Details of a Researcher - Okamura, Tomonori

Papers - Okamura, Tomonori

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[NIPPON DATA (National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged)].

Okamura T

Nihon rinsho. Japanese journal of clinical medicine 74 Suppl 4 Pt 1 685 - 90 2016.06

Research paper (scientific journal), ISSN 0047-1852

[NIPPON DATA (National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged)].

Okamura T

Nihon rinsho. Japanese journal of clinical medicine 74 Suppl 4 Pt 1 685 - 90 2016.06

Research paper (scientific journal), ISSN 0047-1852

Independent prognostic value of single and multiple non-specific 12-lead electrocardiographic findings for long-term cardiovascular outcomes

Sawano Mitsuaki, Kohsaka Shun, Okamura Tomonori, Inohara Taku, Sugiyama Daisuke, Shiraishi Yasuyuki, Watanabe Makoto, Nakamura Yasuyuki, Higashiyama Aya, Kadota Aya, Okuda Nagako, Murakami Yoshitaka, Ohkubo Takayoshi, Fujiyoshi Akira, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu

PLoS One 11 ( 6 ) e0157563 2016.06

Research paper (scientific journal), ISSN 1932-6203

Aims The long-term prognostic effect of non-specific 12-lead electrocardiogram findings is unknown. We aimed to evaluate the cumulative prognostic impact of axial, structural, and repolarization categorical abnormalities on cardiovascular death, independent from traditional risk scoring systems such as the Framingham risk score and the NIPPON DATA80 risk chart. Methods and Results A total of 16,816 healthy men and women from two prospective, longitudinal cohort studies were evaluated. 3,794 (22.6%) individuals died during a median follow-up of 15 years (range, 2.0-24 years). Hazard ratios for cardiovascular death, all-cause death, coronary death and stroke death were calculated for the cumulative and independent axial, structural, and repolarization categorical abnormalities adjusted for the Framingham risk score and the NIPPON DATA80 risk chart. Individuals with two or more abnormal categories had a higher risk of cardiovascular death after adjustment for Framingham risk score (men: HR 4.27, 95%CI 3.35-5.45; women: HR 4.83, 95%CI 3.76-6.22) and NIPPON DATA80 risk chart (men: HR 2.39, 95%CI 1.87-3.07; women: HR 2.04, 95%CI 1.58-2.64). Conclusion Cumulative findings of axial, structural, and repolarization abnormalities are significant predictors of long-term cardiovascular death in asymptomatic, healthy individuals independent of traditional risk stratification systems.

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Cross-sectional association between exposure to particulate matter and inflammatory markers in the Japanese general population

Michikawa Takehiro, Okamura Tomonori, Nitta Hiroshi, Nishiwaki Yuji, Takebayashi Toru, Ueda Kayo, Kadota Aya, Fujiyoshi Akira, Ohkubo Takayoshi, Ueshima Hirotsugu, Okayama Akira, Miura Katsuyuki

Environmental Pollution 213 460 - 467 2016.06

Research paper (scientific journal), ISSN 0269-7491

A suggestive mechanism behind the association between particulate matter and cardiovascular disease is inflammatory response. Earlier population-based studies investigating the association between particulate matter and inflammatory biological markers, in particular C-reactive protein (CRP), showed inconsistent results. In addition, evidence from the Asian population, in which CRP levels are typically lower than those observed in Western populations, was sparse. We examined the cross-sectional association between short- and long-term exposure to particulate matter and inflammatory markers, including high-sensitivity CRP (hs-CRP) and white blood cell (WBC) count, in a representative population of Japanese community dwellers (NIPPON DATA2010). We analysed data from 2360 participants (1002 men and 1358 women), aged 20 years or older, who resided in 300 randomly selected districts (222 public health centre areas) throughout Japan. We used background concentrations of suspended particulate matter (SPM, defined as particles with a 100% cut-off level at 10 μm aerodynamic diameter) and co-pollutants within the public health centre area. A logistic regression model was applied to estimate odds ratios (ORs) of elevated hs-CRP (> 0.3 mg/dl) or WBC (> 9000/μl). Since smoking is an important confounding factor, we firstly included this in the models, and additionally conducted the analyses after excluding current smokers. The one-month average concentration of SPM was positively associated with hs-CRP (OR per 10 μg/m³ increase in SPM = 1.42, 95% confidence interval = 1.00-2.04), and high exposure to SPM on the day of blood draw was associated with increased WBC count, after excluding current smokers (OR = 1.13, 1.01-1.28). Similar association patterns were observed for ozone. In conclusion, exposure to particulate matter was associated with inflammatory markers in the general Japanese population. Systemic inflammation may play a role in the link between particulate matter and cardiovascular disease.

