loci rs2107595 in HDAC9 gene with ischemic stroke in southern Han Chinese. Gene 2015; 570:282-7. [DOI: 10.1016/j.gene.2015.06.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 06/06/2015] [Accepted: 06/15/2015] [Indexed: 11/22/2022]
|
31
|
Nakai M, Miyamoto Y, Higashiyama A, Murakami Y, Nishimura K, Yatsuya H, Saitoh S, Sakata K, Iso H, Miura K, Ueshima H, Okamura T. Calibration between the Estimated Probability of the Risk Assessment Chart of Japan Atherosclerosis Society and Actual Mortality Using External Population: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN). J Atheroscler Thromb 2015; 23:176-95. [PMID: 26347049 DOI: 10.5551/jat.31286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM In Japan Atherosclerosis Society guidelines for the prevention of atherosclerotic cardiovascular diseases 2012 (JAS2012), NIPPON DATA80 risk assessment chart (ND80RAC) was adopted to estimate the 10-year probability of coronary artery disease (CAD) mortality. However, there was no comparison between the estimated mortality calculated by ND80RAC and actual mortality in external populations. Accordingly, we used the large pooled database of cohorts in Japan, EPOCH-JAPAN, as an external population. METHODS The participants of EPOCH-JAPAN without a history of cardiovascular disease (15,091 men and 18,589 women aged 40-74 years) were analyzed based on sex. The probability of a 10-year risk of CAD/stroke mortality was estimated by ND80RAC. The participants were divided into both decile of their estimated mortality and three categories according to JAS2012. The calibration between the mean estimated mortality and the actual mortality was performed by the Hosmer and Lemeshow (H-L) test. RESULTS In both sexes, the estimated CAD mortality was higher than the actual mortality, particularly in higher deciles of estimated mortality, and the estimated stroke mortality was almost concordant with the actual mortality in low/moderate deciles of estimated mortality. As for the categories according to JAS2012, the estimated CAD mortality was higher than the actual mortality in both sexes; actual mortality in Category III was lower than that in Category II in women. However, it increased in the ascending order of category when we excluded the presence of diabetes from Category III. CONCLUSIONS The estimated CAD mortality by ND80RAC tended to be higher than the actual mortality in the population in which the baseline survey was more recently performed.
Collapse
Affiliation(s)
- Michikazu Nakai
- Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Wong MCS, Zhang DX, Wang HHX. Rapid emergence of atherosclerosis in Asia: a systematic review of coronary atherosclerotic heart disease epidemiology and implications for prevention and control strategies. Curr Opin Lipidol 2015; 26:257-69. [PMID: 26103609 DOI: 10.1097/mol.0000000000000191] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW There is a global epidemic of coronary heart disease (CHD) caused by atherosclerosis. We discussed its emergence, underlying reasons, and implications for prevention and control strategies in Asia. RECENT FINDINGS Most countries in Asia are experiencing the challenges from CHD, with the mortality rate varying from 103 to 366 per 100 000 adult populations, reported by recently published studies. Raised population cholesterol levels played a pivotal role. Men, older adults, and those with dyslipidemia, hypertension, and diabetes were high-risk individuals. During the past decade, there was a marked rising trend of atherosclerosis-related burden particularly in Eastern Asia where an alarming increase of 117.2 and 115.3% of total deaths and disability adjusted life-years, respectively, were observed. The rise of CHD could be attributed to unhealthy lifestyles, clinical-risk factors, psychosocial factors, and public health transitions. Ageing, urbanization, and increase in prosperity may serve as underlying key drivers. SUMMARY The burden of CHD is substantial, whereas contributors are multifactorial. This grand challenge should be a top priority for injecting healthcare resources. The formulation of public health measures will need to adopt an integrated and life-course approach, based on the need and risks of different population subgroups in Asia.
