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Choy-Lye Chei,
Kazumasa Yamagishi,
Akihiko Kitamura,
Masahiko Kiyama, Hironori Imano,
Tetsuya Ohira,
Renzhe Cui,
Takeshi Tanigawa,
Tomoko Sankai,
Yoshinori Ishikawa,
Shinichi Sato,
Shinichi Hitsumoto,
Hiroyasu Iso
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ABSTRACT: BACKGROUND AND PURPOSE: High-density lipoprotein (HDL) cholesterol is an established protective factor for ischemic stroke. However, the contribution of HDL subclasses to stroke risk and its subtypes is uncertain. METHODS: A prospective nested case-control study of 40- to 85-year-old Japanese was undertaken using frozen serum samples collected from 5280 men and 7524 women. They participated in cardiovascular risk surveys from 1985 to 1999 (1 community) and 1989 to 1998 (2 communities) under Circulatory Risk in Communities Study. HDL cholesterol subclasses were classified by high-performance liquid chromatography into 3 subgroups: S-HDL (very small or small HDL), M-HDL (medium HDL), and L-HDL (large or very large HDL) cholesterol. One control subject per case was matched by sex, age, community, serum storage year, and fasting status. RESULTS: In 2005, we identified 241 strokes (155 ischemic and 86 hemorrhagic). S-HDL and M-HDL cholesterol levels were inversely associated with total stroke risk, ischemic stroke, specifically lacunar infarction, and hemorrhagic stroke. After adjustment for cardiovascular risk factors, these associations remained statistically significant. Multivariable conditional odds ratios (95% confidence interval) for 1 SD (0.12 mmol/L) increment of S-HDL cholesterol levels were 0.34 (0.23-0.52) for total stroke, 0.38 (0.23-0.63) for ischemic stroke, 0.33 (0.18-0.61) for lacunar infarction, 0.30 (0.14-0.65) for hemorrhagic stroke, and 0.30 (0.12-0.77) for intraparenchymal hemorrhage. The respective multivariable odds ratios for 1SD (0.10 mmol/L) increment of M-HDL cholesterol levels were 0.56 (0.41-0.75), 0.63 (0.45-0.88), 0.59 (0.40-0.87), 0.41 (0.21-0.80), and 0.38 (0.16-0.90). No associations were found between L-HDL cholesterol levels and risk of total stroke and its subtypes. CONCLUSIONS: Small- to medium-sized HDL, not large HDL, cholesterol levels were inversely associated with total stroke risk.
Stroke 01/2013; · 5.73 Impact Factor
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ABSTRACT: Dietary behavior can worsen or prevent hypertension. However, data on the association between dietary behavior and the risk of hypertension in Asians are limited. The aim of this study was to determine these associations in Japanese male workers. We conducted a prospective study of 30-71-year-old Japanese male workers in Osaka, Japan, between 2001 and 2011. The study subjects were 3486 normotensive males who were assessed for an average of 4.6 years using an annual survey. We defined hypertension by a systolic blood pressure of 140 mm Hg, a diastolic blood pressure of 90 mm Hg and/or the use of antihypertensive medications. Dietary behavior questionnaires were included in the annual surveys. For each question on dietary behavior, we calculated the odds ratios (ORs) for the risk of hypertension using logistic regression models. We used subjects who consistently gave affirmative answers in the baseline and end-point surveys as a reference. The number of new cases of hypertension was 846 among 3486 subjects. Compared with subjects who eat meat frequently, subjects who did not eat meat frequently showed a higher risk of hypertension (OR=1.26, 95% confidence interval (CI): 1.00-1.59). Subjects who did not consume dairy products every day showed a higher risk of hypertension (OR=1.39, 95% CI: 1.13-1.71) compared with those who did. Meat and dairy product intake was associated with the prevention of hypertension among Japanese male workers.Hypertension Research advance online publication, 10 January 2013; doi:10.1038/hr.2012.205.
