Hiroyasu Iso

Osaka University, Suika, Ōsaka, Japan

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Publications (454)2133.48 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The evidence for the impact of saturated fat intake on cardiovascular disease remains inconsistent. One reason for this inconsistency may be the large difference in the distribution of saturated fat intake between the East and West. In this review, we focus on the published literature on this topic among Japanese population. Three studies have examined the link between saturated fat intake and intraparenchymal hemorrhage, consistently showing an inverse association. However, the association for ischemic stroke is less clear, although it is generally inverse. As for myocardial infarction, the findings in Japanese studies are inconsistent, as are those of Western studies. The JPHC study, however, found a positive association, the first report in Asia. Taken together with the results of the JPHC and Western studies, a saturated fat intake of around 20 g/day (approximately 10% of total energy) may be optimal, which corresponds to 200 g of milk a day and 150 g of meat every other day.
    Journal of atherosclerosis and thrombosis 03/2015; DOI:10.5551/jat.28316 · 2.93 Impact Factor
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    ABSTRACT: Although non-communicable diseases (NCDs) have become the predominant health problems of Palauan society, there have been no comprehensive data on NCD risk factors available to develop effective control strategies. Therefore, the first Palauan national STEPwise approach to risk factor Surveillance (STEPS) was completed in mid-2013 to provide information on its adult population aged 25 to 64 years. This study aims to obtain corresponding data from the younger adults aged 18 to 24 years, who remained to be surveyed. We conducted an epidemiological study, targeting the 18- to 24-year-old age group. A survey station and a mobile team were established to recruit voluntary participants dwelling in Koror. A slightly modified WHO STEPS instrument was used, including a structured questionnaire for behavioral risk factors, physical measurements, and blood tests. A total of 356 young people were recruited during the survey. In both sexes, nearly half of the participants were overweight/obese. The prevalence of hypertension was higher in men than in women (17.6% vs 1.7%). Raised blood glucose and impaired fasting glucose were observed in 3.5% and 5.2% of the total participants, respectively. About 36% of the subjects were observed to have raised levels of total cholesterol. More than 70% of the young people were current tobacco users, in terms of all kinds of tobacco products. The current survey, for the first time, revealed a high prevalence of NCD risk factors, especially overweight/obesity and tobacco use, among young people in Palau. This indicates that swift measures against NCDs are required even in this young age group.
    Journal of Epidemiology 03/2015; DOI:10.2188/jea.JE20140156 · 2.11 Impact Factor
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    ABSTRACT: Background: Despite the rising consumption of coffee worldwide, few prospective cohort studies assessed the association of coffee intake with mortality including total and major causes of death. Objective: We aimed to investigate the association between habitual coffee drinking and mortality from all causes, cancer, heart disease, cerebrovascular disease, respiratory disease, injuries, and other causes of death in a large-scale, population-based cohort study in Japan. Design: We studied 90,914 Japanese persons aged between 40 and 69 y without a history of cancer, cerebrovascular disease, or ischemic heart disease at the time of the baseline study. Subjects were followed up for an average of 18.7 y, during which 12,874 total deaths were reported. The association between coffee intake and risk of total and cause-specific mortality was assessed by using a Cox proportional hazards regression model with adjustment for potential confounders. Results: We showed an inverse association between coffee intake and total mortality in both men and women. HRs (95% CIs) for total death in subjects who consumed coffee compared with those who never drank coffee were 0.91 (0.86–0.95) for <1 cup/d, 0.85 (0.81–0.90) for 1–2 cups/d, 0.76 (0.70–0.83) for 3–4 cups/d, and 0.85 (0.75–0.98) for >5 cups/d (P-trend < 0.001). Coffee was inversely associated with mortality from heart disease, cerebrovascular disease, and respiratory disease. Conclusion: With this prospective study, we suggest that the habitual intake of coffee is associated with lower risk of total mortality and 3 leading causes of death in Japan.
