Takayoshi Ohkubo

Teikyo University, Edo, Tōkyō, Japan

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Publications (474)2663.26 Total impact

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    ABSTRACT: Pulse wave velocity (PWV) is a simple and valid clinical method for assessing arterial stiffness. Coronary artery calcification (CAC) is an intermediate stage in the process leading to overt cardiovascular disease (CVD) and an established determinant of coro nary artery disease. This study aimed to examine the association between PWV and CAC in a population-based sample of Japanese men. This is a cross-sectional study of 986 randomly selected men aged 40-79 years from Shiga, Japan. CVD-free participants were examined from 2006 to 2008. Brachial-ankle PWV (baPWV) was measured using an automatic waveform analyzer. CAC was assessed using computed tomography. Agatston scores ≥ 10 were defined as the presence of CAC. Prevalence of CAC progressively increased with rising levels of baPWV: 20.6%, 41.7%, 56.3%, and 66.7% across baPWV quartiles <1378, 1378-1563, 1564-1849, and >1849 cm/s (P< 0.001 for trend). Associations remained significant after adjusting for age and other factors, including body mass index, systolic blood pressure, pulse rate, total and high-density lipoprotein cholesterol, hemoglobin A1c, drinking, smoking and exercise status, and the use of medication to treat hypertension, dyslipidemia and diabetes (P=0.042 for trend). The optimal cutoff level of baPWV to detect CAC was 1612 cm/s using receiver operating characteristic curve analysis. Arterial stiffness as defined by an elevated baPWV is associated with an increased prevalence of CAC in a general population-based setting among Japanese men.
    Journal of atherosclerosis and thrombosis 08/2015; DOI:10.5551/jat.30247 · 2.77 Impact Factor
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    ABSTRACT: To generate outcome-driven thresholds for home blood pressure (BP) in the elderly, we analyzed 375 octogenarians (60.3% women; 83.0 years [mean]) enrolled in the International Database on home BP in relation to cardiovascular outcome. Over 5.5 years (median), 155 participants died, 76 from cardiovascular causes, whereas 104, 55, 36, and 51 experienced a cardiovascular, cardiac, coronary, or cerebrovascular event, respectively. In 202 untreated participants, home diastolic in the lowest fifth of the distribution (≤65.1 mm Hg) compared with the multivariable-adjusted average risk was associated with increased risk of cardiovascular mortality and morbidity (hazard ratios [HRs], ≥1.96; P≤0.022), whereas the HR for cardiovascular mortality in the top fifth (≥82.0 mm Hg) was 0.37 (P=0.034). Among 173 participants treated for hypertension, the HR for total mortality in the lowest fifth of systolic home BP (<126.9 mm Hg) was 2.09 (P=0.020). In further analyses of home BP as continuous variable (per 1-SD increment), higher diastolic BP predicted lower cardiovascular mortality and morbidity and cardiac and coronary risk (HR≤0.65; P≤0.039) in untreated participants. In those treated, cardiovascular morbidity was curvilinearly associated with systolic home BP with nadir at 148.6 mm Hg and with a 1.45 HR (P=0.046) for a 1-SD decrease below this threshold. In conclusion, in untreated octogenarians, systolic home BP ≥152.4 and diastolic BP ≤65.1 mm Hg entails increased cardiovascular risk, whereas diastolic home BP ≥82 mm Hg minimizes risk. In those treated, systolic home BP <126.9 mm Hg was associated with increased total mortality with lowest risk at 148.6 mm Hg.
    Hypertension 07/2015; DOI:10.1161/HYPERTENSIONAHA.115.05800 · 7.63 Impact Factor
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    ABSTRACT: The prevalence of overweight (body mass index (BMI)=25.0-29.9 kg m(-)(2)) and obesity (⩾30.0 kg m(-)(2)) has been increasing over the last several decades in Japan. We examined trends of the impact of overweight and obesity on hypertension (systolic/diastolic blood pressure ⩾140/90 mm Hg or antihypertensive drugs use) using four national surveys in Japan, from which the participants were randomly sampled from the entire population. Study participants aged 30-79 years were selected for each survey (10 370 in 1980, 8005 in 1990, 5327 in 2000 and 2547 in 2010). The results showed that the impact of overweight and obesity on hypertension had increased significantly (P=0.040 and 0.006 in men and women, respectively). From 1980 to 2010, the multivariable-adjusted odds ratios for hypertension, comparing overweight and obesity with normal weight (BMI =18.5-24.9 kg m(-)(2)), went from 1.94 (95% confidence intervals: 1.64, 2.28) to 2.82 (2.07, 3.83) in men, and from 2.37 (2.05, 2.73) to 3.48 (2.57, 4.72) in women. Most of the association was observed in overweight participants, as only 3% of the Japanese were obese. In addition to the relationship between excessive BMI and other adverse health conditions, the rise in the association with hypertension increases the urgency in addressing weight control. We need to address the overweight and obesity epidemic.Hypertension Research advance online publication, 16 July 2015; doi:10.1038/hr.2015.81.