Hypertension Research 01/2013; · 2.58 Impact Factor
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Hironori Imano,
Hiroyasu Iso,
Masahiko Kiyama,
Kazumasa Yamagishi,
Tetsuya Ohira,
Shinichi Sato,
Hiroyuki Noda,
Kenji Maeda,
Takeo Okada,
Takeshi Tanigawa,
Akihiko Kitamura
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ABSTRACT: OBJECTIVE: The objective was to determine whether non-fasting glucose concentration is a predictor for incident coronary heart disease. METHODS: We investigated a cohort data of 9,900 40- to 69-year-old residents in four Japanese communities for 1975-1986 baseline surveys of the Circulatory Risk in Communities Study (CIRCS). Non-fasting blood glucose concentrations were available for 7,332 participants. Diabetic type was defined as a glucose level of ≥11.1mmol/L and/or the use of medication for diabetes mellitus. RESULTS: A total of 170 coronary heart disease including 113 myocardial infarctions occurred in non-fasting participants within the median 22-year follow-up period. Multivariable hazard ratios (HRs) of incident coronary heart disease for the participants with diabetic type compared with the normal type were 1.98 (0.84-4.68) for men, 3.39 (1.47-7.81) for women, and 2.47 (1.37-4.46) for total subjects. Corresponding HRs for myocardial infarction were 2.14 (0.83-5.55), 5.70 (2.21-14.67) and 3.17 (1.65-6.10), respectively. Multivariable HRs of incident coronary heart disease per one standard deviation of serum glucose levels were 1.17 (1.02-1.36), 1.19 (1.03-1.38), and 1.19 (1.08-1.32), respectively. The corresponding HRs for myocardial infarction were 1.18 (1.00-1.38), 1.27 (1.07-1.49) and 1.23 (1.10-1.37). CONCLUSION: Non-fasting glucose concentration, either as diagnosis of diabetic type or as continuous variable, proved to be an independent predictor for incident coronary heart disease in middle-aged general population.
Preventive Medicine 09/2012; · 3.22 Impact Factor
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Yuji Shimizu, Hironori Imano,
Tetsuya Ohira,
Akihiko Kitamura,
Masahiko Kiyama,
Takeo Okada,
Yoshinori Ishikawa,
Takashi Shimamoto,
Kazumasa Yamagishi,
Takeshi Tanigawa,
Hiroyasu Iso
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ABSTRACT: Although serum alkaline phosphatase (ALP) levels have been associated with mortality from all-cause and from either ischemic or hemorrhagic stroke, no study has been published of the associations between ALP and the incidence of stroke. We therefore examined the associations of ALP with risk of stroke among Japanese, stratified by drinking status because ALP is known as an enzyme affected by alcohol consumption. We conducted a prospective cohort study of 10,754 Japanese subjects (4098 men and 6656 women) aged 40-69 years and living in 4 communities under systematic surveillance for stroke incidence. During the 16-year follow-up, we documented 264 strokes (164 ischemic strokes and 69 hemorrhagic strokes) for men and 225 strokes (118 ischemic strokes and 89 hemorrhagic strokes) for women. There was a U-shaped association between ALP level and stroke incidence in both men and women, which was confined primarily to nondrinkers. For nondrinkers, higher ALP levels were associated with an elevated risk of ischemic stroke for men and of hemorrhagic stroke for women, whereas lower ALP levels were associated with elevated risks of ischemic and hemorrhagic strokes in both men and women. Our data indicate that not only higher, but also lower, serum ALP level may be a predictor for the risk of stroke in nondrinking men and women.
Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association 07/2012;
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Kazumasa Yamagishi,
Shinichi Sato,
Akihiko Kitamura,
Masahiko Kiyama,
Takeo Okada,
Takeshi Tanigawa,
Tetsuya Ohira, Hironori Imano,
Masahide Kondo,
Ichiro Okubo,
Yoshinori Ishikawa,
Takashi Shimamoto,
Hiroyasu Iso
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ABSTRACT: The nation-wide, community-based intensive hypertension detection and control program, as well as universal health insurance coverage, may well be contributing factors for helping Japan rank near the top among countries with the longest life expectancy. We sought to examine the cost-effectiveness of such a community-based intervention program, as no evidence has been available for this issue.
The hypertension detection and control program was initiated in 1963 in full intervention and minimal intervention communities in Akita, Japan. We performed comparative cost-effectiveness and budget-impact analyses for the period 1964-1987 of the costs of public health services and treatment of patients with hypertension and stroke on the one hand, and incidence of stroke on the other in the full intervention and minimal intervention communities.
The program provided in the full intervention community was found to be cost saving 13 years after the beginning of program in addition to the fact of effectiveness that; the prevalence and incidence of stroke were consistently lower in the full intervention community than in the minimal intervention community throughout the same period. The incremental cost was minus 28,358 yen per capita over 24 years.