Collapse
Affiliation(s)
- Martin C S Wong
- aJC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong bSchool of Public Health, Sun Yat-Sen University, Guangzhou, P.R. China cGeneral Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK *Martin C.S. Wong and De Xing Zhang contributed equally to the writing of this article
| | | | | |
Collapse
|
33
|
Kawada T. Relationships between the smoking status and plasma fibrinogen, white blood cell count and serum C-reactive protein in Japanese workers. Diabetes Metab Syndr 2015; 9:180-182. [PMID: 25801482 DOI: 10.1016/j.dsx.2015.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Confirmation of the association between smoking status and biological inflammatory or anticoagulant markers is required in the field of occupational therapy to promote anti-smoking education. The associations between the smoking status and biological markers were clarified. METHODS The study was performed in 5102 working men aged 30-60 years old. The author measured the plasma fibrinogen, white blood cell count (WBC) and serum high-sensitivity C-reactive protein (CRP) as biomarkers of the smoking status. RESULTS After adjustment for age, the mean plasma fibrinogen level in never-smokers was significantly lower than that in current smokers. The mean WBC count was also significantly lower in the never-smokers than that in current smokers and ex-smokers who had quit within the previous 1 year. Furthermore, the mean log-transformed serum CRP value in never-smokers was significantly lower than that in current smokers smoking ≥20 cigarettes daily. Spearman's rank correlation coefficients between the plasma fibrinogen and the serum CRP and WBC were 0.561 and 0.243, respectively. The mean plasma fibrinogen, serum CRP and WBC count in the ex-smokers showed a trend toward decreasing as the duration of abstinence became longer. CONCLUSION Among the three biomarkers, the plasma fibrinogen was the most strongly associated with the smoking status, its value being to be the highest in current smokers smoking ≥20 cigarettes daily. The same trend was also observed for the WBC count.
Collapse
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Japan.
| |
Collapse
|
34
|
Hatanaka Y, Tamakoshi A, Tsushita K. [Risk factors for ischemic heart disease in males in the prime of life: An eight-year follow-up study]. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2015; 57:67-76. [PMID: 25753607 DOI: 10.1539/sangyoeisei.b14008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In order to prevent ischemic heart disease in working adult males, we analyzed risk factors by age groups based on data from an eight-year follow-up study of male employees enrolled in the Denso Health Insurance Program. SUBJECTS AND METHODS Of the 27,945 male employees aged 30 to 55 enrolled in the program in 2003, the data of 19,742 (70.6%) who underwent regular health checkups were analyzed. Information obtained from health insurance claims for hospitalization and cause of death from discontinuation data were used to analyze risk factors for ischemic heart disease by age group. Hazard ratios and 95% confidence intervals were estimated from Cox proportional-hazards models. RESULTS In males aged 30-39 years, a BMI of 25.0-27.5 was associated with a 2.21 higher risk of ischemic heart disease (95%CI: 1.01-4.84) than those not overweight (BMI of <25.0); LDL of 160 mg/dl or more was associated with a 3.85 higher risk (95%CI:1.62-9.14) than LDL of less than 120 mg/dl; and FPG of 160 mg/dl or more was associated with a 6.43 higher risk (95%CI: 1.02-40.63) than a FPG of less than 110 mg/dl. For males aged 40-55 years, higher LDL was a risk factor of ischemic heart disease (1.95 (95%CI: 1.28-2.98) and 1.97 (95%CI: 1.34-2.90) for LDL of more than 160 mg/dl and 140-159 mg/dl, respectively), compared to those with LDL of less than 120 mg/dl. In the same age group, compared to those unaffected, the risk of ischemic heart disease was 1.94 times higher (95%CI: 1.27-2.97) and 1.61 times higher (95%CI: 1.08-2.40) for those treated for hypertension and hyperlipidemia, respectively. Furthermore, compared to non-smokers, those smoking more than 20 cigarettes a day had 3.12 higher risk (95%CI: 1.21-8.06) and 1.81 higher risk (95%CI: 1.25-2.62) of ischemic heart disease in the 30-39 and 40-55 years age groups, respectively. Interaction effects with age group were not significant. DISCUSSION In males aged 30-39 years having a high BMI, LDL, FPG, and smoking more than 20 cigarettes increased the risk of ischemic heart disease. For males aged 40-55 years taking medication for hypertension and hyperlipidemia increased the risk. To prevent ischemic heart disease during the prime of life, offering support for weight control and stopping smoking is necessary in younger age groups. Moreover, implementing a long-term risk management plan to prevent the onset of hypertension, diabetes, or hyperlipidemia is also important.
