Hiroyasu Iso

Osaka City University, Ōsaka, Ōsaka, Japan

Are you Hiroyasu Iso?

Claim your profile

Publications (416)1904.3 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Studies have shown that elevated high-sensitivity C-reactive protein (hs-CRP) predicts stroke, which is a risk factor for dementia. It remains, however, unclear whether hs-CRP increases risk of dementia. Methods A prospective nested case–control study of Japanese 40–69 years of age was conducted using frozen serum samples collected from approximately 7531men and women who participated in cardiovascular risk surveys from 1984 to 1994 in one community and 1989–1995 in another community under the Circulatory Risk in Communities Study (CIRCS). Two control subjects per case were matched by sex, age, community, and year of serum storage. The hs-CRP was measured using a latex particle-enhanced immunonephelometric assay. Results Between 1999 and 2013, we identified 275 disabling dementia cases (96 cases with history of stroke and 179 without it). There was a positive association between hs-CRP levels and risk of dementia with history of stroke. No significant association was observed between hs-CRP levels and risk of dementia without history of stroke. After adjustment for hypertension, diabetes and other confounding variables, the positive association remained statistically significant. The multivariable odds ratios associated with 1-SD increment of log hs-CRP were 1.02 (0.87–1.20) for total dementia, 1.35 (1.02–1.79) for dementia with history of stroke, and 0.89 (0.72–1.10) for dementia without history of stroke. Conclusion Elevated hs-CRP levels were associated with increased risk of disabling dementia in individuals with history of stroke but not in those without it.
    Atherosclerosis 10/2014; 236(2):438–443. · 3.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Having a small social network and lack of social support have been associated with incident coronary heart disease; however, epidemiological evidence for incident stroke is limited. We assessed the longitudinal association of a small social network and lack of social support with risk of incident stroke and evaluated whether the association was partly mediated by vital exhaustion and inflammation.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim: Patients with peripheral artery disease (PAD) are at a high risk of cardiovascular disease (CVD) among Western populations. However, evidence for an elevated risk in Asian populations is limited. Methods: This prospective cohort study examined 939 Japanese men 60-74 years of age at the time of the baseline survey. A total of 115 cases of CVD were detected during a median 9.3 years of follow-up, and the ankle brachial blood pressure index (ABI) functioned as a surrogate measurement of PAD. Results: The age-adjusted risks of coronary heart disease, ischemic stroke and ischemic CVD (coronary heart disease and ischemic stroke) were higher among men in the lowest ABI tertile compared with that observed in the men in the highest tertile (<1.08 vs. >1.17). These associations did not change substantially after adjusting for cardiovascular risk factors. The respective multivariable hazard ratios (HRs, 95% CI) for the three conditions were as follows: 2.48 (1.08-5.71), p for trend=0.03; 1.95 (0.94-4.02), p for trend=0.04; and 2.16 (1.25-3.72), p for trend=0.004. These results did not vary based on a comparison of the three ABI categories: ≤0.90, 0.91-1.10 and >1.10. The multivariable HRs (95% CI) for an ABI ≤0.90 versus >1.10 were as follows: 2.04 (0.67-6.20), p for trend=0.14 for coronary heart disease; 3.39 (1.10-10.5), p for trend=0.006 for ischemic stroke; and 2.61 (1.19-5.76), p for trend=0.003 for ischemic CVD. There were no associations between the ABI and the risk of hemorrhagic stroke. Conclusions: A low ABI is associated with the risk of coronary heart disease, ischemic stroke and ischemic CVD in elderly Japanese men.