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Impact of Flushing Response on the Relationship between Alcohol Consumption and Gamma-glutamyl Transpeptidase: the KOBE study.

Hirata T, Higashiyama A, Kubota Y, Sugiyama D, Kuwabara K, Tatsumi Y, Hirata A, Nishida Y, Kadota A, Imano H, Nishikawa T, Miyamatsu N, Miyamoto Y, Okamura T

Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence 51 ( 3 ) 173 - 183 2016.06

Research paper (scientific journal), ISSN 1341-8963

Impact of Flushing Response on the Relationship between Alcohol Consumption and Gamma-glutamyl Transpeptidase: the KOBE study.

Hirata T, Higashiyama A, Kubota Y, Sugiyama D, Kuwabara K, Tatsumi Y, Hirata A, Nishida Y, Kadota A, Imano H, Nishikawa T, Miyamatsu N, Miyamoto Y, Okamura T

Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence 51 ( 3 ) 173 - 183 2016.06

Research paper (scientific journal), ISSN 1341-8963

Relationship between outpatient visit frequency and hypertension control

Shima Azusa, Tatsumi Yukako, Ishizaki Tatsuro, Godai Kayo, Kawatsu Yuichiro, Okamura Tomonori, Nishikawa Tomofumi, Morimoto Akiko, Morino Ayumi, Miyamatsu Naomi

Hypertension Research 39 ( 5 ) 376 - 381 2016.05

Research paper (scientific journal), ISSN 0916-9636

The purpose of this study was to investigate the relationship between the frequency of outpatient visits and hypertension control as determined from health insurance records. This 9-year cohort study in Japan was based on 518 participants with hypertension who underwent health checkups in 2004. Participants were aged 35-56 years and none had a history of cardiovascular or cerebrovascular disease. All were covered by the same employee health insurer. Mean annual outpatient visit days at a hospital/clinic during the 9-year period were classified within four quartiles (Q1, Q2, Q3, Q4). Uncontrolled hypertension was defined as a systolic blood pressure (BP) ≥140 mm Hg and a diastolic BP ≥90 mm Hg. Logistic regression analysis was used to estimate the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of uncontrolled hypertension in groups Q1, Q2 and Q3 vs. Q4. The median (25th-75th percentile) annual outpatient visit days was 9.4 (4.0-15.5). Uncontrolled hypertension was observed in 62.4% of the participants in 2013. The multivariable-adjusted ORs and 95% CIs for uncontrolled hypertension in Q1, Q2 and Q3 vs. Q4 were 4.03 (2.28-7.12), 1.67 (0.99-2.81) and 1.44 (0.86-2.41), respectively. Uncontrolled hypertension increased significantly as the number of outpatient visits decreased (P for trend

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Dietary tofu intake and long-term risk of death from stroke in a general population

Nguyen Ho N., Miyagawa Naoko, Miura Katsuyuki, Okuda Nagako, Yoshita Katsushi, Arai Yusuke, Nakagawa Hideaki, Sakata Kiyomi, Ojima Toshiyuki, Kadota Aya, Takashima Naoyuki, Fujiyoshi Akira, Ohkubo Takayoshi, Abbott Robert D., Okamura Tomonori, Okayama Akira, Ueshima Hirotsugu