Collapse
Affiliation(s)
- Yoko Hatanaka
- DENSO Health Insurance Society, 2-41 Shintomichou, Kariya, Aichi 448-0045, Japan
| | | | | |
Collapse
|
35
|
Sanchez-Ramos J. Neurologic Complications of Psychomotor Stimulant Abuse. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 120:131-60. [PMID: 26070756 DOI: 10.1016/bs.irn.2015.02.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Psychomotor stimulants are drugs that act on the central nervous system (CNS) to increase alertness, elevate mood, and produce a sense of well-being. These drugs also decrease appetite and the need for sleep. Stimulants can enhance stamina and improve performance in tasks that have been impaired by fatigue or boredom. Approved therapeutic applications of stimulants include attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. These agents also possess potent reinforcing properties that can result in excessive self-administration and abuse. Chronic use is associated with adverse effects including psychosis, seizures, and cerebrovascular accidents, though these complications usually occur in individuals with preexisting risk factors. This chapter reviews the adverse neurologic consequences of chronic psychomotor stimulant use and abuse, with a focus on two prototypical stimulants methamphetamine and cocaine.
Collapse
Affiliation(s)
- Juan Sanchez-Ramos
- Ellis Endowed Chair of Neurology, University of South Florida, Tampa, Florida, USA.
| |
Collapse
|
36
|
Kawada T, Andou T, Fukumitsu M. Predictors of the incidence of metabolic syndrome in general inhabitants. Nutrition 2014; 30:1208-9. [PMID: 25194616 DOI: 10.1016/j.nut.2014.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 05/10/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School Bunkyo, Tokyo, Japan
| | | | | |
Collapse
|
37
|
Sugiyama D, Okamura T, Watanabe M, Higashiyama A, Okuda N, Nakamura Y, Hozawa A, Kita Y, Kadota A, Murakami Y, Miyamatsu N, Ohkubo T, Hayakawa T, Miyamoto Y, Miura K, Okayama A, Ueshima H. Risk of hypercholesterolemia for cardiovascular disease and the population attributable fraction in a 24-year Japanese cohort study. J Atheroscler Thromb 2014; 22:95-107. [PMID: 25185893 DOI: 10.5551/jat.25908] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS The population-attributable fraction (PAF) is an indicator of the disease burden. In Western countries, the PAF of hypercholesterolemia in cardiovascular disease (CVD) is the highest among that for traditional risk factors; however, data for Asian populations are limited. METHODS A 24-year cohort study was conducted among 9,209 randomly selected participants who were not taking statins. We estimated the hazard ratio (HR) after adjusting for covariates and PAF associated with the serum total cholesterol (TC) levels in relation to CVD mortality. RESULTS The TC level was found to be positively associated with an increased risk of CVD, coronary heart disease (CHD) and cardiac death (CHD plus heart failure), with an HR of 1.08 (95% confidence interval [CI]: 1.00-1.16), 1.33 (95% CI: 1.14-1.55) and 1.21 (95% CI: 1.08-1.35) for a 1-SD increment in the serum TC level, respectively. Similar positive associations between the TC level and both CHD and cardiac death were observed after classifying the patients by age and sex. Furthermore, the highest serum TC level (≥ 6.72 mmol/L) was positively associated with CVD death, with an HR of 1.76 (95% CI: 1.25-2.47), as well as both CHD death and cardiac death. In contrast, no significant relationships were observed between the serum TC level and stroke. Meanwhile, the PAF for CVD, CHD, and cardiac deaths due to hypercholesterolemia (serum TC level ≥ 5.69 mmol/L, defined by the Japan Atherosclerosis Society) was 1.7%, 10.6% and 5.6%, respectively. CONCLUSIONS The estimated PAF of CVD death due to hypercholesterolemia is moderately high, but lower than that for other risk factors, such as hypertension.