The community-based intensive hypertension detection and control program was found to be both effective and cost saving. The national government's policy to support this program may have contributed in part to the substantial decline in stroke incidence and mortality, which was largely responsible for the increase in Japanese life expectancy.
Journal of hypertension 07/2012; 30(9):1874-9. · 4.02 Impact Factor
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Tetsuya Ohira,
Minako Maruyama, Hironori Imano,
Akihiko Kitamura,
Masahiko Kiyama,
Takeo Okada,
Kenji Maeda,
Kazumasa Yamagishi,
Hiroyuki Noda,
Renzhe Cui,
Sachiko Masuda,
Hiromichi Kimura,
Koji Tachikawa,
Yoshinori Ishikawa,
Hiroyasu Iso
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ABSTRACT: There is little evidence concerning risk factors for sudden cardiac death (SCD) among Asians.
A prospective, nested, case-control study of Japanese patients aged between 30 and 84 years was undertaken using data collected from 26 870 participants in cardiovascular risk surveys conducted in four communities between 1975 and 2005. The incidence of SCD was ascertained by systematic surveillance, with 239 cases of SCD identified over this period. For each case of SCD, three control patients were selected, matched by age, sex, examination year, follow-up time, and community.
Hypertension, diabetes mellitus, smoking, major ST-T abnormalities, left high amplitude R waves, and increased heart rate (≥77 beat/min) were all independently associated with a 1.5-3.2-fold increase in SCD risk, whereas no associations were observed for body mass index and hypercholesterolemia. The population-attributable fraction [95% confidence interval (CI)] was 23.0% (2.9-39.0) for hypertension, 15.3% (3.8-25.5) for current smoking, 14.5% (8.0-20.5) for major ST-T abnormalities, and 8.1% (2.2-13.7) for diabetes mellitus. The number of SCD risk factors (hypertension, diabetes, smoking, and ECG abnormalities) was positively associated with increased SCD risk. The odds ratio for increased SCD risk with three or more risk factors versus zero risk factors was 5.76 (95% CI 3.20-10.39).
Among the Japanese population, hypertension, smoking, major ST-T abnormalities, left high amplitude R waves, and diabetes mellitus were associated with an increased incidence of SCD, whereas there were no associations of body mass index or hypercholesterolemia with SCD incidence.
Journal of hypertension 06/2012; 30(6):1137-43. · 4.02 Impact Factor
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ABSTRACT: To examine the relationships between anger expression and blood pressure (BP) levels and their effect modification by stress
coping behaviors, the authors analyzed data from a cross-sectional study of 790 Japanese male workers aged 20–60 years. We
used the Spielberger anger expression scales to measure anger-out, anger-in, and anger-control. Relationships between anger
expression scales and mean systolic and diastolic BP levels were examined in the total sample and in two subgroups of high
and low stress coping behaviors (low coping behavior group: having none, one, or two coping behaviors; and high coping behavior
group: having three or more coping behaviors). Anger expression scales were not associated with BP levels in the total sample.
Among men who reported only two or fewer coping behaviors, however, the anger-out score was significandy associated with systolic
blood pressure (SBP) levels while no association was found among men who reported the larger number of coping behaviors. Anger-in
and anger-control were not associated with BP levels in either low or high coping behavior groups. This study suggests that
male workers who do not express their anger have a higher probability of developing high BP when they have no or few stress
coping behaviors.
Environmental Health and Preventive Medicine 04/2012; 5(1):37-42.
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Mako Nagayoshi,
Takeshi Tanigawa,
Kazumasa Yamagishi,
Susumu Sakurai,
Akihiko Kitamura,
Masahiko Kiyama,
Takeo Okada,
Kenji Maeda,
Tetsuya Ohira, Hironori Imano,
Shinichi Sato,
Hiroyasu Iso
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ABSTRACT: Although associations between snoring and cardiovascular disease have been reported in several prospective studies, there is limited evidence from Asian populations. The objective of this study was to determine if there is an association between self-reported snoring frequency and the incidence of cardiovascular disease in Japanese.
The subjects were 2350 men and 4163 women aged 40 to 69 years who lived in 3 communities in Japan. All subjects were participants in the Circulatory Risk in Communities Study (CIRCS) and were followed for 6 years. Incidence of cardiovascular disease during the follow-up period comprised events of myocardial infarction, angina pectoris, sudden cardiac death and stroke.