    American Journal of Clinical Nutrition 03/2015; DOI:10.3945/ajcn.114.104273 · 6.50 Impact Factor
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    ABSTRACT: Chronic kidney disease (CKD) is a potential independent risk factor for atrial fibrillation (AF). It remains unclear whether anemia is synergistically associated with increased risk of AF onset in subjects with CKD. We evaluated the association of kidney function, hemoglobin (Hb), and their combination with new-onset AF in a population-based cohort study. We conducted a 15-year prospective cohort study of 132,250 Japanese subjects aged 40 to 79 years who participated in annual health checkups from 1993. Kaplan-Meier survival analysis was used to compare freedom from new-onset AF between groups classified by estimated glomerular filtration rate grade, Hb grade, and their combination. Cox proportional hazard model analysis was used to estimate hazard ratios (HRs) for new-onset AF. During a 13.8-year mean follow-up period, 1,232 (0.93%) subjects with new-onset AF were identified. Lower estimated glomerular filtration rate and lower Hb grades were significantly associated with a higher incidence of new-onset AF. Multivariate HRs and 95% confidence intervals (CIs) of new-onset AF were 1.38 (1.21 to 1.56) for mild CKD group, 2.56 (2.09 to 3.13) for CKD group, and 1.50 (1.24 to 1.83) for anemia group. Borderline Hb level was not significantly associated with increased risk for new-onset AF (HR 1.07, CI 0.91 to 1.25, p = 0.4284). In the model with interaction term between CKD and anemia, the risk was significantly higher (p = 0.0343 for the interaction) than that predicted by each factor independently. In conclusion, decreased kidney function and lower Hb level are associated with increased risk for new-onset AF, especially when both are present. Copyright © 2015 Elsevier Inc. All rights reserved.
    The American Journal of Cardiology 02/2015; 115(3):328-33. DOI:10.1016/j.amjcard.2014.10.041 · 3.43 Impact Factor
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    ABSTRACT: No large-scale, longitudinal studies have examined the combined effects of blood pressure (BP) and total cholesterol levels on long-term risks for subtypes of cardiovascular death in an Asian population. To investigate these relationships, a meta-analysis of individual participant data, which included 73 916 Japanese subjects (age, 57.7 years; men, 41.1%) from 11 cohorts, was conducted. During a mean follow-up of 15.0 years, deaths from coronary heart disease, ischemic stroke, and intraparenchymal hemorrhage occurred in 770, 724, and 345 cases, respectively. Cohort-stratified Cox proportional hazard models were used. After stratifying the participants by 4 systolic BP ×4 total cholesterol categories, the group with systolic BP ≥160 mm Hg with total cholesterol ≥5.7 mmol/L had the greatest risk for coronary heart disease death (adjusted hazard ratio, 4.39; P<0.0001 versus group with systolic BP <120 mm Hg and total cholesterol <4.7 mmol/L). The adjusted hazard ratios of systolic BP (per 20 mm Hg) increased with increases in total cholesterol categories (hazard ratio, 1.52; P<0.0001 in group with total cholesterol ≥5.7 mmol/L). Similarly, the adjusted hazard ratios of total cholesterol increased with increases in systolic BP categories (P for interaction ≤0.04). Systolic BP was positively associated with ischemic stroke and intraparenchymal hemorrhage death, and total cholesterol was inversely associated with intraparenchymal hemorrhage, but no significant interactions between BP and total cholesterol were observed for stroke. High BP and high total cholesterol can synergistically increase the risk for coronary heart disease death but not for stroke in the Asian population. © 2015 American Heart Association, Inc.