Clinical Nutrition (Clinical Nutrition) 37 ( 1 ) 182 - 188 2016.04

Research paper (scientific journal), ISSN 0261-5614

Background & aim: Although dietary soy intake is linked with health benefits, a relation with stroke has not been established. The present study examined the association between the intake of tofu, the richest source of dietary soy, with stroke mortality in a general population cohort of Japanese men and women. Methods: Data comprise 9244 Japanese enrolled in the National Nutrition Survey of Japan in 1980. Participants were free of cardiovascular disease and followed for 24 years. Dietary intake was estimated from 3-day weighed food records. Multivariable Cox regression models were used to estimate hazard ratios across levels of tofu intake. Results: During follow-up, there were 417 deaths due to stroke (88 cerebral hemorrhage [CH], 245 cerebral infarction [CI], and 84 of other subtypes). Among all men, and in women aged 65 years or more, tofu intake was unrelated to each form of stroke. For young women (<65 years of age), a significantly lower risk of CH in the top versus bottom quartile of tofu intake was observed (Multivariable-adjusted HR = 0.26, 95% CI: 0.08-0.85). Conclusions: In this large prospective study with long follow-up of Japanese men and women, consumption of tofu was unrelated to the risk of stroke except for CH in women <65 years of age. Whether the association in younger women is real or due to chance alone warrants further study.

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Profiling of plasma metabolites in postmenopausal women with metabolic syndrome

Iida Miho, Harada Sei, Kurihara Ayako, Fukai Kota, Kuwabara Kazuyo, Sugiyama Daisuke, Takeuchi Ayano, Okamura Tomonori, Akiyama Miki, Nishiwaki Yuji, Suzuki Asako, Hirayama Akiyoshi, Sugimoto Masahiro, Soga Tomoyoshi, Tomita Masaru, Banno Kouji, Aoki Daisuke, Takebayashi Toru

Menopause 23 ( 7 ) 749 - 58 2016.04

Research paper (scientific journal), ISSN 1072-3714

OBJECTIVE:: The aim of the study was to investigate the associations of amino acids and other polar metabolites with metabolic syndrome (MetS) in postmenopausal women in a lean Asian population. METHODS:: The participants were 1,422 female residents enrolled in a cohort study from April to August 2012. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III modified for Japanese women. Associations were examined between MetS and 78 metabolites assayed in fasting plasma samples using capillary electrophoresis-mass spectrometry. Replication analysis was performed to confirm the robustness of the results in a separate population created by random allocation. RESULTS:: Analysis was performed for 877 naturally postmenopausal women, including 594 in the original population and 283 in the replication population. The average age, body mass index, and levels of high- and low-density lipoprotein cholesterol of the entire population were 64.6 years, 23.0?kg/m, 72.1?mg/dL, and 126.1?mg/dL, respectively. There was no significant difference in low-density lipoprotein cholesterol levels between women with and without MetS. Thirteen metabolites were significantly related to MetS: multiple plasma amino acids were elevated in women with MetS, including branched-chain amino acids, alanine, glutamate, and proline; and alpha-aminoadipate, which is generated by lysine degradation, was also significantly increased. CONCLUSIONS:: Our large-scale metabolomic profiling indicates that Japanese postmenopausal women with MetS have abnormal polar metabolites, suggesting altered catabolic pathways. These results may help to understand metabolic disturbance, including in persons with normal body mass index and relatively high levels of high-density lipoprotein cholesterol, and may have clinical utility based on further studies.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0

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Relationship between non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in the general population

Kuwabara Kazuyo, Harada Sei, Sugiyama Daisuke, Kurihara Ayako, Kubota Yoshimi, Higashiyama Aya, Hirata Takumi, Nishida Yoko, Kawasaki Midori, Takebayashi Toru, Okamura Tomonori