During the 6-year follow-up period, 97 participants (56 men and 41 women) had cardiovascular events. After adjustment for potential confounding factors, self-reported snoring frequency was associated with an increased risk of cardiovascular events among women but not men. The hazard ratios (95% CI) for cardiovascular events were 0.9 (0.4-2.0) for sometimes snoring and 2.5 (1.0-6.1) for everyday snoring in women and 0.7 (0.3-1.3) and 1.0 (0.5-2.1), respectively, in men. Further adjustment for body mass index attenuated the association in women; the respective hazard ratios for cardiovascular events were 0.9 (0.4-1.9) and 2.1 (0.9-5.4).
Self-reported habitual snoring was associated with increased risk of cardiovascular events among Japanese women. Overweight may partly mediate this association.
Journal of Epidemiology 03/2012; 22(4):295-301. · 1.86 Impact Factor
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Minako Maruyama,
Tetsuya Ohira, Hironori Imano,
Akihiko Kitamura,
Masahiko Kiyama,
Takeo Okada,
Kenji Maeda,
Kazumasa Yamagishi,
Hiroyuki Noda,
Yoshinori Ishikawa,
Takashi Shimamoto,
Hiroyasu Iso
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ABSTRACT: There is little evidence whether sudden cardiac death (SCD) is increasing in Asia, although the incidence of coronary heart disease among urban middle-aged Japanese men has increased recently. We examined trends in the incidence of SCD and its risk factors in the Circulatory Risk in Communities Study.
This was a population-based longitudinal study. Surveillance of men and women for SCD incidence and risk factors was conducted from 1981 to 2005.
The surveyed population was all men and women aged 30-84 years who lived in three rural communities and one urban community in Japan.
Trends in SCD incidence and its risk factors.
Age-adjusted and sex-adjusted incidence of SCD decreased from 1981-1985 to 1991-1995, and plateaued thereafter. The annual incidence per 100 000 person-years was 76.0 in 1981-1985, 57.9 in 1986-1990, 39.3 in 1991-1995, 31.6 in 1996-2000 and 36.8 in 2001-2005. The prevalence of hypertension decreased from 1981-1985 to 1991-1995, and plateaued thereafter for men and women. The age-adjusted prevalence of current smoking for men decreased while that of diabetes mellitus increased for both sexes from 1981-1985 to 2001-2005.
The incidence of SCD decreased from 1981 to 1995 but was unchanged from 1996 to 2005. Continuous surveillance is necessary to clarify future trends in SCD in Japan because of an increasing incidence of diabetes mellitus.
BMJ open. 01/2012; 2(2):e000573.
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Yuji Shimizu,
Kenji Maeda, Hironori Imano,
Tetsuya Ohira,
Akihiko Kitamura,
Masahiko Kiyama,
Takeo Okada,
Yoshinori Ishikawa,
Takashi Shimamoto,
Kazumasa Yamagishi,
Takeshi Tanigawa,
Hiroyasu Iso
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ABSTRACT: Several epidemiological studies have established an association between chronic kidney disease (CKD), based on estimated glomerular filtration rate (GFR), and risk of stroke. However, sex-specific evidence for the relationship between CKD and risk of stroke and its subtypes is still limited.
We conducted a prospective cohort study of 12 222 Japanese men and women age 40 to 69 years living in 4 communities under systematic surveillance of stroke incidence to determine the relationship between CKD and risk of stroke and its subtypes.
During the 17-year follow-up, there were 566 strokes (327 ischemic and 186 hemorrhagic strokes). GFR was inversely associated with age- and community-adjusted risk of total stroke for both men and women. Compared with the reference group without CKD (GFR ≥60 mL/min per 1.73m(2)), the adjusted risks of total stroke for subjects with CKD (GFR <60 mL/min per 1.73m(2)) were 1.63 (1.22-2.17) for men and 1.51 (1.13-2.02) for women. Excess risk of stroke associated with CKD was identified primarily for hemorrhagic stroke among men and for ischemic stroke among women. After adjustment for traditional cardiovascular risk factors, associations remained statistically significant. When stratified by drinking status, excess risk of hemorrhagic stroke with CKD was confined to drinkers; adjusted risks were 4.18 (2.31-7.57) for men and 7.00 (1.92-25.56) for women.