    Hypertension 01/2015; 65(3). DOI:10.1161/HYPERTENSIONAHA.114.04639 · 7.63 Impact Factor
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    ABSTRACT: Accurate high-density lipoprotein cholesterol (HDL-C) measurements are important for management of cardiovascular diseases. The US Centers for Disease Control and Prevention (CDC) and Cholesterol Reference Method Laboratory Network (CRMLN) perform ultracentrifugation (UC) reference measurement procedure (RMP) to value assign HDL-C. Japanese CRMLN laboratory (Osaka) concurrently runs UC procedure and the designated comparison method (DCM). Osaka performance of UC and DCM was examined and compared with CDC RMP. CDC RMP involved UC, heparin-MnCl2 precipitation, and cholesterol analysis. CRMLN DCM for samples containing <200mg/dl triglycerides involved 50-kDa dextran sulfate-MgCl2 precipitation and cholesterol determination. HDL-C regression equations obtained with CDC (x) and Osaka (y) were y=0.992x+0.542 (R(2)=0.996) for Osaka UC and y=1.004x-0.181 (R(2)=0.998) for DCM. Pass rates within ±1mg/dl of the CDC target value were 91.9 and 92.1% for Osaka UC and DCM, respectively. Biases at 40mg/dl HDL-C were +0.22 and -0.02mg/dl for Osaka UC and DCM, respectively. Osaka UC and DCM were highly accurate, precise, and stable for many years, assisting manufacturers to calibrate products for clinical laboratories to accurately measure HDL-C for patients, calculate non-HDL-C, and estimate low-density lipoprotein cholesterol with the Friedewald equation. Copyright © 2014 Elsevier B.V. All rights reserved.
    Clinica Chimica Acta 01/2015; 439:185-90. DOI:10.1016/j.cca.2014.10.039 · 2.76 Impact Factor
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    ABSTRACT: Neighborhood deprivation has been shown in many studies to be an influential factor in cardiovascular disease risk. However, no previous studies have examined the effect of neighborhood socioeconomic conditions on the risk of stroke in Asian countries. This study investigated whether neighborhood deprivation was associated with the risk of stroke and stroke death using data from the Japan Public Health Center-based Prospective Study. We calculated the adjusted hazard ratios of stroke mortality (mean follow-up, 16.4 years) and stroke incidence (mean follow-up, 15.4 years) according to the area deprivation index (ADI) among 90 843 Japanese men and women aged 40-69 years. A Cox proportional-hazard regression model using a shared frailty model was applied. The adjusted hazard ratios of stroke incidence, in order of increasing deprivation with reference to the least deprived area, were 1.16 (95% CI, 1.04-1.29), 1.12 (95% CI, 1.00-1.26), 1.18 (95% CI, 1.02-1.35), and 1.19 (95% CI, 1.01-1.41), after adjustment for individual socioeconomic conditions. Behavioral and psychosocial factors attenuated the association, but the association remained significant. The associations were explained by adjusting for biological cardiovascular risk factors. No significant association with stroke mortality was identified. Our results indicate that the neighborhood deprivation level influences stroke incidence in Japan, suggesting that area socioeconomic conditions could be a potential target for public health intervention to reduce the risk of stroke.
    Journal of Epidemiology 01/2015; 25(3):254-60. DOI:10.2188/jea.JE20140117 · 2.11 Impact Factor
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    ABSTRACT: Sleep duration could affect glucose tolerance and mortality. However, the impact that sleep duration has on prognosis of people with diabetes is unclear. A cohort of Japanese self-reported diabetic people (1674 men and 1240 women) aged 40 to 79 years without a history of cardiovascular disease, cancer, renal diseases or pulmonary tuberculosis at baseline (1988 to 1990) were followed until 2009. The average sleep duration was grouped into the following five categories: ≤5 (≤5.4), 6 (5.5–6.4), 7 (6.5–7.4, reference), 8 (7.5–8.4), and ≥9 (≥8.5) hours. Multivariable hazard ratios were calculated for total and cause-specific mortality in each category by using Cox proportional hazard model. During 45 329 person-years of follow-up, 1315 deaths from all-cause (785 men and 530 women), 389 from cardiovascular disease (210 men and 179 women), 359 from cancer (244 men and 115 women), and 138 from infectious disease (87 men and 51 women) were documented. Multivariable hazard ratios (95% CI) were as follows; for men, 1.49 (1.02–2.17) for all-cause in ≤5 h sleepers; 1.53 (1.22–1.91) for all-cause in ≥9 h sleepers; 1.56 (1.01–2.41) for cardiovascular disease in ≥9 h sleepers; 3.08 (1.17–8.12) for infectious disease in ≤5 h sleepers; 2.23 (1.13–4.39) for infectious disease in ≥9 h sleepers; for women, 1.44 (1.09–1.90) for all-cause in ≥9 h sleepers; 2.03 (1.05–3.94) for cancer in ≤5 h sleepers. In conclusion, diabetic people with ≤5 h or ≥9 h of sleep had significantly higher risks of mortality than 7-hour diabetic sleepers.