    Journal of atherosclerosis and thrombosis. 07/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim: The levels of lipids, especially triglycerides (TG), and obesity are associated with diabetes mellitus (DM). Although typically measured in fasting individuals, non-fasting lipid measurements play an important role in predicting future DM. This study compared the predictive efficacy of lipid variables according to the fasting status and body mass index (BMI) category. Methods: Data were collected for 39,196 nondiabetic men and 87,980 nondiabetic women 40-79years of age who underwent health checkups in Ibaraki-Prefecture, Japan in 1993 and were followed through 2007. The hazard ratios (HRs) for DM in relation to sex, the fasting status and BMI were estimated using a Cox proportional hazards model. Results: A total of 8,867 participants, 4,012 men and 4,855 women, developed DM during a mean follow-up of 5.5 years. TG was found to be an independent predictor of incident DM in both fasting and non-fasting men and non-fasting women. The multivariable-adjusted HR for DM according to the TG quartile (Q) 4 vs. Q1 was 1.18 (95% confidence interval (CI): 1.05, 1.34) in the non-fasting men with a normal BMI (18.5-24.9). This trend was also observed in the non-fasting women with a normal BMI. That is, the multivariable-adjusted HRs for DM for TG Q2, Q3 and Q4 compared with Q1 were 1.07 (95% CI: 0.94, 1.23), 1.17 (95%CI: 1.03, 1.34) and 1.48 (95%CI: 1.30, 1.69), respectively. Conclusions: The fasting and non-fasting TG levels in men and non-fasting TG levels in women are predictive of future DM among those with a normal BMI. Clinicians must pay attention to those individuals at high risk for DM.
    Journal of atherosclerosis and thrombosis. 07/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background and Purpose—Little research has been conducted to examine the effect of inconsistencies in socioeconomic status on cardiovascular health. In particular, no studies have been reported in Asian countries, including Japan, which is thought to have high socioeconomic status inconsistency among women. Methods—We examined the effect of status inconsistency between education level and occupation on stroke risk in a prospective 20-year study of 14 742 middle-aged Japanese women included in the prospective Japan Public Health Centerbased (JPHC) Study Cohort I in 1990. Status inconsistency between education level and occupation was determined (qualified, overqualified, and underqualified), and the association with risk of stroke was examined. Cox proportional regression analysis was used to determine hazard ratios, which were adjusted for age, marital status, and geographical area. Results—Adjusted hazard ratio for stroke in overqualified compared with qualified women was 2.06 (95% confidence interval, 1.13–3.78). Adjusted hazard ratios for stroke among highly educated manual workers and workers in service industry were 3.47 (95% confidence interval, 1.54–7.84) and 3.21 (95% confidence interval, 1.49–6.90), respectively, when compared with highly educated professionals/managers. Conclusions—High academic qualifications without an appropriate job could be a risk factor for stroke among Japanese women. Our result suggests that status inconsistency could be a potential explanation for the increased stroke risk among highly educated women.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: The present study examined the prevalence of diabetes in Japan during the late 1990s and early 2000s using the Japan Public Health Center-based Prospective Diabetes cohort. We also investigated the distributions of HbA1c values in noncompliant diabetic participants in the cohort.Methods: A total of 28 183 registered inhabitants aged 46-75 years from 10 public health center areas were included in the initial survey. The 5-year follow-up survey included 20 129 participants. The prevalence of diabetes was estimated using both a self-reported questionnaire and laboratory measurements. Among the participants who reported the presence of diabetes on the questionnaire (self-reported diabetes), the distributions of HbA1c values were described according to their treatment status.Results: The age-standardized prevalence of diabetes in 55- to 74-year-old adults was 8.2% at the initial survey and 10.6% at the 5-year follow-up. At the initial survey, among participants with self-reported diabetes, the mean HbA1c values in the participants who had never and who had previously received diabetes treatment were 7.01% (standard deviation [SD] 1.56%) and 6.56% (SD 1.46%), respectively. Approximately 15% of the participants who had self-reported diabetes but had never received diabetes treatment had an HbA1c ≥ 8.4%.Conclusions: The prevalence of diabetes increased in the JPHC cohort between the late 1990s and early 2000s. A certain proportion of participants who were aware of their diabetes but were not currently receiving treatment had poor diabetic control. Efforts to promote continuous medical attendance for diabetes care may be necessary.