CKD was associated with increased risk of hemorrhagic stroke for men, and of ischemic stroke for women. This sex difference may partly be explained by the difference in prevalence of drinkers between men and women.
Stroke 08/2011; 42(9):2531-7. · 5.73 Impact Factor
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ABSTRACT: The aim of this study was to identify the threshold level for non-high-density lipoprotein cholesterol (non-HDL-cholesterol) to raise the risk of coronary heart disease (CHD) incidence in a Japanese general population.
A total of 8,132 men and women, aged 40 to 69 years with no history of stroke or CHD, completed the baseline risk factor surveys between 1975 and 1987. Systematic surveillance of cardiovascular disease incidence was performed through 2003 (the median follow-up period was 21.9 years), and 155 incidents of CHD were identified.
We found a statistically significant association between non-HDL-cholesterol levels and the risk of CHD with a threshold around 140 mg/dL. After adjustment for potential confounding factors, this association did not change materially. The multivariable hazard ratio of CHD compared with that for levels of < 100 mg/dL was 2.49 (95% confidence interval: 1.35 to 4.61) for 140-159 mg/dL and 3.13 (1.58-6.21) for ≥ 180 mg/dL. Setting the cut-off point at ≥ 140 mg/dL non-HDL-cholesterol resulted in the greatest improvement of integrated discrimination.
Higher concentrations of non-HDL-cholesterol are associated with an increased risk of CHD with a threshold around 140 mg/dL, suggesting that the optimal cut-off point for healthy per-sons to prevent increasing the risk of CHD might be around 140 mg/dL non-HDL-cholesterol.
Journal of atherosclerosis and thrombosis 03/2011; 18(6):454-63. · 2.69 Impact Factor
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Choy-Lye Chei,
Kazumasa Yamagishi,
Akihiko Kitamura,
Masahiko Kiyama, Hironori Imano,
Tetsuya Ohira,
Renzhe Cui,
Takeshi Tanigawa,
Tomoko Sankai,
Yoshinori Ishikawa,
Shinichi Sato,
Hiroyasu Iso
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ABSTRACT: Epidemiological studies have shown high-sensitive C-reactive protein (hs-CRP) to predict cardiovascular disease. However, there are only limited studies on the effects of hs-CRP levels on risk of stroke especially stroke subtypes. We examined associations of hs-CRP levels with risks of total stroke and its subtypes.
A prospective nested case-control study of Japanese 40-85 years of age was conducted using frozen serum samples collected from 13,521 men and women who participated in cardiovascular risk surveys from 1984 to 2001 for one community and 1989 to 1998 for the other two communities under the Circulatory Risk in Communities Study (CIRCS). Three control subjects per case were matched by sex, age, community, year of serum storage, and fasting status.
By the end of 2005, we identified 261 incident strokes (165 ischemic strokes and 96 hemorrhagic strokes). There was a positive association between hs-CRP and incidence of incidence of total stroke, ischemic stroke and lacunar infarction. After further adjustment for known cardiovascular risk factors, these relationships remained statistically significant. The multivariable conditional odds ratios associated with 1-SD increment of log-transformed hs-CRP were 1.17(1.01-1.35) for total stroke, 1.27(1.06-1.52) for ischemic stroke, and 1.24(1.00-1.55) for lacunar infarction. The association between hs-CRP levels and incidence of ischemic stroke did not vary by sex, age, body mass index and smoking. No associations were found between hs-CRP levels and risk of hemorrhagic stroke.
hs-CRP predicts the incidence of total and ischemic strokes among middle-aged Japanese men and women.
Atherosclerosis 03/2011; 217(1):187-93. · 3.79 Impact Factor
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Hironori Imano,
Hiroyuki Noda,
Akihiko Kitamura,
Shinichi Sato,
Masahiko Kiyama,
Tomoko Sankai,
Tetsuya Ohira,
Masakazu Nakamura,
Kazumasa Yamagishi,
Ai Ikeda,
Takashi Shimamoto,
Hiroyasu Iso
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ABSTRACT: The objective of this study was to assess the association between serum LDL-cholesterol levels and risk of coronary heart disease (CHD) among Japanese who have lower means of LDL-cholesterol than Western populations.