    Sleep and Biological Rhythms 12/2014; 13(1). DOI:10.1111/sbr.12091 · 1.05 Impact Factor
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    ABSTRACT: South Asian individuals have an increased prevalence of type 2 diabetes, but little is known about the development of glycaemic traits in this ethnic group. We compared age-related changes in glycaemic traits between non-diabetic South Asian and white participants. In a prospective British occupational cohort with 5-yearly clinical examinations (n = 230/5,749 South Asian/white participants, age 39-79 years at baseline), age-related trajectories of fasting glucose (FG) and 2 h post-load glucose (PLG), log-transformed fasting insulin (FINS) and 2 h post-load insulin (PLINS), HOMA insulin sensitivity (HOMA2-%S) and HOMA insulin secretion (HOMA2-%B) were fitted for South Asian and white individuals who remained free of diabetes between 1991 and 2009. In sex-adjusted multilevel models, FG was stable in white participants but increased with age in South Asians (0.12 [SE = 0.04] mmol/l per decade). PLG, FINS and PLINS levels were lower among white participants (by 0.271 [SE = 0.092] mmol/l, 0.306 [SE = 0.046] log pmol/l, 0.707 [SE = 0.059] log pmol/l at age 50, respectively) compared with South Asians, although their age-related trajectories were parallel. HOMA2-%S was higher (0.226 [SE = 0.038] at age 50) and HOMA2-%B lower (by 0.189 [SE = 0.026] at age 50) among white than South Asian participants. The age-related decline in HOMA2-%S was similar in these groups, but the age-related increase in HOMA2-%B was greater in white participants (0.04 [SE = 0.02] per decade). This difference was explained by obesity, lifestyle and social status. Findings from a diabetes-free population suggest an inadequate pancreatic beta cell reserve in South Asians, as a significantly steeper age-related increase in FG was observed in this ethnic group compared with white individuals.
    Diabetologia 11/2014; 58(3). DOI:10.1007/s00125-014-3448-9 · 6.88 Impact Factor
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    ABSTRACT: The purpose of this study is to explore neighborhood contextual factors in terms of smoking behaviors among middle-aged Japanese, by using a multilevel analysis. Subjects were Japanese men and women, between 40 and 59 years of age (40,961 for the cross-sectional analysis, and 9,177 for the longitudinal analysis), nested in 39 neighborhoods (Kyuson). The results showed that women in a less residentially stable neighborhood were more likely to be smokers. No associations were seen between current smoking and neighborhood deprivation; however, women in the most deprived neighborhood were more likely to quit smoking. This study is the first to demonstrate the associations between neighborhood environment and current smoking or smoking cessation, in a Japanese setting. The findings imply that policy makers should consider targeting neighborhood conditions in order to help reduce smoking prevalence, especially among women. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Health & Place 11/2014; 31C:17-23. DOI:10.1016/j.healthplace.2014.10.010 · 2.44 Impact Factor
  • Kaori Honjo, Hiroyasu Iso
    Stroke 11/2014; 45(12). DOI:10.1161/STROKEAHA.114.006995 · 6.02 Impact Factor
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    ABSTRACT: Non-fasting triglycerides were reported to have a greater impact on risk of ischemic cardiovascular events than fasting triglycerides. However, evidence from Asia, where the prevalence of dyslipidemia is generally lower, has been limited. We used 1975-1986 baseline surveys to investigate cohort data of 10,659 (4264 men and 6395 women) residents aged 40-69 years, initially free from ischemic heart disease and stroke, in four Japanese communities. Serum triglyceride concentrations at baseline were obtained for 2424 fasting (≥8 h after meal) and 8235 non-fasting (<8 h after meal) participants. During the 22-year follow-up, 284 (165 men and 119 women) developed ischemic heart disease and 666 (349 men and 317 women) ischemic stroke. After adjustment for age, sex and known cardiovascular risk factors, multivariable hazard ratios (95%CI) of ischemic cardiovascular disease (ischemic heart disease and ischemic stroke) for the highest versus lowest quartiles of triglycerides were 1.71 (1.14-2.59), P for trend = 0.013, for fasting participants and 1.60 (1.25-2.05), P for trend <0.001, for non-fasting participants. The positive associations did not differ between fasting and non-fasting men, while they were strong for non-fasting women. They were stronger for ischemic heart disease than for ischemic stroke. After further adjustment for HDL-cholesterol, these associations were slightly attenuated, but remained statistically significant. Non-fasting as well as fasting triglycerides are predictive of risk of ischemic cardiovascular disease for Japanese men, as are non-fasting triglycerides for women. Copyright © 2014. Published by Elsevier Ireland Ltd.