Collapse
Affiliation(s)
- Daisuke Sugiyama
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Cocaine use and risk of stroke: a systematic review. Drug Alcohol Depend 2014; 142:1-13. [PMID: 25066468 DOI: 10.1016/j.drugalcdep.2014.06.041] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 06/17/2014] [Accepted: 06/28/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Both cocaine use and strokes impact public health. Cocaine is a putative cause of strokes, but no systematic review of the scientific evidence has been published. METHODS All relevant bibliographic-databases were searched until January 2014 for articles on the epidemiological association between cocaine use and strokes. Search strings were supervised by expert librarians. Three researchers independently reviewed studies for inclusion and data extraction following STROBE recommendations. Quality appraisal included study validity and bias. Both ischemic and hemorrhagic strokes were considered. RESULTS Of 996 articles, 9 were selected: 7 case-control studies (CCS) and 2 cross-sectional (CSS) studies. One CCS (aOR=6.1; 95% CI: 3.3-11.8) and one CSS (aOR=2.33; 95% CI: 1.74-3.11) showed an association between cocaine and hemorrhagic strokes. The latter study also found a positive relationship with ischemic stroke (aOR=2.03; 95% CI: 1.48-2.79). Another CCS found the exposure to be associated with stroke without distinguishing between types (aOR=13.9; 95% CI: 2.8-69.4). One forensic CCS found that deaths with cocaine-positive toxicology presented a 14.3-fold (95% CI: 5.6-37) and 4.6-fold (95% CI: 2.5-8.5) increased risk of atherosclerosis compared to opioid-related deaths and hanging-deaths respectively. One CCS did not provide an aOR but found a statistically significant association between cocaine and hemorrhagic stroke. Three CCS and one CSS did not find any relationship between cocaine and strokes. Inadequate control for confounding was not uncommon. CONCLUSIONS Epidemiological evidence suggests that cocaine use increases the risk of stroke. Larger, more rigorous observational studies, including cohort approaches, are needed to better quantify this risk, and should consider stroke type, hypertension variation, frequency/length of cocaine use, amphetamines co-use, and other factors.
Collapse
|
39
|
Nakamura K, Okamura T, Miura K, Okayama A. Hypertension and medical expenditure in the Japanese population: Review of prospective studies. World J Cardiol 2014; 6:531-538. [PMID: 25068014 PMCID: PMC4110602 DOI: 10.4330/wjc.v6.i7.531] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/11/2014] [Accepted: 05/16/2014] [Indexed: 02/06/2023] Open
Abstract
Hypertension is a major determinant of health and is likely to have an effect on medical economics. The economic burden due to hypertension may be attributable not only to antihypertensive medication but also to the very expensive procedures required for cases of cardiovascular disease that occur more frequently in hypertensive compared with normotensive individuals. The objective of this article was to review articles published on prospective cohort studies that measured medical expenditure attributable to hypertension in community-dwelling populations in Japan. Many medical services in these populations are provided under the medical insurance system that requires the enrolment of all Japanese residents. Personal medical expenditure attributable to hypertension increases with worsening severity of the condition. Medical expenditure was increased further in cases of hypertensive patients who have another concomitant cardiovascular risk factor. In particular, hypertension, especially moderate-to-severe untreated hypertension, increases the risk of long-term hospitalization resulting in considerably higher medical expenditure, compared with non-hospitalized cases. Therefore, assuming that the use of antihypertensive medication is essential for hypertensive patients to prevent serious vascular diseases, a cost-effective high-risk strategy needs to be considered to reduce both ill-health and the economic burden due to hypertension. However, from a population perspective, medical expenditure attributable to hypertension comes mainly from pre-to-mild hypertension. Therefore, there is also a need to consider a population strategy that aims to shift the entire population to lower levels of blood pressure.
Collapse
|
40
|
Luksiene D, Tamosiunas A, Baceviciene M, Radisauskas R, Malinauskiene V, Peasey A, Bobak M. Trends in prevalence of dyslipidaemias and the risk of mortality in Lithuanian urban population aged 45-64 in relation to the presence of the dyslipidaemias and the other cardiovascular risk factors. PLoS One 2014; 9:e100158. [PMID: 24955583 PMCID: PMC4067295 DOI: 10.1371/journal.pone.0100158] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 05/22/2014] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to provide reliable information on dyslipidaemias, to estimate the trend of the prevalence of dyslipidaemias and other selected cardiovascular disease (CVD) risk factors at population level, and to evaluate the risk of all-cause and CVD mortality in relation to presence of mixed dyslipidaemias and other CVD risk factors. Methods Data from the five surveys (1983–2008) are presented. A random sample of 9,209 subjects aged 45–64 was selected for statistical analysis. During follow-up there were 1653 death cases from any cause, 864 deaths from CVD. Estimates of hazard ratios (HR) and 95% confidence intervals (CI) were based on the multivariate Cox proportional hazards regression for all-cause mortality and CVD mortality. Results During 25 year period the prevalence of normal total cholesterol level (<5.2 mmol/L) significantly increased only in women; triglycerides and high density lipoprotein (HDL) cholesterol did not change in men and women. Findings in our longitudinal study showed that in men and women mixed dyslipidaemias (HDL cholesterol <1.03 mmol/L plus triglycerides ≥1.70 mmol/L) significantly increased the risk for all-cause and CVD mortality (respectively in men HR = 1.30; HR = 1.15, in women HR = 1.83; HR = 2.13). These mixed dyslipidaemia combinations combination with the other risk factors such as arterial hypertension, high fasting glucose level increased all-cause and CVD mortality risk in men and women; while, these mixed dyslipidaemias plus smoking increased all-cause and CVD mortality risk only in men compared to never smokers without these dyslipidaemias (respectively HR = 1.89; HR = 1.92); and these dyslipidaemias plus obesity increased all-cause and CVD mortality risk in women (respectively HR = 2.25; HR = 2.39) and CVD mortality risk in men (HR = 1.72), as compared to responders without obesity and these dyslipidaemias. Conclusion Mixed dyslipidaemias (reduced HDL cholesterol plus elevated triglycerides) significantly increased the risk for all-cause and CVD mortality in this Lithuanian population aged 45–64 years.