The predictive power of estimated serum LDL-cholesterol levels in casual blood samples for risk of CHD was evaluated among residents from four Japanese communities participating in the Circulatory Risk in Communities Study (CIRCS). A total of 8131 men and women, aged 40 to 69 years with no history of stroke or CHD, completed baseline risk factor surveys between 1975 and 1987. By 2003, 155 cases of incident CHD (myocardial infarction, angina pectoris and sudden cardiac death) had been identified.
Mean LDL-cholesterol values were 99.4 mg/dL for men and 109.4 mg/dL for women. The crude incidence rate (per 100,000 person-years) of CHD was 152.0 for men and 51.9 for women. The respective multivariable hazard ratios for ≥ 140 mg/dL versus <80mg/dL LDL-cholesterol were 2.80 (95% confidence interval: 1.59 to 4.92) for total CHD, 3.83 (1.78-8.23) for myocardial infarction, 4.07 (2.02-8.20) for non-fatal CHD, and 1.24 (0.44-3.47) for fatal CHD.
Serum LDL-cholesterol levels ranging from around 80 mg/dL to 200mg/dL were positively associated with risk of CHD in a Japanese population.
Preventive Medicine 02/2011; 52(5):381-6. · 3.22 Impact Factor
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Renzhe Cui,
Takeshi Tanigawa,
Susumu Sakurai,
Kazumasa Yamagishi,
Isao Muraki, Hironori Imano,
Tetsuya Ohira,
Masahiko Kiyama,
Akihiko Kitamura,
Yoshinori Ishikawa,
Hiroyasu Iso
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ABSTRACT: The associations between alcohol consumption and sleep-disordered breathing in women are uncertain.
We conducted a cross-sectional study of 3113 women aged 30-69 years. The 3% oxygen desaturation index (3% ODI), based on overnight pulse oximetry findings, was selected as an indicator of sleep-disordered breathing.
3% ODI frequencies of ≥5 were higher for drinking women with ethanol intakes of ≥23.0 g/d than for never drinkers: the respective multivariable odds ratios and 95% confidence intervals was 1.8(1.0-3.4). The corresponding odds ratio was 3.0(1.6-5.8) for habitual snoring. The associations of ethanol intakes of ≥23.0 g/d with 3% ODI ≥ 5 was more evident among women with BMI <23.0 kg/m(2) (median) than those with higher BMI but did not vary by habitual snoring. The multivariable odds ratios of 3%ODI ≥ 5 for women with ethanol intakes of ≥23.0 g/d versus never drinkers were 2.7(1.0-6.7) for lower BMI and 1.5(0.6-3.3) for higher BMI and the corresponding odds ratio were 2.8(1.6-7.2) and 3.2(1.3-7.9) for habitual snoring, respectively.
Alcohol consumption was associated with higher prevalence of sleep-disordered breathing among Japanese women.
Respiratory medicine 01/2011; 105(5):796-800. · 2.33 Impact Factor
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Mako Nagayoshi,
Kazumasa Yamagishi,
Takeshi Tanigawa,
Susumu Sakurai,
Akihiko Kitamura,
Masahiko Kiyama, Hironori Imano,
Tetsuya Ohira,
Shinichi Sato,
Tomoko Sankai,
Hiroyasu Iso
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ABSTRACT: This study seeks to examine risk factors for snoring, a major symptom of sleep-disordered breathing (SDB) because the evidence is limited in Asian populations.
Subjects for the present cross-sectional study were 3,138 men and 5,345 women aged 35–79 years from three communities in Japan who participated in the Circulatory Risk in Communities Study. The data on snoring frequency and cardiovascular health were obtained during annual cardiovascular surveys between 2000 and 2005. The logistic regression model was used to estimate the odds ratios (ORs) for snoring associated with body mass index (BMI), alcohol consumption, and other cardiovascular risk factors.
The prevalence of almost everyday snoring was 24% among men and 10% among women. After adjustments for age, community, cigarette smoking, alcohol consumption, and for women, menopausal status, the multivariable-adjusted ORs for everyday snoring in the highest versus lowest quartiles of BMI categories were 3.4 (95% confidence interval (CI): 2.6–4.4) for men and 3.9 (2.8–5.4) for women. The respective ORs in ≥23 g ethanol per day versus never-drinkers categories were 1.4 (1.1–1.8) and 3.1 (1.8–5.3) and those in ≥20 cigarettes versus never-smokers categories were 1.4 (1.0–1.8) and 1.9 (0.9–3.7). The associations of alcohol consumption and cigarette smoking with everyday snoring were stronger for BMI<25 kg/m2 than BMI≥25 kg/m2 in both sexes.