    Atherosclerosis 11/2014; 237(1):361-8. DOI:10.1016/j.atherosclerosis.2014.08.028 · 3.71 Impact Factor
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    ABSTRACT: The long-term prognosis of subjects with supraventricular premature complexes (SVPCs) remains unclear in the general population. The aim of this study was to examine the prognostic significance of SVPCs in community-based health checkups.
    European Heart Journal 10/2014; 36(3). DOI:10.1093/eurheartj/ehu407 · 14.72 Impact Factor
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    ABSTRACT: Since few studies have developed food frequency questionnaires (FFQs) and examined their reliability for Japanese urban populations, FFQ developed for urban Japanese population may show reasonable reliability for estimating intakes of nutrients and food groups. Therefore, the objective of this study was to examine the reliability of an FFQ developed for a prospective cohort study in a Japanese urban area. A total of 29 men and 29 women aged 47–78 years were from participants in the Suita Study from February 1997 to February 1998. Seven-consecutive-day dietary records (DRs) were collected in each season (28-day DRs). The FFQs were administered three times in total in each season, except in autumn. We calculated Spearman correlation coefficients to assess the validation of the first and third FFQs compared with 28-day DRs and to assess the repeatability for three-, six-, and nine-month intervals. Reasonable validity of each FFQ compared with 28-day DRs was observed for energy intake and for 27 nutrients, and 11 food groups were selected. Median (range) Spearman rank correlation coefficients for energy-adjusted nutrient and food group intakes of the first FFQs were 0.52 (0.14–0.88) and 0.53 (0.24–0.74), and those of the third FFQs were 0.51 (0.07–0.84) and 0.57 (0.16–0.75), respectively. The repeatability of each interval was relatively good; median (range) Spearman correlation coefficients of nutrients for three-, six-, and nine-month intervals were 0.67 (0.40–0.85), 0.63 (0.25–0.93), and 0.62 (0.31–0.87), respectively; those for food groups were 0.58 (0.42–0.76), 0.56 (0.24–0.80), and 0.65 (0.30–0.76), respectively. In conclusion, this FFQ is useful for evaluating the associations of nutrient and food intakes with cardiovascular diseases and their risk factors in Japanese urban populations.
    Nutrition Research 10/2014; 35(1). DOI:10.1016/j.nutres.2014.10.012 · 2.59 Impact Factor
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    ABSTRACT: To investigate the hypothesis that postmenopausal women demonstrate greater cardiovascular stress reactivity during mental stress tasks than do both premenopausal women and men.