Collapse
Affiliation(s)
- Dalia Luksiene
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
- * E-mail:
| | - Abdonas Tamosiunas
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Migle Baceviciene
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ricardas Radisauskas
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vilija Malinauskiene
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Anne Peasey
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| |
Collapse
|
41
|
Asayama K, Satoh M, Murakami Y, Ohkubo T, Nagasawa SY, Tsuji I, Nakayama T, Okayama A, Miura K, Imai Y, Ueshima H, Okamura T, Ueshima H, Okamura T, Imai Y, Ohkubo T, Irie F, Iso H, Kiyohara Y, Miura K, Murakami Y, Nakagawa H, Nakayama T, Okayama A, Sairenchi T, Saitoh S, Sakata K, Tamakoshi A, Tsuji I, Yamada M, Kitamura A, Miyamoto Y. Cardiovascular Risk With and Without Antihypertensive Drug Treatment in the Japanese General Population. Hypertension 2014; 63:1189-97. [DOI: 10.1161/hypertensionaha.113.03206] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kei Asayama
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Michihiro Satoh
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Yoshitaka Murakami
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Takayoshi Ohkubo
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Sin-ya Nagasawa
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Ichiro Tsuji
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Takeo Nakayama
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Akira Okayama
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Katsuyuki Miura
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Yutaka Imai
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Hirotsugu Ueshima
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | - Tomonori Okamura
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (K.A.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., M.S., T. Ohkubo, Y.I.); Department of Pharmacy, Tohoku University Hospital, Sendai, Japan (M.S.); Medical Statistics, Shiga University of Medical Science, Otsu
| | | | | | - Yutaka Imai
- Tohoku University Graduate School of Pharmaceutical Sciences
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Chapter 1. Epidemiology of hypertension. Hypertens Res 2014. [DOI: 10.1038/hr.2014.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
43
|
Murakami Y. Meta-analyses using individual participant data from cardiovascular cohort studies in Japan: current status and future directions. J Epidemiol 2014; 24:96-101. [PMID: 24584399 PMCID: PMC3956690 DOI: 10.2188/jea.je20130177] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Meta-analysis of individual participant data (IPD meta-analysis) has several advantages over meta-analysis using aggregated published data, including the possibility of using statistical methods such as a fine stratification analysis, interaction analysis between 2 risk factors, and absolute risk estimation. The Evidence for Cardiovascular Prevention from Observational Cohorts in Japan Study (EPOCH-JAPAN), which was initiated in 2005, is a collaborative research project for IPD meta-analysis and includes 13 participating cohort studies in Japan. We generated 2 pooled databases with data on all-cause mortality (n = 199 047) and cardiovascular outcomes (n = 90 528) and applied a stratified Cox model to account for the different baseline hazards between cohorts. The results of our analyses show the age- and sex-specific associations between all-cause and cardiovascular disease mortality and established cardiovascular risk factors (blood pressure, smoking, total cholesterol, proteinuria, and kidney function). During the 9 years of its existence, the results generated by EPOCH-JAPAN have had important implications for clinical medicine and public health policy in Japan. The project is expected to draw upon new analytical methods such as interaction analysis and absolute risk evaluation in the near future. We believe that, over the next decade, this project will continue to provide new insights that can be applied to research on other Asian populations.