Journal of Atherosclerosis and Thrombosis 23 ( 4 ) 477 - 490 2016.04

Research paper (scientific journal), ISSN 1340-3478

Aim: The Japan Atherosclerosis Society (JAS) Guidelines for Diagnosis and Prevention of Atherosclerotic Cardiovascular Diseases for Japanese 2012 version have set a non-high-density lipoprotein cholesterol (non-HDL-C)-management target of low-density lipoprotein cholesterol (LDL-C) + 30 mg/ dL. However, the actual difference between non-HDL-C and LDL-C is not clear. Therefore, we evaluated its joint distribution and assessed the validity of this criterion in the general Japanese population. Methods: We used baseline cross-sectional data of 4,110 participants from two studies; the KOBE Study (n=1,108) and the Tsuruoka Metabolomic Cohort Study (n= 3,002). To evaluate whether the difference between LDL-C and non-HDL-C in the general population match that of the current guidelines, we classified LDL-C levels into four groups according to the JAS Guideline and evaluated its agreement with the corresponding non-HDL-C group. Analysis was also done using six groups (the previous four groups plus the upper and lower cut-off values). Results: The mean difference (mg/dL) between the non-HDL-C and LDL-C (for the KOBE Study and Tsuruoka Metabolomic Cohort Study, respectively) was 19.6 and 24.1 (p <0.001) for men and 15.9 and 18.3 (p <0.001) for women. In both the cohort studies, the difference was lower than 30 mg/dL. It was especially small among individuals with normal triglyceride levels. Conclusions: In the general Japanese population, the difference between non-HDL-C and LDL-C was lower than the expected difference of 30 mg/dL. Changes to the criteria for non-HDL-C target levels may be considered in the future.

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Association of total energy intake with 29-year mortality in the Japanese

Nagai Masato, Ohkubo Takayoshi, Miura Katsuyuki, Fujiyoshi Akira, Okuda Nagako, Hayakawa Takehito, Yoshita Katsushi, Arai Yusuke, Nakagawa Hideaki, Nakamura Koshi, Miyagawa Naoko, Takashima Naoyuki, Kadota Aya, Murakami Yoshitaka, Nakamura Yasuyuki, Abbott Robert D., Okamura Tomonori, Okayama Akira, Ueshima Hirotsugu

Journal of Atherosclerosis and Thrombosis 23 ( 3 ) 339 - 354 2016.03

Research paper (scientific journal), ISSN 1340-3478

Aim: In animals, dietary energy restriction is reported to increase longevity, whereas in humans, all cohort studies from Western countries have not shown an association between the low energy intake and longevity. We examined the association between total energy intake and longevity in Japan where dietary pattern is different from that in the West. Methods: A total of 7,704 Japanese aged 30–69 years were followed from 1980 to 2009. Participants were divided into the quintiles of total energy (kcal/day. based on data collected from the National Nutrition Survey. Hazard ratios and 95% confidence intervals (CIs. were derived through the use of Cox proportional hazards models to compare the risk of death across and between the quintiles. Results: There was a significant association between increased energy intake and all-cause mortality risk in only men (P for linear trend=0.008). In cause-specific analysis, compared with the lowest quintile, there was rise in coronary heart disease (CHD. mortality among men (HR; 2.63, 95%CI; 0.95–7.28, P for linear trend 0.016. and women (HR; 2.91, 95%CI; 1.02–8.29, P for linear trend 0.032. and cancer mortality among men (HR; 1.50, 95%CI; 0.999–2.24, P for linear trend 0.038. in the top quintile. Conclusion: We observed significant associations of high energy intake with all-cause and cancer mortality among men and with CHD mortality among men and women. Further studies are needed to confirm the benefits of caloric restriction.