    Hypertension Research 07/2015; DOI:10.1038/hr.2015.81 · 2.94 Impact Factor
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    ABSTRACT: We previously demonstrated validation of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Diabetes Mellitus (ICF-CS for DM) in patients with diabetic nephropathy (DMN). The objective of the present study was to identify differences in experience of physical and psychosocial problems between DMN patients with and without hemodialysis (HD), and diabetes patients without nephropathy using the ICF-CS for DM. A total of 302 diabetes outpatients (men, 68 %; mean age, 62 years) were interviewed using four components of the ICF-CS for DM including "Body functions", "Body structures", "Activities and participation", and "Environmental factors". The mean number of categories in which difficulty was experienced in the four components was significantly greater in DMN patients with HD followed by DMN patients without HD, and diabetes patients without nephropathy (23.9 vs. 18.0 vs. 13.1, respectively). Multivariate logistic regression models revealed that, compared with diabetes patients without nephropathy, diabetes patients with nephropathy were more likely to have difficulty with physical problems and social activities and participation. Among DMN patients, dialysis patients were found to have larger numbers of problems, and face difficulty with employment status after adjusting for sex, age, type, and duration of diabetes. The results of this study using the ICF-CS for DM identified the areas for improvement among physical and psychosocial problems in DMN patients with and without HD in contrast to diabetes patients without nephropathy.
    Clinical and Experimental Nephrology 07/2015; DOI:10.1007/s10157-015-1143-x · 1.71 Impact Factor
  • Journal of Hypertension 07/2015; 33(7):1492-3. DOI:10.1097/HJH.0000000000000608 · 4.22 Impact Factor
  • Atherosclerosis 07/2015; 241(1):e130. DOI:10.1016/j.atherosclerosis.2015.04.450 · 3.97 Impact Factor
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    ABSTRACT: Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
    The Lancet 06/2015; 386(9995):743–800. DOI:10.1016/S0140-6736(15)60692-4 · 45.22 Impact Factor
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    ABSTRACT: We aimed to evaluate the hypotensive effect and the time to attain the maximal antihypertensive effect (stabilization time) of 8 mg candesartan/6.25 mg hydrochlorothiazide (HCTZ) combination therapy (combination regimen) and therapy with an increased candesartan dose (12 mg; maximum dose regimen) using home blood pressure (BP) measurements. A prospective, multicenter, open-label, randomized, comparative trial was conducted. Essential hypertensive patients who failed to achieve adequate BP control (systolic BP (SBP) ⩽135 mm Hg) on 8 mg candesartan alone were randomized to two groups: the combination regimen (n=103) and the maximum dose regimen (n=103). Home morning SBP reduction at 8 weeks after randomization was 11.4±1.3 mm Hg in the combination regimen and 7.8±1.2 mm Hg in the maximum dose regimen. The combination regimen provided additional reduction of 4.0 mm Hg (95% confidence interval (CI): 0.8-7.2 mm Hg, P=0.01) in home morning SBP over the maximum dose regimen at 8 weeks after randomization. The maximal antihypertensive effect and stabilization time for home SBP were 9.4 mm Hg and 37.1 days (P<0.0001), respectively, with the combination regimen. The maximum dose regimen decreased home SBP with a very gentle slope, and estimated maximal effect and estimated stabilization time were not significant (P>0.2). The rate of achieving target BP (home morning SBP <135 mm Hg) was significantly higher with the combination regimen than with the maximum dose regimen (52.4 vs. 30.1%, P=0.002). In conclusion, changing from 8 mg candesartan to combination therapy was more effective in reducing home SBP and achieving goal BP more rapidly than increasing the candesartan dose.Hypertension Research advance online publication, 4 June 2015; doi:10.1038/hr.2015.64.