BMI, alcohol consumption, and cigarette smoking were positively associated with habitual snoring for both men and women, especially in nonoverweight persons.
Sleep And Breathing 01/2011; 15(1):63-9. · 1.84 Impact Factor
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Isao Muraki,
Takeshi Tanigawa,
Kazumasa Yamagishi,
Susumu Sakurai,
Tetsuya Ohira, Hironori Imano,
Akihiko Kitamura,
Masahiko Kiyama,
Shinichi Sato,
Takashi Shimamoto,
Masamitsu Konishi,
Hiroyasu Iso
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ABSTRACT: There are conflicting results for the association between obstructive sleep apnoea and raised C reactive protein (CRP) levels. A study was undertaken to investigate whether nocturnal intermittent hypoxia, a surrogate marker for obstructive sleep apnoea, was associated with CRP levels among a community-dwelling Japanese population.
Among participants in the Circulatory Risk in Communities Study (CIRCS), 1422 male and 2466 female community residents aged 40-69 years were tested during sleep. No nocturnal intermittent hypoxia, mild nocturnal intermittent hypoxia and moderate to severe nocturnal intermittent hypoxia were defined using 3% oxygen desaturation index cut-off points at 5 and 15 events/h, respectively. High-sensitivity CRP levels were measured using a latex particle-enhanced immunonephelometric assay. Multivariate analysis was adjusted for age, sex, body mass index, smoking status, current alcohol intake, hypertension, hypercholesterolaemia, diabetes mellitus and menopausal status for women.
Multivariable-adjusted mean CRP levels among men were 0.70 mg/l (95% CI 0.65 to 0.75) for no nocturnal intermittent hypoxia, 0.82 mg/l (95% CI 0.74 to 0.89) for mild nocturnal intermittent hypoxia and 0.84 mg/l (95% CI 0.70 to 1.00) for moderate to severe nocturnal intermittent hypoxia (p for trend=0.03). The values for women were 0.59 mg/l (95% CI 0.57 to 0.62), 0.66 mg/l (95% CI 0.59 to 0.73) and 0.82 mg/l (95% CI 0.62 to 1.03), respectively (p for trend=0.008). Compared with no nocturnal intermittent hypoxia, the prevalence of a high CRP level (>or=1.0 mg/l) was 1.4-1.7-fold higher for mild to severe nocturnal intermittent hypoxia in both sexes.
Nocturnal intermittent hypoxia is associated with raised serum CRP levels among middle-aged Japanese subjects.
Thorax 06/2010; 65(6):523-7. · 6.84 Impact Factor
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Isao Muraki,
Takeshi Tanigawa,
Kazumasa Yamagishi,
Susumu Sakurai,
Tetsuya Ohira, Hironori Imano,
Masahiko Kiyama,
Akihiko Kitamura,
Shinichi Sato,
Takashi Shimamoto,
Masamitsu Konishi,
Hiroyasu Iso
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ABSTRACT: We investigated whether nocturnal intermittent hypoxia, a surrogate marker for obstructive sleep apnea, is associated with metabolic syndrome and its components among Japanese.
We examined 1,710 male and 2,896 female community-dwelling Japanese aged 40 to 69, who participated in annual cardiovascular examinations and investigations of sleep. Nocturnal intermittent hypoxia was estimated based on a 3% oxygen desaturation index measured with pulse-oximetry during sleep. No, mild and moderate-to-severe nocturnal intermittent hypoxia were defined by <5, 5 to <15 and >or=15 events/hour, respectively. Metabolic syndrome was defined by modified criteria of the Adult Treatment Panel III guidelines.
Compared with no nocturnal intermittent hypoxia, the multivariable odds ratio of metabolic syndrome was 1.9 (95% confidence interval: 1.6-2.4) for mild and 3.2 (2.2-4.7) for moderate-to-severe nocturnal intermittent hypoxia among men; 2.6 (2.1-3.4) and 5.8 (3.4-9.8) among women, respectively. When stratified by overweight status (body mass index >or=25 kg/m(2)), the multivariable odds ratio of two or more metabolic risk factors (other than overweight) associated with moderate-to-severe nocturnal intermittent hypoxia was 1.9 (1.2-3.1) among non-overweight subjects and 1.4 (0.9-2.1) among overweight subjects (p for interaction=0.002).