Collapse
|
44
|
Increased risk for stroke in burn patients: A population-based one-year follow-up study. Burns 2014; 40:54-60. [DOI: 10.1016/j.burns.2013.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 05/23/2013] [Accepted: 05/25/2013] [Indexed: 11/23/2022]
|
45
|
Yao Q, Zhang C, Zhang X, Yuan R, Li J, Sun F, Zhou C. Synergistic effect of ALOX5AP polymorphisms and cigarette smoking on the risk of atherosclerotic cerebral infarction in a Northern Han Chinese population. J Clin Neurosci 2014; 21:975-9. [PMID: 24411318 DOI: 10.1016/j.jocn.2013.08.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 08/15/2013] [Accepted: 08/20/2013] [Indexed: 11/17/2022]
Abstract
The effect of activating 5-lipoxygenase (ALOX5AP) gene polymorphisms on stroke risk may be influenced by the coexistence of modifiable predisposing conditions. We explored the interactions of ALOX5AP polymorphisms and cigarette smoking in a case-control study of patients with atherosclerotic cerebral infarction (ACI). Three polymorphisms of the ALOX5AP gene (rs10507391, rs4769874, and rs9551963) were analyzed in 420 ACI patients and 488 unrelated healthy controls matched for age and sex from a Northern Han Chinese population. Among the three single nucleotide polymorphisms, only rs10507391 genotype TT/TA was observed to be associated with an increased risk of ACI on multivariate analysis (odds ratio [OR]=1.82, 95% confidence interval [CI]=1.14-2.92, p=0.012) compared with the AA genotype. However, after stratifying by smoking status, multivariate logistic regression analysis revealed that rs10507391 genotype TT/TA and rs9551963 genotype CC/CA had a 5.63-fold (OR=5.63, 95%CI=2.00-15.84, p=0.001) and a 2.71-fold (OR=2.71, 95%CI=1.28-5.73, p=0.009) increased risk for ACI patients who smoked compared with the AA genotype, respectively. Additionally, according to the haplotype analysis, the risk of haplotype TGC (OR=3.12, 95%CI=2.00-4.88, p<0.001, corrected p [pc]<0.001) increased for ACI patients who smoked compared to the data (OR=1.60, 95%CI=1.28-1.98, p<0.001, pc<0.001) in total samples. These results suggest that ALOX5AP polymorphisms are associated with ACI, and cigarette smoking along with ALOX5AP could increase the risk of ACI.
Collapse
Affiliation(s)
- Qianqian Yao
- Department of Neurology, The Affiliated Hospital of Medical College, Qingdao University, Number 16 Jiangsu Road, Qingdao, Shandong Province 266003, China
| | - Chen Zhang
- Department of Neurology, The Affiliated Hospital of Medical College, Qingdao University, Number 16 Jiangsu Road, Qingdao, Shandong Province 266003, China
| | - Xinhua Zhang
- Department of Psychology and Psychiatry, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Rongrong Yuan
- Department of Neurology, The Affiliated Hospital of Medical College, Qingdao University, Number 16 Jiangsu Road, Qingdao, Shandong Province 266003, China
| | - Jianye Li
- Department of Neurology, The Affiliated Hospital of Medical College, Qingdao University, Number 16 Jiangsu Road, Qingdao, Shandong Province 266003, China
| | - Fengjiao Sun
- Department of Neurology, The Affiliated Hospital of Medical College, Qingdao University, Number 16 Jiangsu Road, Qingdao, Shandong Province 266003, China
| | - Chang Zhou
- Department of Neurology, The Affiliated Hospital of Medical College, Qingdao University, Number 16 Jiangsu Road, Qingdao, Shandong Province 266003, China.