    Psychosomatic Medicine 10/2014; DOI:10.1097/PSY.0000000000000121 · 4.09 Impact Factor
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    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. DOI:10.1016/j.atherosclerosis.2014.07.036 · 3.71 Impact Factor
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    ABSTRACT: Objective: To examine whether coenzyme Q10, a potent antioxidant, is associated with risk of dementia, which has not yet been elucidated. Approach and results: We performed a case-control study nested in a community-based cohort of approximately 6000 Japanese aged 40-69 years at baseline (1984-1994). Serum coenzyme Q10 was measured in 65 incident cases of disabling dementia with dementia-related behavioral disturbance or cognitive impairment incident between 1999 and 2004, and in 130 age-, sex- and baseline year-matched controls. Serum coenzyme Q10 was inversely associated with dementia: the multivariate odds ratios (95% confidence intervals) were 0.68 (0.26-1.78), 0.92 (0.33-2.56), and 0.23 (0.06-0.86) for individuals with the second, third, and highest quartiles of coenzyme Q10, respectively, as compared with the lowest quartile (P for trend = 0.05). A similar association was found for the coenzyme Q10/total cholesterol ratio: the respective ORs were 0.67 (0.25-1.78), 0.73 (0.28-1.92), and 0.21 (0.05-0.90) (P for trend = 0.04). Conclusions: Serum coenzyme Q10 levels were inversely associated with risk of disabling dementia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Atherosclerosis 09/2014; 237(2):400-403. DOI:10.1016/j.atherosclerosis.2014.09.017 · 3.71 Impact Factor
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    ABSTRACT: Background and Purpose-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. Methods-The Atherosclerosis Risk in Communities study measured social network and social support in 13 686 men and women (mean, 57 years; 56% women; 24% black; 76% white) without a history of stroke. Social network was assessed by the 10-item Lubben Social Network Scale and social support by a 16-item Interpersonal Support Evaluation List-Short Form. Results-During a median follow-up of 18.6 years, 905 incident strokes occurred. Relative to participants with a large social network, those with a small social network had a higher risk of stroke (hazard ratio [95% confidence interval], 1.44 [1.02-2.04]) after adjustment for demographics, socioeconomic variables, marital status, behavioral risk factors, and major stroke risk factors. Vital exhaustion, but not inflammation, partly mediated the association between a small social network and incident stroke. Social support was unrelated to incident stroke. Conclusions-In this sample of US community-dwelling men and women, having a small social network was associated with excess risk of incident stroke. As with other cardiovascular conditions, having a small social network may be associated with a modestly increased risk of incident stroke.
    Stroke 08/2014; 45(10). DOI:10.1161/STROKEAHA.114.005815 · 6.02 Impact Factor
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    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; 21(12). DOI:10.5551/jat.24133 · 2.77 Impact Factor
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    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; 21(11). DOI:10.5551/jat.22913 · 2.77 Impact Factor

Publication Stats

11k Citations
2,133.48 Total Impact Points


  • 2005–2015
    • Osaka University
      • • Graduate School of Medicine
      • • Department of Social and Environmental Medicine
      Suika, Ōsaka, Japan
    • University of Leeds
      • Institute of Psychological Sciences
      Leeds, ENG, United Kingdom
    • University of Shizuoka
      • Department of Food and Nutritional Sciences
      Sizuoka, Shizuoka, Japan
  • 2006–2014
    • Osaka City University
      • Department of Public Health
      Ōsaka, Ōsaka, Japan
  • 2003–2013
    • Ibaraki Prefectural University of Health Sciences
      Ibaragi, Ōsaka, 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
    • Kanazawa Medical University
      • Department of Epidemiology and Public Health
      Kanazawa, Ishikawa, Japan
    • Toho University
      • Department of Environmental and Occupational Health
      Edo, Tōkyō, Japan
  • 2011
    • The University of Tokyo
      • School of Public Health
      Tokyo, Tokyo-to, Japan
  • 2004–2011
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
    • Kagawa University
      Takamatu, Kagawa, Japan
    • Kyoto University
      • Department of Health and Environmental Sciences
      Kioto, Kyōto, Japan
  • 2009
    • Ehime University
      Matuyama, Ehime, Japan
  • 2007–2009
    • National Cancer Center, Japan
      • Research Center for Cancer Prevention and Screening
      Edo, Tōkyō, Japan
    • University of Occupational and Environmental Health
      • Department of Preventive Medicine and Community Health
      Kitakyūshū, Fukuoka, Japan
    • Okayama University
      • Department of Medicine and Clinical Science
      Okayama, Okayama, Japan
    • National Cerebral and Cardiovascular Center
      Ōsaka, Ōsaka, Japan
  • 2005–2006
    • Juntendo University
      • • Department of Epidemiology and Environmental Health
      • • Department of Public Health
      Edo, Tōkyō, Japan
  • 2001
    • Brigham and Women's Hospital
      • Division of Preventive Medicine
      Boston, MA, United States
  • 1999–2001
    • Harvard Medical School
      • 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