Nocturnal intermittent hypoxia was associated with the accumulation of metabolic risk factors, especially among non-overweight individuals.
Journal of atherosclerosis and thrombosis 04/2010; 17(4):369-77. · 2.69 Impact Factor
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Yuji Shimizu, Hironori Imano,
Tetsuya Ohira,
Akihiko Kitamura,
Masahiko Kiyama,
Takeo Okada,
Shinichi Sato,
Takashi Shimamoto,
Kazumasa Yamagishi,
Takeshi Tanigawa,
Hiroyasu Iso
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ABSTRACT: Although serum gamma-glutamyltranspeptidase (GGT) levels have been associated with cardiovascular disease incidence, few studies have taken into account the effect of alcohol intake on GGT levels. In this study, we examined the relationship between GGT and stroke incidence according to drinking status.
We conducted a prospective cohort study of Japanese women (N=6281) and men (N=3471) aged 40 to 69 years living in communities under systematic surveillance for stroke incidence.
During the 18-year follow-up, 202 (3.2%) women and 230 (6.6%) men had strokes. Serum GGT levels were positively associated with risk of total stroke for women but not men. The multivariable hazard ratios of total stroke for the highest quartile of GGT compared with the lowest quartile were 1.56 (95% CI, 1.01 to 2.39) for women and 1.37 (95% CI, 0.89 to 2.11) for men. Moreover, GGT was associated with total and ischemic stroke risks for never-drinking women.
Serum GGT is associated with risk of total and ischemic strokes for Japanese women, especially never-drinkers.
Stroke 02/2010; 41(2):385-8. · 5.73 Impact Factor
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ABSTRACT: Aging and postmenopausal women are associated with increased risks of cardiovascular disease; however, epidemiological evidence concerning the relationship of aging and the menopause with vascular biological activity is limited.
We investigated the relationship of aging and the menopause with urinary excretion of cyclic guanosine 3',5' monophosphate (cGMP) in 1,541 Japanese men and women aged 40 to 79 years. The 24-hour urinary excretion of cGMP was measured with a (125)I-labeled cGMP radioimmunoassay and was adjusted for urinary creatinine excretion (nmol/mmol creatinine).Results: Aging was positively associated with urinary excretion of cGMP for both sexes. Postmenopausal women excreted significantly less urinary cGMP than premenopausal women after adjustment for age and other cardiovascular risk factors: 48.3+/-0.04 nmol/mmol vs. 61.5+/-0.07 nmol/mmol, p=0.006.
Our data suggest that cGMP-related vasodilatation is impaired in postmenopausal women.
Journal of atherosclerosis and thrombosis 09/2009; 16(4):457-62. · 2.69 Impact Factor
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ABSTRACT: An inverse association between protein intake and blood pressure has been reported in Western countries. However, the evidence is limited for Asians, whose protein sources are different from those in Western populations.
The objective was to examine the association between protein intake and blood pressure in Japanese adults. Methods: We conducted a population-based, cross-sectional study of 7585 subjects (3499 men and 4086 women) from 40 to 69 y of age living in 5 communities in Japan. Dietary intakes of total, animal, and plant protein were estimated by a single 24-h dietary recall. We then examined the associations between dietary intake of those proteins and blood pressure after adjustment for age, sex, community, body mass index, antihypertensive medication use, ethanol intake, smoking, and dietary intakes of sodium, potassium, and calcium.
After adjustment for cardiovascular disease risk factors, a 25.5-g/d increment in total protein intake was associated with a decrease in systolic blood pressure of 1.14 mm Hg (P < 0.001) and in diastolic blood pressure of 0.65 mm Hg (P < 0.001), and a 19.9-g/d increment in animal protein intake was associated with a decrease in systolic blood pressure of 1.09 mm Hg (P < 0.001) and in diastolic blood pressure of 0.41 mm Hg (P = 0.003). A 13.1-g/d increment in plant protein intake was associated with a decrease in diastolic blood pressure of 0.57 mm Hg (P < 0.001). Further adjustment for nutritional factors weakened these associations, but the inverse associations of total protein intake with diastolic blood pressure and of animal protein intake with systolic blood pressure remained statistically significant.
Total and animal protein intakes were inversely associated with blood pressure in Japanese adults.
American Journal of Clinical Nutrition 06/2009; 90(2):377-84. · 6.67 Impact Factor