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Lipoprotein-associated phospholipase A₂ is related to risk of subclinical atherosclerosis but is not supported by Mendelian randomization analysis in a general Japanese population

Ueshima Hirotsugu, Kadowaki Takashi, Hisamatsu Takashi, Fujiyoshi Akira, Miura Katsuyuki, Ohkubo Takayoshi, Sekikawa Akira, Kadota Aya, Kadowaki Sayaka, Nakamura Yasuyuki, Miyagawa Naoko, Okamura Tomonori, Kita Yoshikuni, Takashima Naoyuki, Kashiwagi Atsunori, Maegawa Hiroshi, Horie Minoru, Yamamoto Takashi, Kimura Takeshi, Kita Toru

Atherosclerosis 246 141 - 147 2016.03

Research paper (scientific journal), ISSN 0021-9150

Objective: Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is an enzyme predominantly bound to low-density lipoprotein (LDL). Lp-PLA₂ is recognized as playing a key role in inflammatory processes and the development of atherosclerosis. This study aimed to investigate whether Lp-PLA₂ is related to subclinical atherosclerosis, independently from traditional risk factors, in a general Japanese population by analyses of both the observational study and Mendelian randomization using V279F polymorphism. Methods and results: We cross-sectionally examined community-based sample of 929 Japanese men aged 40-79 years, without statin treatment, who were randomly selected from the resident registration. Multiple regression analyses of Lp-PLA₂ activity and concentration were undertaken separately for men aged 40-49 years and 50-79 years, to clarify interactions of age and Lp-PLA₂. Lp-PLA₂ activity for men aged 50-79 years was significantly and positively related to intima-media thickness (IMT) (P = 0.013) and plaque index (P = 0.008) independent of traditional risk factors including small LDL particles, but not to coronary artery calcification (CAC) score. Associations with Lp-PLA₂ concentration were qualitatively similar to those of activity. Corresponding relationships were not observed in men aged 40-49 years. Mendelian randomization analyses based on V279F genotype did not show any significant associations with subclinical atherosclerosis, although the homozygote and heterozygote of V279F showed low Lp-PLA₂ activity and concentration. Conclusions: Lp-PLA₂ activity in Japanese men aged 50-79 years was associated significantly and positively with IMT and plaque in the carotid artery but Mendelian randomization did not support that Lp-PLA₂ is a causative factor for subclinical atherosclerosis.

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Calibration between the estimated probability of the risk assessment chart of Japan atherosclerosis society and actual mortality using external population

Nakai Michikazu, Miyamoto Yoshihiro, Higashiyama Aya, Murakami Yoshitaka, Nishimura Kunihiro, Yatsuya Hiroshi, Saitoh Shigeyuki, Sakata Kiyomi, Iso Hiroyasu, Miura Katsuyuki, Ueshima Hirotsugu, Okamura Tomonori, The EPOCH-JAPAN Research Group EPOCH-JAPAN Research Group, Ueshima Hirotsugu, Okamura Tomonori, Ueshima Hirotsugu, Imai Yutaka, Ohkubo Takayoshi, Irie Fujiko, Iso Hiroyasu, Kitamura Akihiko, Kiyohara Yutaka, Miura Katsuyuki, Murakami Yoshitaka, Nakagawa Hideaki, Nakayama Takeo, Okayama Akira, Sairenchi Toshimi, Saitoh Shigeyuki, Sakata Kiyomi, Tamakoshi Akiko, Tsuji Ichiro, Yamada Michiko, Kiyama Masahiko, Miyamoto Yoshihiro, Ishikawa Shizukiyo, Yatsuya Hiroshi, Okamura Tomonori