    Hypertension Research 06/2015; DOI:10.1038/hr.2015.64 · 2.94 Impact Factor
  • Article: 7A.01
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    ABSTRACT: The association between obesity and all-cause mortality is controversial and may differ according to subjects' characteristics. Blood pressure variability (BPV) may be increased in obese individuals and thus impair prognosis. The purpose of this study was to evaluate whether the relationship between obesity and mortality is influenced by short-term ambulatory BPV. The analysis was performed in 8724 participants (54% men) aged 51 ± 15 years enrolled in 8 prospective studies in Australia, Italy, Japan, and U.S.A. The predictive power of obesity (BMI >=30 kg/m2) for mortality was evaluated from multivariable Cox models in the subjects stratified by high or low nocturnal BPV (above or below the median). Obese participants (N = 1286) had higher age-and-sex adjusted systolic and diastolic BPV than the non-obese participants (p = 0.002/<0.001). Obese subjects with high systolic or diastolic BPV had higher nocturnal heart rate (p = 0.01/<0.001) than obese subjects with low BPV and were more frequently diabetic (p<0.001) and heavy alcohol drinkers (p < 0.001). During a median follow-up of 6.4 years there were 361 deaths, 4.7% in the obese and 4.0% in the non-obese individuals (P = NS). However, the risk of mortality among the obese subjects greatly differed according to BPV level. In Cox models including age, sex, mean ambulatory BP, smoking, alcohol use, diabetes, cholesterol, creatinine, and nocturnal heart rate, the obese group with high systolic BPV had a doubled risk of mortality compared to the non-obese group (HR,2.0, 95%CI,1.4-2.9, p < 0.001), whereas the risk was not increased in the obese group with low BPV (P = 0.81). Similar results were found for diastolic BPV, with a HR of 1.7 (1.2-2.5, p = 0.002) in the high BPV group and no association at all with mortality (p = 0.87) in the low BPV group. Inclusion of night-time BP dipping in the regressions did not change the strength of the associations. These data show that high nocturnal BPV greatly increases the risk of mortality related to obesity. High BPV is accompanied by increased heart rate and may reflect the influence of transient BP elevations related to sleep apnea and/or baroreflex dysfunction.
    Journal of Hypertension 06/2015; 33 Suppl 1 - ESH 2015 Abstract Book:e89. DOI:10.1097/01.hjh.0000467588.04230.c3 · 4.22 Impact Factor
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    Dataset: pgs.13
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    ABSTRACT: Women who had hypertensive disorders in pregnancy have an increased risk of cardiovascular diseases in later life. No studies, however, have investigated whether maternal hypertensive disorders in pregnancy affect self-measured blood pressure at home (HBP) in mothers and their children. We evaluated the association between maternal hypertension during pregnancy and HBP based on the prospective Tohoku Study of Child Development birth cohort study, which was performed in two areas in Japan. We included children in a singleton birth at term (36-42 weeks of gestation) with a birth weight of >2400 g. We collected prenatal care data from the medical charts. Because only two mothers experienced preeclampsia, we defined gestational hypertension (GH) as a hypertensive disorder in pregnancy. Seven years after birth, mothers and their children measured their HBP in the morning for 2 weeks. Of 813 eligible mothers, 28 (3.4%) experienced GH, and those were of a similar age compared with 785 non-GH mothers (37.3 vs. 38.0 years; P=0.41). Women with GH had higher body mass index (BMI) (23.8 vs. 21.4 kg m(-)(2); P=0.01) and elevated HBP (120.3/76.8 vs. 110.4/68.6 mm Hg; P<0.0002) 7 years after delivery. However, HBP was similar in children with and without GH mothers (93.5/55.9 vs. 94.1/56.1 mm Hg, P>0.38). These results were confirmatory in case-control (1:2) analyses with matching by maternal age, maternal BMI before pregnancy, survey area and parity. In conclusion, maternal GH did not affect HBP in offspring but strongly affected maternal HBP even 7 years after birth.Hypertension Research advance online publication, 14 May 2015; doi:10.1038/hr.2015.63.