    Journal of epidemiology / Japan Epidemiological Association. 07/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To examine the relationship between body mass index (BMI) and the risk of stage ≥3 chronic kidney disease (CKD) in a general Japanese population.Methods: A total of 105 611 participants aged 40-79 years who completed health checkups in Ibaraki Prefecture, Japan, and were free of CKD in 1993 were followed-up through 2006. Stage ≥3 CKD was defined by an estimated glomerular filtration rate <60 mL/min/1.73 m(2) reported during at least 2 successive annual surveys or as treatment for kidney disease. Hazard ratios (HRs) for the development of stage ≥3 CKD relative to the BMI categories were calculated using the Cox proportional hazards regression model, which was adjusted for possible confounders and mediators.Results: During a mean follow-up of 5 years, 19 384 participants (18.4%) developed stage ≥3 CKD. Compared to a BMI of 21.0-22.9 kg/m(2), elevated multivariable-adjusted HRs were observed among men with a BMI ≥23.0 kg/m(2) and women with a BMI ≥27.0 kg/m(2). Significant dose-response relationships between BMI and the incidence of stage ≥3 CKD were observed in both sexes (P for trend <0.001).Conclusions: Obesity was associated with the risk of developing stage ≥3 CKD among men and women.
    Journal of epidemiology / Japan Epidemiological Association. 07/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: No large population-based prospective study has investigated the risks of suicide and death by other externally caused injuries (ECIs) among stroke patients. The purpose of this study was to examine whether stroke increases the risks of suicide and ECI deaths.
    Psychosomatic medicine. 06/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Despite evidence that neighbourhood conditions affect residents’ health, no prospective studies of the association between neighbourhood socio-demographic factors and all-cause mortality have been conducted in non-Western societies. Thus, we examined the effects of areal deprivation and population density on all-cause mortality in Japan. Methods: We employed census and survival data from the Japan Public Health Center-based Prospective Study, Cohort I (n = 37,455), consisting of middle-aged residents (40 to 59 years at the baseline in 1990) living in four public health centre districts. Data spanned between 1990 and 2010. A multilevel parametric proportional-hazard regression model was applied to estimate the hazard ratios (HRs) of all-cause mortality by two census-based areal variables —areal deprivation index and population density—as well as individualistic variables such as socioeconomic status and various risk factors. Results: We found that areal deprivation and population density had moderate associations with all-cause mortality at the neighbourhood level based on the survival data with 21 years of follow-ups. Even when controlling for individualistic socioeconomic status and behavioural factors, the HRs of the two areal factors (using quartile categorical variables) significantly predicted mortality. Further, this analysis indicated an interaction effect of the two factors: areal deprivation prominently affects the health of residents in neighbourhoods with high population density. Conclusions: We confirmed that neighbourhood socio-demographic factors are significant predictors of all-cause death in Japanese non-metropolitan settings. Although further study is needed to clarify the cause-effect relationship of this association, the present findings suggest that health promotion policies should consider health disparities between neighbourhoods and possibly direct interventions towards reducing mortality in densely populated and highly deprived neighbourhoods.
    PLoS ONE 06/2014; 9(6). · 3.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rice consumption has been associated with risk of type 2 diabetes, but its relation with cardiovascular disease (CVD) is limited. We examined the association between rice consumption and risk of CVD incidence and mortality in a Japanese population. This was a prospective study in 91,223 Japanese men and women aged 40-69 y in whom rice consumption was determined and updated from 3 self-administered food-frequency questionnaires, each 5 y apart. Follow-up for incidence was from 1990 to 2009 in cohort I and 1993 to 2007 in cohort II and for mortality was from 1990 to 2009 in cohort I and 1993-2009 in cohort II. HRs and 95% CIs of CVD incidence and mortality were calculated according to quintiles of cumulative average rice consumption. In 15-18 y of follow-up, we ascertained 4395 incident cases of stroke, 1088 incident cases of ischemic heart disease (IHD), and 2705 deaths from CVD. Rice consumption was not associated with risk of incident stroke or IHD; the multivariable HR (95% CI) in the highest compared with lowest rice consumption quintiles was 1.01 (0.90, 1.14) for total stroke and 1.08 (0.84, 1.38) for IHD. Similarly, there was no association between rice consumption and risk of mortality from CVD; the HR (95% CI) for mortality from total CVD was 0.97 (0.84, 1.13). There were no interactions with sex or effect modifications by body mass index for any endpoint. Rice consumption is not associated with risk of CVD morbidity or mortality.