Journal of Atherosclerosis and Thrombosis 23 ( 2 ) 176 - 195 2016.02

Research paper (scientific journal), ISSN 1340-3478

Aim: In Japan Atherosclerosis Society guidelines for the prevention of atherosclerotic cardiovascular diseases 2012 (JAS2012), NIPPON DATA80 risk assessment chart (ND80RAC) was adopted to estimate the 10-year probability of coronary artery disease (CAD) mortality. However, there was no comparison between the estimated mortality calculated by ND80RAC and actual mortality in external populations. Accordingly, we used the large pooled database of cohorts in Japan, EPOCH-JAPAN, as an external population.Methods:The participants of EPOCH-JAPAN without a history of cardiovascular disease (15,091 men and 18,589 women aged 40–74 years) were analyzed based on sex. The probability of a 10-year risk of CAD/stroke mortality was estimated by ND80RAC. The participants were divided into both decile of their estimated mortality and three categories according to JAS2012. The calibration between the mean estimated mortality and the actual mortality was performed by the Hosmer and Lemeshow (H-L) test.Results: In both sexes, the estimated CAD mortality was higher than the actual mortality, particularly in higher deciles of estimated mortality, and the estimated stroke mortality was almost concordant with the actual mortality in low/moderate deciles of estimated mortality. As for the categories according to JAS2012, the estimated CAD mortality was higher than the actual mortality in both sexes; actual mortality in Category III was lower than that in Category II in women. However, it increased in the ascending order of category when we excluded the presence of diabetes from Category III.Conclusions: The estimated CAD mortality by ND80RAC tended to be higher than the actual mortality in the population in which the baseline survey was more recently performed.

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The Associations of C-Reactive Protein with Serum Levels of Polyunsaturated Fatty Acids and Trans Fatty Acids Among Middle-Aged Men from Three Populations

El-Saed A., Masaki K., Okamura T., Evans R. W., Nakamura Y., Willcox B. J., Lee S., Maegawa H., Seto T. B., Choo J., Fujiyoshi A., Miura K., Kuller L. H., Ueshima H., Sekikawa A.

Journal of Nutrition, Health and Aging 20 ( 1 ) 16 - 21 2016.01

ISSN 1279-7707

BACKGROUND: C-reactive protein (CRP) and many fatty acids (FAs) have been linked to cardiovascular disease. Associations of serum CRP with FAs in different populations have not been established.METHODS: Participants were 926 men aged 40-49 (2002-2006) from a population-based sample; 310 Whites from Pennsylvania, U.S., 313 Japanese from Shiga, Japan, and 303 Japanese Americans from Hawaii, U.S. Serum CRP (mg/L) was measured using immunosorbent assay while serum FAs (%) were measured using capillary-gas-liquid chromatography.RESULTS: Whites had CRP (mg/L) levels higher than Japanese with Japanese Americans in-between (age-adjusted geometric mean "GM" 0.96, 0.38, 0.66, respectively). Whites had also higher levels of total n-6 FAs (%) and trans fatty acids (TFAs) but lower levels of marine-derived n-3 FAs compared to Japanese (41.78 vs. 35.05, 1.04 vs. 0.58, and 3.85 vs. 9.29, respectively). Japanese Americans had FAs levels in-between the other two populations. Whites had significant inverse trends between CRP and tertiles of total n-6 FAs (GM 1.20, 0.91 and 0.80; p=0.002) and marine-derived n-3 FAs (GM 1.22, 1.00 and 0.72; pCONCLUSIONS: With the exception of consistent inverse association of CRP with total n-6 FAs, there are considerable variations across the three populations in the associations of CRP with different FAs.