| |
Collapse
|
46
|
Béjot Y, Jacquin A, Daubail B, Lainay C, Janoura S, Aboa-Eboulé C, Durier J, Giroud M. Smoking status and severity of ischemic stroke. A population-based study. Eur Neurol 2013; 71:59-64. [PMID: 24334964 DOI: 10.1159/000355021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 08/12/2013] [Indexed: 11/19/2022]
Abstract
We aimed to investigate the impact of smoking status on clinical severity in patients with ischemic stroke event (IS). Patients were prospectively identified among residents of the city of Dijon, France (ca. 151,000 inhabitants), using a population-based registry, between 2006 and 2011. Demographic and clinical data were recorded. The initial clinical severity was quantified by the means of the National Institutes of Health Stroke Scale (NIHSS). Multivariable ordinal logistic regression was used to assess the effect of smoking status on severity. Among the 1,056 recorded patients with IS, data about smoking status were available for 973 (92.1%), of whom 658 (67.3%) were non-smokers, 187 (19.2%) were current smokers, and 128 (13.2%) were former smokers. Compared with non-smoking, former smoking was associated with less severe IS (OR 0.55; 95% CI 0.38-0.82, p = 0.003), whereas this association was not found for current smokers (OR 0.97; 95% CI 0.69-1.36, p = 0.856). Further work is needed to understand the underlying mechanisms of this finding.
Collapse
Affiliation(s)
- Yannick Béjot
- Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon, University of Burgundy, Dijon, France
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Kumagai N, Okuhara Y, Iiyama T, Fujimoto Y, Takekawa H, Origasa H, Kawanishi Y, Yamaguchi T. Effects of smoking on outcomes after acute atherothrombotic stroke in Japanese men. J Neurol Sci 2013; 335:164-8. [PMID: 24112970 DOI: 10.1016/j.jns.2013.09.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 08/27/2013] [Accepted: 09/16/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND The effects of smoking on clinical outcomes following acute stroke remain controversial. METHODS We evaluated the influence of smoking on 90-day outcomes after acute atherothrombotic stroke in 292 Japanese men extracted from the database of the Edaravone and Argatroban Stroke Therapy for Acute Ischemic Stroke randomized parallel-group trial that tested the safety and efficacy of edaravone and argatroban therapy in 814 patients in 2004-2008. Smokers were matched with non-smokers of the same age for identical age distribution in the smoker and non-smoker groups. Poor 90-day outcomes (defined as death, Barthel index<60, or modified Rankin score>3) were evaluated using a logistic regression model. Significant variables (P<0.05) in univariate analysis were further evaluated by multivariate logistic regression analysis using a forward-selection method. RESULTS Body temperature, age, National Institute of Health Stroke Scale score at admission, systolic blood pressure, and smoking status were selected in the final model. Smokers had significantly increased odds of poor 90-day functional outcomes independent of other statistically significant predictor variables (adjusted odds ratio, 2.28; 95% confidence interval, 1.15-4.55; P=0.019). CONCLUSIONS In Japanese men, smoking leads to poor functional outcomes at 3 months after acute atherothrombotic stroke.
Collapse
Affiliation(s)
- Naoko Kumagai
- Center of Medical Information Science, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan; Integrated Center for Advanced Medical Technologies, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Peters SAE, Huxley RR, Woodward M. Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3,980,359 individuals and 42,401 strokes. Stroke 2013; 44:2821-8. [PMID: 23970792 DOI: 10.1161/strokeaha.113.002342] [Citation(s) in RCA: 148] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE It is currently unknown whether the excess risk of stroke by smoking is the same for women and men. We performed a systematic review and meta-analysis to estimate the effect of smoking on stroke in women compared with men. METHODS PubMed MEDLINE was systematically searched for prospective population-based cohort studies published between January 1, 1966, and January 26, 2013. Studies that presented sex-specific estimates of the relative risk of stroke comparing current smoking with nonsmoking and its associated variability were selected. The sex-specific relative risks and their ratio (RRR), comparing women with men, were pooled using random-effects meta-analysis with inverse variance weighting. Similarly, the RRR for former versus never smoking was pooled. RESULTS Data from 81 prospective cohort studies that included 3,980,359 individuals and 42,401 strokes were available. Smoking was an independent risk factor for stroke in both sexes. Overall, the pooled multiple-adjusted RRR indicated a similar risk of stroke associated with smoking in women compared with men (RRR, 1.06 [95% confidence interval, 0.99-1.13]). In a regional analysis, there was evidence of a more harmful effect of smoking in women than in men in Western (RRR, 1.10 [1.02-1.18)] but not in Asian (RRR, 0.97 [0.87-1.09]) populations. Compared with never-smokers, the beneficial effects of quitting smoking among former smokers on stroke risk were similar between the sexes (RRR, 1.10 [0.99-1.22]). CONCLUSIONS Compared with nonsmokers, the excess risk of stroke is at least as great among women who smoke compared with men who smoke.