    American Journal of Clinical Nutrition 04/2014; · 6.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Seafood/fish intake has been regarded as a protective factor for coronary heart disease (CHD), while smoking is a strong risk factor. To examine whether associations between smoking and risk of CHD are modified by seafood/fish intake, we studied 72,012 Japanese men and women aged 45-74 years who completed 2 food frequency questionnaires, 5 years apart, during the period 1995-2009. After 878,163 person-years of follow-up, 584 incident cases of CHD (101 fatal and 483 nonfatal), including 516 myocardial infarctions, were documented. There was a clear dose-response association between smoking and CHD risk among subjects with a low seafood/fish intake (<86 g/day) but not among those with a high seafood/fish intake (≥86 g/day). Compared with never smokers, the multivariable hazard ratios in light (1-19 cigarettes/day), moderate (20-29 cigarettes/day), and heavy (≥30 cigarettes/day) smokers were 2.39 (95% confidence interval (CI): 1.60, 3.56), 2.74 (95% CI: 1.90, 3.95), and 3.24 (95% CI: 2.12, 4.95), respectively, among low seafood/fish eaters and 1.13 (95% CI: 0.64, 1.99), 1.29 (95% CI: 0.95, 2.04), and 2.00 (95% CI: 1.18, 3.51), respectively, among high seafood/fish eaters. Compared with heavy smokers with a low seafood/fish intake, light smokers with a high seafood/fish intake had substantially reduced risk of CHD (hazard ratio = 0.57, 95% CI: 0.32, 0.98). High seafood/fish intake attenuated the positive association between smoking and risk of CHD.
    American journal of epidemiology 04/2014; · 5.59 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective There have been very few population-based prospective studies that have investigated the risks of deaths by suicide and other externally caused injuries (ECIs) among cancer patients in an Asian population. This study investigated whether the risk of death by both suicide and ECIs increases during the first year following the initial diagnosis of cancer.Methods Data were analyzed from a population-based cohort of Japanese residents between 1990 and 2010, collected during the Japan Public Health Center-based Prospective Study. Poisson regression models were used to calculate adjusted risk ratios (RRs) for both suicide and ECI deaths. To adjust for unmeasured confounding factors, case-crossover analyses were conducted for all patients with cancer who died by suicide and ECIs.ResultsA population-based cohort of 102,843 Japanese residents was established. During the follow-up period, there were 34 suicides and 48 ECI deaths among patients with cancer, as compared with 527 suicides and 707 ECI deaths among those who did not have cancer. Analyses revealed that those who were newly diagnosed with cancer were at a greatly increased risk of death by suicide and ECIs within the first year after their diagnosis (suicide RR = 23.9, 95% CI: 13.8–41.6; ECI RR = 18.8, 95% CI: 11.4–31.0). Furthermore, the case-crossover analyses generally confirmed the results of the Poisson regressions.Conclusions The risks of suicide and ECI deaths within the first year after a cancer diagnosis were higher than those among cancer-free populations. A diagnosis of cancer is a critical experience that may increase the risk of fatal outcomes. Copyright © 2014 John Wiley & Sons, Ltd.