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The associations of C-reactive protein with serum levels of polyunsaturated fatty acids and trans fatty acids among middle-aged men from three populations

El-Saed A., Masaki K., Okamura T., Evans R. W., Nakamura Y., Willcox B. J., Lee S., Maegawa H., Seto T. B., Choo J., Fujiyoshi A., Miura K., Kuller L. H., Ueshima H., Sekikawa Akira

Journal of Nutrition, Health and Aging 20 ( 1 ) 16 - 21 2016.01

ISSN 1279-7707

Background: C-reactive protein (CRP) and many fatty acids (FAs) have been linked to cardiovascular disease. Associations of serum CRP with FAs in different populations have not been established. Methods: Participants were 926 men aged 40-49 (2002-2006) from a population-based sample; 310 Whites from Pennsylvania, U.S., 313 Japanese from Shiga, Japan, and 303 Japanese Americans from Hawaii, U.S. Serum CRP (mg/L) was measured using immunosorbent assay while serum FAs (%) were measured using capillary-gasliquid chromatography. Results: Whites had CRP (mg/L) levels higher than Japanese with Japanese Americans in-between (age-adjusted geometric mean “GM” 0.96, 0.38, 0.66, respectively). Whites had also higher levels of total n-6 FAs (%) and trans fatty acids (TFAs) but lower levels of marine-derived n-3 FAs compared to Japanese (41.78 vs. 35.05, 1.04 vs. 0.58, & 3.85 vs. 9.29, respectively). Japanese Americans had FAs levels in-between the other two populations. Whites had significant inverse trends between CRP and tertiles of total n-6 FAs (GM 1.20, 0.91 & 0.80; p=0.002) and marine-derived n-3 FAs (GM 1.22, 1.00 & 0.72; p

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Hypertension and lifetime risk of stroke

Turin Tanvir Chowdhury, Okamura Tomonori, Afzal Arfan Raheen, Rumana Nahid, Watanabe Makoto, Higashiyama Aya, Nakao Yoko, Nakai Michikazu, Takegami Misa, Nishimura Kunihiro, Kokubo Yoshihiro, Okayama Akira, Miyamoto Yoshihiro

Journal of Hypertension 34 ( 1 ) 116 - 122 2016.01

Research paper (scientific journal), ISSN 0263-6352

Background: The lifetime risk (LTR) articulates the probability of disease in the residual lifetime for an index age. These estimates can be useful for general audience-targeted knowledge translation activities against hypertension. There are only a few reports on lifetime of impact of hypertension on stroke events in Asians in whom stroke incidence is higher than Westerners. Methods: The Suita Study, a cohort study of cardiovascular diseases in Japan, was established in 1989. We included all participants who were stroke free at baseline. Age (in years) was used as the time scale. Age-specific incidence rates were calculated with person-year method within 10-year bands. We estimated the sex and index-age specific LTR of first-ever stroke with taking the competing risk of death into account. Results: We followed 5783 men and women during 1989-2007 for 74 933 person-years. During the follow-up period, 276 (149 men and 127 women) participants had incident stroke. Of them, majority were cerebral infarction; 166 (102 men and 64 women). The LTR of stroke, accounted for competing risk of death, at 45 years of age for men without hypertension was 17.21% and it was 32.79% for hypertensive men. Among the hypertensive patients, participants with stage 2 or greater hypertension had higher LTR of stroke than the participants with stage 1 hypertension. This increased LTR of stroke for hypertensive patients were also observed among women and across all index ages for stroke. Conclusion: In this urban community-based population, we observed that hypertension has significant effect on the residual LTR of stroke among both men and women of middle age, specifically for ischemic stroke.

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Epidemiologic studies for cardiovascular disease in Japan

Okamura Tomonori

Respiration and Circulation 64 ( 1 ) 7 2016.01

ISSN 0452-3458

Set up and prospect of new cohort studies

Nishida Yoko, Okamura Tomonori, Harada Sei, Takebayashi Toru

Respiration and Circulation 64 ( 1 ) 71 - 77 2016.01

ISSN 0452-3458

Serum level of LOX-1 ligand containing ApoB is associated with increased carotid intima-media thickness in Japanese community-dwelling men, especially those with hypercholesterolemiaLOX-1 ligand and IMT in Japanese