    Hypertension Research 05/2015; DOI:10.1038/hr.2015.63 · 2.94 Impact Factor
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    ABSTRACT: The objective of this study was to investigate physicians' awareness and use of the Japanese Society of Hypertension (JSH) Guidelines for the Management of Hypertension (JSH2004 and JSH2009), and determine what changes need to be implemented in the future. A questionnaire was used to survey physicians' awareness and their use of JSH2004 and JSH2009. Physicians attending educational seminars on hypertension that were held during the months after the publication of JSH2009 (January-April 2009) were asked to participate in the survey. Of the 5795 respondents, 88% were aware of the JSH2009 publication. Furthermore, physicians were also aware of JSH2004, with about 90% using JSH2004 in their practice. A hypertension blood pressure (BP) reference value of 140/90 mm Hg was used by 55% in office BP, whereas 31% used 135/85 mm Hg for home BP. Target BP levels used by physicians were 130/80 mm Hg for patients with diabetes or kidney disease (52%) and for elderly patients with diabetes or kidney disease (45%), whereas 140/90 mm Hg was used for elderly patients with low cardiovascular disease risk (44%) and for patients with chronic-phase stroke (27%). Answers to the questionnaire varied among physicians according to sex, age, workplace and specialty. The majority of the participating Japanese physicians were familiar with both JSH2004 and JSH2009, with many following the guidelines in their practice. However, some physicians use different reference values for hypertension and target BP levels. Physicians' adherence to and use of the guidelines should be regularly examined and promoted.Hypertension Research advance online publication, 2 April 2015; doi:10.1038/hr.2015.21.
    Hypertension Research 04/2015; 38(6). DOI:10.1038/hr.2015.21 · 2.94 Impact Factor
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    ABSTRACT: Rapid increases in life expectancy have led to concurrent increases in the number of elderly people living alone or those forced to change living situations. Previous studies have found that poor dietary intake was common in elderly people living alone. However, there have been few studies about the dietary intake in elderly people living in other situations, particularly those living with family other than a spouse (nonspouse family), which is common in Japan. To examine the differences in dietary intake by different living situations in elderly Japanese people. We analyzed the data of 1542 healthy residents in the town of Ohasama aged 60 years and over who had completed self-administered questionnaires. The dietary intake was measured using a validated 141-item food frequency questionnaire. Multiple regression models with robust (White-corrected) standard errors were individually fitted for nutrients and foods by living situation. In men, although the presence of other family was correlated with significantly lower intake of protein-related foods, e.g., legumes, fish and shellfish, and dairy products, these declines were more serious in men living with nonspouse family. Conversely, in men living alone the intake of fruits and vegetables was significantly lower. In women, lower intakes of fruit and protein-related foods were significantly more common in participants living with nonspouse family than those living with only a spouse. These findings revealed that elderly people living alone as well as those living with family other than a spouse had poor dietary intake, suggesting that strategies to improve food choices and skills for food preparation could promote of healthy eating in elderly Japanese people.
    The Journal of Nutrition Health and Aging 04/2015; 19(4). DOI:10.1007/s12603-015-0456-5 · 2.66 Impact Factor
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    ABSTRACT: In addition to day-to-day variability in blood pressure (BP) or heart rate (HR), N-terminal pro B-type natriuretic peptide (NT-proBNP) has been reported to be a predictor of cardiovascular disease. Here, we tested the hypothesis that day-to-day BP or HR variability calculated as the intraindividual standard deviation (SD) of home BP or HR is associated with elevated NT-proBNP in a cross-sectional study. Among 664 participants (mean age, 61.9 years; female, 70.5%) from a general Japanese population without a history of heart disease, 86 (13.0%) had NT-proBNP at least 125 pg/ml. Each 1 SD increase in the SD of home systolic BP (SBP) [odds ratio (OR), 1.82; P < .0001) and in the SD of home HR (OR, 1.44; P = 0.008) were significantly associated with the prevalence of NT-proBNP at least 125 pg/ml after adjustment for possible confounding factors including home SBP and HR. Among the four groups defined by the median SD of home SBP and of home HR, the group with higher SDs in home SBP (≥8.0 mmHg) and HR (≥5.0 bpm) had the greatest OR for the prevalence of NT-proBNP at least 125 pg/ml (OR, 4.80; P = 0007 vs. a reference group with lower SDs of home SBP and HR). These results suggest that day-to-day variability in BP and HR may be associated with target-organ damage or complications, which can lead to an elevated NT-proBNP level. An elevated NT-proBNP level may be involved in the prognostic significance of day-to-day variability in BP or HR.