    Psycho-Oncology 04/2014; · 3.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: It may be useful to examine associations of fat intakes with total mortality as a basis for dietary recommendations. We aimed to elucidate associations between dietary fat and total mortality among Japanese populations with low fat intake. We conducted a prospective study consisting of 58,672 men and women aged 40 to 79 years. Fat intakes were estimated using a food frequency questionnaire. Multivariate-adjusted hazard ratios (HRs) for mortality by sex were computed according to quintiles of energy-adjusted fat intakes. During the follow-up period (median duration, 19.3 years), 11,656 deaths were recorded. In men, we found no clear association between total fat and total mortality. HRs across quintiles of total fat intake were 1.00, 1.03 (95% confidence interval [CI], 0.95-1.12), 1.02 (0.94-1.10), 0.98 (0.90-1.07), and 1.07 (0.98-1.17). No significant association was detected in regard to types of fat. In women, HR was lowest in the fourth quintile of total fat intake followed by the top quintile; HRs across quintiles were 1.00, 1.03 (0.94-1.11), 1.00 (0.92-1.09), 0.88 (0.81-0.96), and 0.94 (0.86-1.03). Regarding types of fat in women, total mortality was inversely associated with intakes of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids (PUFA); the lowest HR was in the top quintile of intake for SFA, MUFA, and PUFA: 0.91 (95% CI, 0.83-1.00), 0.91 (0.83-0.99) and 0.88 (0.80 - 0.97), respectively (trend P across quintiles, 0.020, 0.012, and 0.029, respectively). Causes of death other than cancer and cardiovascular disease contributed most to decreases in HRs for total and types of fat. In women, analysis with finer categories revealed that the lowest risk for total mortality appeared at total fat intake of 28% of energy. Our findings from a large cohort study among populations with relatively low fat intake provide evidence regarding optimal levels of fat intakes.
    Nutrition & Metabolism 03/2014; 11(1):12. · 3.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Accurate measurement of blood lipids is crucial in cardiovascular disease risk management. The Centers for Disease Control and Prevention (CDC) Cholesterol Reference Method Laboratory Network (CRMLN) has assured the accuracy of these measurements for >20 y using beta quantification (BQ) method as reference measurement procedure (RMP) for high- and low-density lipoprotein cholesterol (HDL-C, LDL-C). Only limited data exist about the performance of the BQ RMP. Bottom fraction cholesterol (BFC), HDL-C, and LDL-C results after ultracentrifugation from the CDC lipid reference laboratory and the Japanese CRMLN laboratory were compared using 280 serum samples measured over the past 15 y. Data were compared statistically using method comparison and bias estimation analysis. Regression analysis between CDC (x) and Osaka (y) for BFC, HDL-C, and LDL-C were y=0.988x+1.794 (R(2)=0.997), y=0.980x+1.118 (R(2)=0.994), and y=0.987x+1.200 (R(2)=0.997), respectively. The Osaka laboratory met performance goals for 90% to 95% of the CDC reference values. The BQ method by the Osaka CRMLN laboratory is highly accurate and has been stable for over 15years. Accurate measurement of BFC is critical for determination of LDL-C.
    Clinica chimica acta; international journal of clinical chemistry 02/2014; · 2.54 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Evidence regarding the relationship between different levels of alcohol consumption and the risk of atrial fibrillation (AF) is currently limited in Asian populations. Methods and Results: Between 1991 and 1995, a total of 8,602 Japanese men and women aged 30-80 years took part in the first examination of the Circulatory Risk in Communities Study (CIRCS), a population-based cohort study in Japanese communities. An interviewer obtained detailed information on weekly alcohol intake. During the follow-up period, the incidence of AF was ascertained from annual ECG records, the subject's medical history of AF, and cardiovascular disease surveillance. The hazard ratios (HRs) of incident AF and the 95% confidence intervals (CIs) relative to the never-drinking group were calculated with adjustment for potential confounding factors by using the Cox proportional hazard model. During a median follow-up period of 6.4 years, 296 incidents of AF occurred. A higher incidence of AF was observed among participants with an ethanol intake >69g/day, compared with never-drinkers. Compared with the never-drinkers, the multivariable-adjusted HRs (CIs) of past, light (<23g/day), light-moderate (23-46g/day), moderate (46-69g/day), and heavy (>69g/day) drinkers were 1.30 (0.68-2.49), 0.89 (0.60-1.32), 1.19 (0.73-1.95), 1.36 (0.79-2.35), and 2.90 (1.61-5.23), respectively. Conclusions: Heavy alcohol consumption is associated with a higher risk of AF.