Okamura Tomonori, Miura Katsuyuki, Sawamura Tatsuya, Kadota Aya, Hisamatsu Takashi, Fujiyoshi Akira, Miyamatsu Naomi, Takashima Naoyuki, Miyagawa Naoko, Kadowaki Takashi, Ohkubo Takayoshi, Murakami Yoshitaka, Nakamura Yasuyuki, Ueshima Hirotsugu

Journal of Clinical Lipidology 10 ( 1 ) 172 - 180e1 2016.01

Research paper (scientific journal), ISSN 1933-2874

Background The serum level of LOX-1 ligand containing ApoB (LAB) may reflect atherogenicity better than usual lipid parameters; however, the relationship between LAB and carotid intima-media thickness (IMT) was not clear even in Asian populations. Methods A total of 992 community-dwelling Japanese men, aged 40 to 79 years, were enrolled in the present study. Serum LAB levels were measured by enzyme-linked immunosorbent assays (ELISAs) with recombinant LOX-1 and monoclonal anti-apolipoprotein B antibody. Results Serum LAB levels (median [interquartile range], μg cs/L) were 5341 μg cs/L (4093-7125). The mean average IMT of the common carotid artery was highest in the fourth LAB quartile (842 μm) compared with the first quartile (797 μm) after adjustment for age, high-density lipoprotein cholesterol, triglyceride, body mass index, hypertension, diabetes, high sensitivity C-reactive protein, smoking, and alcohol drinking. However, this statistically significant difference was lost after further adjustment for total cholesterol (TC). After stratification using the combination of median LAB and hypercholesterolemia (serum TC ≥ 6.21 mmol/L and/or lipid-lowering medication), the adjusted mean average IMT (standard error) in the high LAB/hypercholesterolemia group was 886 μm (12.7), 856 μm (16.7) in the low LAB/hypercholesterolemia group, and 833 μm (8.4) in the low LAB/normal cholesterol group (P =.004). After further adjustment for TC, mean average IMT in the high LAB group was significantly higher than that measured in the low LAB group in hypercholesterolemic participants not taking lipid-lowering medication. Conclusion Serum LAB was associated with an increased carotid IMT in Japanese men, especially those with hypercholesterolemia.

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Effects of a public education campaign on the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset

Nishikawa Tomofumi, Okamura Tomonori, Nakayama Hirofumi, Miyamatsu Naomi, Morimoto Akiko, Toyoda Kazunori, Suzuki Kazuo, Toyota Akihiro, Hata Takashi, Yamaguchi Takenori

Journal of Epidemiology 26 ( 3 ) 115 - 122 2016

Research paper (scientific journal), ISSN 0917-5040

Background: An immediate ambulance call offers the greatest opportunity for acute stroke therapy. Effectively using ambulance services requires strengthening the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset, and encouraging the public to use ambulance services. Methods: The present study utilized data from the Acquisition of Stroke Knowledge (ASK) study, which administered multiple-choice, mail-in surveys regarding awareness of early stroke symptoms and response to a stroke attack before and after a 2-year stroke education campaign in two areas subject to intensive and moderate intervention, as well as in a control area, in Japan. In these three areas, 3833 individuals (1680, 1088 and 1065 participants in intensive intervention, moderate intervention, and control areas, respectively), aged 40 to 74 years, who responded appropriately to each survey were included in the present study. Results: After the intervention, the number of correctly identified symptoms significantly associated with intention to call an ambulance (P <0.05) increased (eg, from 4 to 5 correctly identified symptoms), without increasing choice of decoy symptoms in the intensive intervention area. Meanwhile, in other areas, rate of identification of not only correct symptoms but also decoy symptoms associated with intention to call an ambulance increased. Furthermore, the association between improvement in the knowledge of stroke symptoms and intention to call an ambulance was observed only in the intensive intervention area (P = 0.009). Conclusions: Our results indicate that intensive interventions are useful for strengthening the association between correct knowledge of early stroke symptoms and intention to call an ambulance, without strengthening the association between incorrect knowledge and intention to call an ambulance.

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