Collapse
Affiliation(s)
- Sanne A E Peters
- From The George Institute for Global Health, University of Sydney, New South Wales, Australia (S.A.E.P., R.R.H., M.W.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (S.A.E.P.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN (R.R.H.); and Department of Epidemiology, Johns Hopkins University, Baltimore, MD (M.W.)
| | | | | |
Collapse
|
49
|
Yamaguchi Y, Moriki T, Igari A, Matsubara Y, Ohnishi T, Hosokawa K, Murata M. Studies of a microchip flow-chamber system to characterize whole blood thrombogenicity in healthy individuals. Thromb Res 2013; 132:263-70. [PMID: 23777751 DOI: 10.1016/j.thromres.2013.05.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 04/20/2013] [Accepted: 05/27/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION A whole blood flow-chamber system, the Total Thrombus-formation Analysis System (T-TAS), was developed for quantitative analysis of platelet thrombus formation (PTF) using microchips with thrombogenic surfaces (collagen, PL chip; collagen plus tissue thromboplastin, AR chip) under shear stress conditions. We evaluated the usefulness of the T-TAS for assessing individual thrombogenicity compared with other platelet function tests. MATERIALS AND METHODS Blood samples from 31 healthy volunteers were applied to the T-TAS to measure PTF starting time (T10: time to reach 10 kPa), occlusion time (T60 for PL chip; T80 for AR chip), and area under the curve (AUC10, area under curve until 10 min for PL chip; AUC30, 30 min for AR chip) under various shear rates (1000, 1500, 2000s(-1) for PL chip; 300 s(-1) for AR chip). Platelet functions were also tested using platelet aggregometry, the PFA-100 (collagen and epinephrine [C/EPI], collagen and adenosine diphosphate [C/ADP]), and the VerifyNow P2Y12 assay. RESULTS Individual pressure waveforms, including PTF starting and ending points, varied among healthy subjects. In the PL chip, T10 and AUC10 showed a shear-dependent correlation with C/EPI or C/ADP. VerifyNow P2Y12 values were not significantly associated with the parameters of the T-TAS. Platelet counts were correlated with all AR measurements, and mostly with PL measurements. CONCLUSION The results of the T-TAS were associated with those of the PFA-100 in many respects, indicating that its characteristics are related to shear-induced PTF. The T-TAS showed few correlations with platelet aggregometry and the VerifyNow P2Y12 assay. The T-TAS may allow for the measurement of comprehensive parameters of individual thrombogenicity under whole blood flow conditions.
Collapse
Affiliation(s)
- Yusuke Yamaguchi
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | | | | | | | | | | | | |
Collapse
|
50
|
Rostila M, Saarela J, Kawachi I. Fatal stroke after the death of a sibling: a nationwide follow-up study from Sweden. PLoS One 2013; 8:e56994. [PMID: 23451131 PMCID: PMC3579925 DOI: 10.1371/journal.pone.0056994] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 01/16/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although less studied than other types of familial losses, the loss of a sibling could be a potential trigger of stroke as it represents a stressful life event. We studied the association between loss of a sibling and fatal stroke up to 18 years since bereavement. METHODOLOGY/PRINCIPAL FINDINGS We conducted a follow-up study between 1981 and 2002, based on register data covering the total population of Swedes aged 40-69 years (n = 1,617,010). An increased risk of fatal stroke (1.31 CI: 1.05, 1.62) was found among women who had experienced the loss of a sibling. No increase in the overall mortality risk was found in men (1.11 CI: 0.92, 1.33). An elevated risk in the short term (during the second and third half-year after the death) was found among both men and women, whereas longer-term elevation in risk was found primarily for women. Both external (1.47 CI: 1.00, 2.17) and not external (1.26 CI: 1.00, 1.60) causes of sibling death showed associations among women. In men, an association was found only if the sibling also died from stroke (1.78 CI: 1.00, 3.17). However, among women, we found an increased risk of stroke mortality if the sibling died from causes other than stroke (1.30 CI: 1.04, 1.62). CONCLUSIONS/SIGNIFICANCE The findings suggest an increased risk of dying from stroke mortality after the death of a sibling, and that bereavement affects particularly women. It is important for health care workers to follow bereaved siblings and recognize potential changes of stress-levels and health related behaviours that could lead to risk of stroke.
Collapse
Affiliation(s)
- Mikael Rostila
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden.
| | | | | |
Collapse
|