    Circulation Journal 02/2014; · 3.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background This study aimed to investigate associations between central aortic pressure (CAP) and subclinical organ damage of the heart amongst the general population. Methods We conducted a cross-sectional study in a community-based population, consisting of 3002 men and women aged between 40 and 79 years. The CAP was measured using the HEM-9000AI device, an automated tonometer. Electrocardiograms (ECG) were read according to the Minnesota Code. Subclinical organ damage in the heart was defined as measurable left high amplitude R waves (LHAR), major and minor ST-T abnormalities, and left ventricular hypertrophy (LVH). Results Age- and sex-adjusted prevalence of LHAR, major and minor ST-T abnormalities, and LVH was higher for subjects in the highest tertile of CAP levels than those in the lowest tertile. After further adjustments for other cardiovascular risk factors, these associations did not change substantially. The multivariable odds ratios (ORs) (95% CI) of LHAR, major and minor ST-T abnormalities, and LVH for the highest tertile of CAP levels compared to the lowest tertile were 2.7(1.9–3.9), 1.8(1.1–2.9), 1.7(1.3–2.3) and 3.2(1.3–8.1), respectively. The positive associations with LHAR and minor ST-T abnormalities were observed primarily among non-hypertensive subjects. The respective corresponding ORs were 2.8(1.7–4.6) and 1.7(1.2–2.4) for non-hypertensive subjects, and 1.7(0.9–3.3) and 1.1(0.7–1.8) for hypertensive subjects. Conclusion CAP levels were associated with subclinical organ damage of the heart independent of cardiovascular risk factors, and these associations were primarily seen in non-hypertensive subjects.
    Atherosclerosis 01/2014; 232(1):94–98. · 3.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Several studies have reported that height and risk of stroke are inversely associated based on the hypothesis that height is a marker of childhood physical condition. However, a limited number of studies have taken account of the effect of current physical condition on the relationship between height and risk of stroke. Methods We conducted a prospective cohort study of 12,222 40- to 69-year-old Japanese patients under systematic surveillance for stroke incidence. Because body mass index (BMI) is regarded as a surrogate marker of current physical condition for cardiovascular risk, we performed a stratified analysis of this risk based on BMI. Results During the median 17-year follow-up, there were 565 incident strokes (326 ischemic and 186 hemorrhagic strokes) showing an inverse association between height and risk of stroke independent of classical cardiovascular risk factors. Compared with the lowest height group (<159 cm for men and <148 cm for women) as reference, the multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the highest height group (>166 cm for men and >154 cm for women) were 0.70 (95% CI 0.49-1.00; P = .043) for men and 0.44 (95% CI 0.27-0.70; P < .001) for women. When the analysis was restricted to those with BMI <23 kg/m2, the associations were stronger for both hemorrhagic and ischemic stroke. Conclusions Height was found to be inversely associated with risk of stroke for middle-aged Japanese men and women, especially with lower BMIs. Our findings suggest that childhood social and physical conditions may contribute to the development of stroke in adulthood because height is a surrogate marker of these conditions.