    Journal of Hypertension 03/2015; 33(8). DOI:10.1097/HJH.0000000000000570 · 4.22 Impact Factor
  • International Journal of Cardiology 02/2015; 184C:291-293. DOI:10.1016/j.ijcard.2015.02.028 · 6.18 Impact Factor
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    ABSTRACT: The association of high-density lipoprotein particle (HDL-P) with atherosclerosis may be stronger than that of HDL-cholesterol (HDL-C) and independent of conventional cardiovascular risk factors. Whether associations persist in populations at low risk of coronary heart disease (CHD) remains unclear. This study examines the associations of HDL-P and HDL-C with carotid intima-media thickness (cIMT) and plaque counts among Japanese men, who characteristically have higher HDL-C levels and a lower CHD burden than those in men of Western populations. We cross-sectionally examined a community-based sample of 870 Japanese men aged 40-79 years, free of known clinical cardiovascular disease (CVD) and not on lipid-lowering medication. Participants were randomly selected among Japanese living in Kusatsu City in Shiga, Japan. Both HDL-P and HDL-C were inversely and independently associated with cIMT in models adjusted for conventional CHD risk factors, including low-density lipoprotein cholesterol (LDL-C) and diabetes. HDL-P maintained an association with cIMT after further adjustment for HDL-C (P < 0.01), whereas the association of HDL-C with cIMT was noticeably absent after inclusion of HDL-P in the model. In plaque counts of the carotid arteries, HDL-P was significantly associated with a reduction in plaque count, whereas HDL-C was not. HDL-P, in comparison to HDL-C, is more strongly associated with measures of carotid atherosclerosis in a cross-sectional study of Japanese men. Findings demonstrate that, HDL-P is a strong correlate of subclinical atherosclerosis even in a population at low risk for CHD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Atherosclerosis 01/2015; 239(2):444-450. DOI:10.1016/j.atherosclerosis.2015.01.031 · 3.97 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: Background/Objectives:There have been few studies on the association of fruit and vegetable (FV) intake with cardiovascular disease (CVD) risk in Asian populations where both dietary habits and disease structure are different from western countries. No study in Asia has found its significant association with stroke. We examined associations of FV intake with mortality risk from total CVD, stroke and coronary heart diseases (CHDs) in a representative Japanese sample.Methods:A total of 9112 participants aged from 24-year follow-up data in the NIPPON DATA80, of which baseline data were obtained in the National Nutrition Survey Japan in 1980, were studied. Dietary data were obtained from 3-day weighing dietary records. Participants were divided into sex-specific quartiles of energy adjusted intake of FV. Multivariate-adjusted hazard ratios (HRs) were calculated between strata of the total of FV intake, fruit intake and vegetable intake. The adjustment included age, sex, smoking, drinking habit and energy adjusted intakes of sodium and some other food groups.Results:Participants with higher FV intake were older, ate more fish, milk and dairy products and soybeans and legumes and ate less meat. Multivariate-adjusted HR (95% confidence interval; P; P for trend) for the highest versus the lowest quartile of the total of FV intake was 0.74 (0.61-0.91; 0.004; 0.003) for total CVD, 0.80 (0.59-1.09; 0.105; 0.036) for stroke and 0.57 (0.37-0.87; 0.010; 0.109) for CHD.Conclusions:The results showed that higher total intake of FVs was significantly associated with reduced risk of CVD mortality in Japan.European Journal of Clinical Nutrition advance online publication, 14 January 2015; doi:10.1038/ejcn.2014.276.