    Journal of Stroke and Cerebrovascular Diseases. 01/2014; 23(4):667–674.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background To examine the modifying effects of overweight status on the association of healthy lifestyle behaviors with cardiovascular mortality in Japanese population. Methods A community-based, prospective cohort of 18,730 men and 24,216 women aged 40-79 years without a history of cardiovascular disease (CVD) or cancer at baseline (1988-1990) was followed through until 2009. Healthy lifestyle behaviors included intake of fruits, fish, and milk; exercise; avoidance of smoking; moderate alcohol intake; and moderate sleep duration. Results During the median of 19.3 years follow-up, there were 2,412 deaths from total CVD. Inverse associations between healthy lifestyle scores and mortality from stroke, total CVD, and coronary heart disease (CHD) were observed for non-overweight and overweight (body mass index ≥ 25 kg/m2), although the association was weaker for overweight. The multivariable hazard ratios (HRs, 95% confidence interval) of mortality from total CVD for the highest (6-7) versus lowest (0-2) scores were 0.44 (0.37-0.54) for non-overweight and 0.56 (0.39-0.81) for overweight individuals. Especially for CHD mortality, such association was more evident for non-overweight compared to that for overweight. Conclusions Our findings suggest that lifestyle modification may be beneficial in the prevention of cardiovascular mortality for persons with and without overweight.
    Preventive Medicine 01/2014; · 3.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Chlamydophila pneumoniae infection is considered a risk factor for atherosclerosis and coronary heart disease in western countries. However, evidence of it being a risk for Japanese is very limited because of a lower risk of coronary heart disease than for western people. The aim of this study was to examine further the association between C. pneumoniae infection and risk of coronary heart disease in Japanese. Methods We conducted a nested case–control study of 49,011 Japanese men and women who participated in The Japan Public Health Center (JPHC) study. By the end of 2004, 196 cases of coronary heart disease and 155 cases of myocardial infarction had been documented among the participants. Two controls were selected for each case. For these subjects, we examined the association between serum anti C. pneumoniae IgA and IgG on the one hand and risk of coronary heart disease on the other. Results Concentration of C. pneumoniae IgA antibody was positively associated with risk of coronary heart disease and more specifically myocardial infarction. Subjects with the highest quartile of IgA antibody showed 2.29 (95%CI, 1.21–4.33) times higher risk of coronary heart disease and 2.58 (95%CI, 1.29–5.19) times higher risk of myocardial infarction than those with lowest quartile. However, no such association was detected for IgG antibody. Conclusion C. pneumoniae infection was found to be positively associated with risk of coronary heart disease.
    Atherosclerosis 01/2014; 233(2):338–342. · 3.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Weight gain is an important risk factor of coronary artery disease, but there is limited evidence for an effect of weight change on heart failure (HF) mortality. Methods and Results: A total of 61,571 subjects aged 40-79 years were selected. Participants were already enrolled in the Japan Collaborative Cohort (JACC) study, for whom data regarding weight at the age of 20 years of age were available. The underlying causes of death were determined based on the International Classification of Diseases. During the median 19.3-year follow-up of the cohort, there were 640 deaths from myocardial infarction (MI) and 605 deaths from HF. Men and women who had gained weight had a higher risk of mortality from MI, whereas those who had lost weight had a higher risk of mortality from HF. Compared to subjects with no weight change (within ±5.0kg), the multivariate hazard ratios (HR; 95% confidence interval [CI]) of MI for weight change of +10.0kg or more were 1.51 (1.11-2.06) for men and 1.80 (1.23-2.64) for women, whereas HRs of HF were 0.76 (0.51-1.13) and 0.94 (0.66-1.33), respectively. The corresponding HRs of MI for weight change of -10.0kg or more were 0.86 (0.57-1.31) for men and 0.90 (0.54-1.53) for women, whereas those of HF were 1.33 (0.93-1.89) and 1.48 (1.04-2.12), respectively. Conclusions: High BMI and weight gain are associated with increased risk of mortality from MI, whereas low BMI and weight loss are associated with increased risk of mortality from HF.
    Circulation Journal 12/2013; · 3.58 Impact Factor

Publication Stats

9k Citations
1,904.30 Total Impact Points


  • 2006–2014
    • Osaka City University
      • • Department of Public Health
      • • Graduate School of Medicine
      • • Department of Nephrology
      Ōsaka, Ōsaka, Japan
    • Osaka University
      • • Graduate School of Medicine
      • • Department of Social and Environmental Medicine
      Suika, Ōsaka, Japan
    • Kyoto Women's University
      Kioto, Kyōto, Japan
  • 2013
    • Hokkaido University
      • Department of Public Health
      Sapporo-shi, Hokkaido, Japan
    • Fukushima Medical University
      • Radiation Medical Science Center for the Fukushima health management survey
      Hukusima, Fukushima, Japan
    • Peking University Health Science Center
      Peping, Beijing, China
    • Fujita Health University
      • Department of Public Health
      Nagoya, Aichi, Japan
  • 2008–2013
    • Dokkyo Medical University
      Totigi, Tochigi, Japan
    • Tokyo University of Science
      • Department of Management Science
      Edo, Tōkyō, Japan
    • Nankai University
      T’ien-ching-shih, Tianjin Shi, China
  • 2007–2013
    • National Cerebral and Cardiovascular Center
      Ōsaka, Ōsaka, Japan
  • 1999–2013
    • Harvard Medical School
      • Department of Medicine
      Boston, Massachusetts, United States
  • 1998–2013
    • Ibaraki Prefectural University of Health Sciences
      Ibaragi, Ōsaka, Japan
    • Aichi Prefectural Institute of Public Health
      Nagoya, Aichi, Japan
  • 1990–2013
    • University of Tsukuba
      • Institute of Community Medicine
      Tsukuba, Ibaraki-ken, Japan
  • 2012
    • Tokyo Medical and Dental University
      • Department of Oral Health Care Promotion
      Edo, Tōkyō, Japan
    • University College London
      • Department of Epidemiology and Public Health
      London, ENG, United Kingdom
    • Kanazawa Medical University
      Kanazawa, Ishikawa, Japan
    • Toho University
      • Department of Environmental and Occupational Health
      Edo, Tōkyō, Japan
  • 2009–2012
    • Kyoto University
      • Department of Health and Environmental Sciences
      Kioto, Kyōto, Japan
    • Harvard University
      • Department of Society, Human Development, and Health
      Boston, MA, United States
    • Kyoto Prefectural University of Medicine
      • Department of Social Medicine and Cultural Sciences
      Kioto, Kyōto, Japan
  • 2011
    • Aichi Medical University
      • Department of Public Health
      Masaki-chō, Ehime, Japan
  • 2009–2011
    • Ehime University
      Matuyama, Ehime, Japan
  • 2005–2011
    • University of Occupational and Environmental Health
      • • Department of Preventive Medicine and Community Health
      • • Department of Clinical Epidemiology
      Kitakyūshū, Fukuoka, Japan
    • University of Leeds
      • Institute of Psychological Sciences
      Leeds, ENG, United Kingdom
    • Nagoya University
      Nagoya, Aichi, Japan
  • 2004–2011
    • National Cancer Center, Japan
      • Research Center for Cancer Prevention and Screening
      Edo, Tōkyō, Japan
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
  • 2010
    • Tezukayama University
      Nara, Nara, Japan
  • 2009–2010
    • Niigata University
      • Division of Health Promotion
      Niahi-niigata, Niigata, Japan
  • 2005–2007
    • University of Shizuoka
      • School of Food and Nutritional Sciences
      Shizuoka-shi, Shizuoka-ken, Japan
  • 2001
    • Yamaguchi Prefectural University
      Yamaguti, Yamaguchi, Japan
  • 2000–2001
    • Brigham and Women's Hospital
      • • Division of Preventive Medicine
      • • Department of Medicine
      Boston, MA, United States
  • 1994–2001
    • Osaka Medical Center for Cancer and Cardiovascular Diseases
      Ōsaka, Ōsaka, Japan
  • 1989–1990
    • University of Minnesota Duluth
      Duluth, Minnesota, United States