    European Journal of Clinical Nutrition 01/2015; 69(4). DOI:10.1038/ejcn.2014.276 · 2.95 Impact Factor
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    ABSTRACT: On March 11, 2011, the Great East Japan Earthquake hit northeast Japan. Previous letter on Hypertension by Sato et al reported that 11.6/3.9mmHg for systolic/diastolic blood pressure (BP) and 4.7bpm for heart rate (HR) elevations were observed by home BP measurement among hypertensive outpatients aged 68.1±8.8 years. In this study we observed home BP change before and after the earthquake among pregnant women. We used database from the BOSHI study which participated pregnant women from October 2006 to September 2011 at a maternity hospital In Miyagi Prefecture, Japan. The participants were asked to measure their own BPs every morning at home while they were pregnant. A linear mixed model was used for analysis of the BP course throughout pregnancy. Total 1137 pregnant woman was included into the analysis. Of those, 210 pregnant women were participated before the earthquake and gave birth after the earthquake. Of those, 133 women measured their BP in March 2011. The average number of home BP measurements was 13.8 in March 2011. Home BP and HR which are not measured in March 2011 were 105.9(105.4-106.4)/63.2(62.8-63.6)mmHg and 74.3(73.9-74.7)bpm, respectively. Home BP and HR were 105.0(103.5-106.4)/64.1(62.8-65.3)mmHg, 73.8(71.8-81.8)bpm in the morning at March 11, 2011 (just before the earthquake), and 110.7(104.8-116.6)/63.6(58.4-68.8)mmHg, 76.3(70.2-82.5)bpm in the morning at March 12, 2011 (just after the earthquake), respectively. Home BP was immediately elevated just after the earthquake and gradually decreased over a month as we previously reported among hypertensive patients. Because we only analyzed BP who could keep their equipment, the BP change just after the earthquake might be underestimated. H. Metoki: Research Support Recipient; Commercial Interest: Omron Healthcare. N. Iwama: None. Z. Watanabe: None. T. Ohkubo: None. M. Ishikuro: None. T. Obara: None. M. Kikuya: None. J. Sugawara: None. S. Kuriyama: None. K. Itoh: None. K. Hoshi: None. M. Suzuki: None. M. Satoh: None. N. Yaegashi: None. Y. Imai: None. Copyright © 2014.
    Pregnancy hypertension; 01/2015
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    ABSTRACT: In 2009, we developed a "100-category checklist" for patients undergoing hemodialysis (HD) based on the International Classification of Functioning, Disability and Health, and we confirmed its validity. However, we found that for patients' daily assessment, 100 categories were too many. The purpose of the present study was to develop and validate a short version of the "100-category checklist." A total of 100 outpatients undergoing HD were recruited. They were interviewed using the "100-category checklist" and asked whether they had experienced problems after starting HD. From the "100-category checklist," we extracted categories that had greater than a 50 % rate of "yes" responses. Content validity was evaluated using the frequency of patients who had a problem in each category. Criterion validity was evaluated based on the correlation of the score from the "short-version checklist" categories with that from the Kidney Disease Quality of Life (KDQOL™) questionnaire. Construct validity was evaluated using Spearman correlation coefficients between the number of problem categories and the presence of HD-related complications. Cronbach's coefficient alpha was calculated to evaluate internal consistency. Twenty-two categories were identified as problem categories. Criterion validity showed that 12 categories were significantly correlated with subscales of the KDQOL™. Construct validity showed that the presence of complications contributed to an increased number of problems associated with HD. Cronbach's coefficient alpha of this checklist was 0.79. The "short-version checklist" had a certain degree of validity, suggesting its usefulness in a simplified assessment of patients undergoing HD.
    Clinical and Experimental Nephrology 12/2014; DOI:10.1007/s10157-014-1075-x · 1.71 Impact Factor

Publication Stats

11k Citations
2,663.26 Total Impact Points


  • 2013–2015
    • Teikyo University
      • • Department of Hygiene and Public Health
      • • Department of Medicine
      Edo, Tōkyō, Japan
    • Teikyo University Hospital
      Edo, Tōkyō, Japan
  • 2006–2015
    • Shiga University of Medical Science
      • Department of Health Science
      Ōtu, Shiga Prefecture, Japan
  • 2014
    • University of Queensland
      • School of Population Health
      Brisbane, Queensland, Australia
    • University of Shizuoka
      • Department of Clinical Pharmacology and Genetics
      Sizuoka, Shizuoka, Japan
  • 1999–2014
    • Tohoku University
      • • Graduate School of Pharmaceutical Sciences
      • • Department of Medical Genetics
  • 2012
    • Shiga University
    • Brighton and Sussex Medical School
      Brighton, England, United Kingdom
  • 2010
    • National Institute of Health and Nutrition
      Edo, Tōkyō, Japan
  • 2009
    • Universidad de Montevideo
      Ciudad de Montevideo, Montevideo, Uruguay
    • Copenhagen University Hospital Hvidovre
      Hvidovre, Capital Region, Denmark
  • 2008
    • Maastricht University
      • Department of Epidemiology
      Maastricht, Provincie Limburg, Netherlands
  • 2007
    • Yonsei University
      Sŏul, Seoul, South Korea
  • 2005
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
  • 2000
    • Osaka University
      Suika, Ōsaka, Japan