Details of a Researcher - Okamura, Tomonori

Papers - Okamura, Tomonori

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Standardized prevalence ratios for atrial fibrillation in adult dialysis patients in Japan

Ohsawa Masaki, Tanno Kozo, Okamura Tomonori, Yonekura Yuki, Kato Karen, Fujishima Yosuke, Obara Wataru, Abe Takaya, Itai Kazuyoshi, Ogasawara Kuniaki, Omama Shinichi, Turin Tanvir Chowdhury, Miyamatsu Naomi, Ishibashi Yasuhiro, Morino Yoshihiro, Itoh Tomonori, Onoda Toshiyuki, Kuribayashi Toru, Makita Shinji, Yoshida Yuki, Nakamura Motoyuki, Tanaka Fumitaka, Ohta Mutsuko, Sakata Kiyomi, Okayama Akira

Journal of Epidemiology 26 ( 5 ) 272 - 276 2016

Research paper (scientific journal), ISSN 0917-5040

Background: While it is assumed that dialysis patients in Japan have a higher prevalence of atrial fibrillation (AF) than the general population, the magnitude of this difference is not known. Methods: Standardized prevalence ratios (SPRs) for AF in dialysis patients (n = 1510) were calculated compared to data from the general population (n = 26 454) living in the same area. Results: The prevalences of AF were 3.8% and 1.6% in dialysis patients and the general population, respectively. In male subjects, these respective values were 4.9% and 3.3%, and in female subjects they were 1.6% and 0.6%. The SPRs for AF were 2.53 (95% confidence interval [CI], 1.88-3.19) in all dialysis patients, 1.80 (95% CI, 1.30-2.29) in male dialysis patients, and 2.13 (95% CI, 0.66-3.61) in female dialysis patients. Conclusions: The prevalence of AF in dialysis patients was twice that in the population-based controls. Since AF strongly contributes to a higher risk of cardiovascular mortality and morbidity in the general population, further longitudinal studies should be conducted regarding the risk of several outcomes attributable to AF among Japanese dialysis patients.

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Serum uric acid and mortality form cardiovascular disease

Zhang Wen, Iso Hiroyasu, Murakami Yoshitaka, Miura Katsuyuki, Nagai Masato, Sugiyama Daisuke, Ueshima Hirotsugu, Okamura Tomonori, Ueshima Hirotsugu, Imai Yutaka, Ohkubo Takayoshi, Irie Fujiko, Kitamura Akihiko, Kiyohara Yutaka, 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

Journal of Atherosclerosis and Thrombosis 23 ( 6 ) 692 - 703 2016

Research paper (scientific journal), ISSN 1340-3478

Aim: To investigate the relationship between serum uric acid levels and cardiovascular disease in Asians. Methods: We examined the above relationship using the data of Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN Study). The data of 36,313 subjects (15,628 men and 20,685 women aged 35 –89 years without histories of stroke, coronary heart disease, or cancer at baseline) were used for the analyses. Sex-specific hazard ratios (HRs) of mortality from cardiovascular disease were estimated according to the quintiles of serum uric acid using Cox hazard models stratified by cohorts. Results: During 441,771 person-years of follow-up, we documented 1,288 cardiovascular deaths. A J-or U-shaped relationship between serum uric acid level and cardiovascular disease mortality was observed. Compared with the lowest quintile of serum uric acid levels, the highest quintile was associated with an increased cardiovascular disease mortality in men [HR: 1.28; 95% confidence interval (CI): 1.01– 1.63] and women (HR: 1.51; 95% CI: 1.14–1.99). However, there was no significant association with mortality from stroke, coronary heart disease or heart failure in both men and women. Conclusion: This large pooled analysis in Japan suggested a J-or U-shaped relationship between serum uric acid levels and cardiovascular mortality. The highest quintile of serum uric acid levels was associated with increased cardiovascular disease mortality in both Japanese men and women.

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Serum γ-glutamyltransferase and mortality due to cardiovascular disease in Japanese men and women

Li Yuanying, Iso Hiroyasu, Cui Renzhe, Murakami Yoshitaka, Yatsuya Hiroshi, Miura Katsuyuki, Nagasawa Shin Ya, Ueshima Hirotsugu, Okamura Tomonori, Imai Yutaka, Ohkubo Takayoshi, Irie Fujiko, Kitamura Akihiko, Kiyohara Yutaka, Nakagawa Hideaki, Nakayama Takeo, Okayama Akira, Sairenchi Toshimi, Saitoh Shigeyuki, Sakata Kiyomi, Tamakoshi Akiko, Tsuji Ichiro, Yamada Michiko, Kiyama Masahiko, Miyamoto Yoshihiro, Ishikawa Shizukiyo

Journal of Atherosclerosis and Thrombosis 23 ( 7 ) 792 - 799 2016

Research paper (scientific journal), ISSN 1340-3478

Aim: Whether the association between serum γ-glutamyltransferase (γ-GTP) levels and total cardiovascular disease (CVD) mortality is independent of alcohol drinking in East Asian populations is not well known. We conducted a pooled analysis of Japanese men and women that enabled an analysis restricted to never-drinkers. Methods: A total of 15,987 men and 25,053 women aged 40-79 years, pooled from seven cohort studies throughout Japan, were followed-up to examine sex-specific relationship between serum γ -GTP levels and total CVD mortality. Cox regression model was used that was adjusted for age, smoking status, body mass index, and systolic blood pressure and serum triglyceride, total cholesterol, aspartate aminotransferase, and alanine aminotransferase levels. Results: During an average follow-up of 8.7 years, we documented 361 and 340 deaths from total CVD, 146 and 168 from stroke, and 101 and 53 from coronary heart disease (CHD) for men and women, respectively. Among the never-drinkers, hazard ratios (HRs) for mortality for one standard deviation of log-γ-GTP for men were 1.89 (1.00-3.58) for stroke, 1.04 (0.57-1.90) for CHD, and 1.43 (1.04-1.96) for total CVD. For women, HRs were 1.28 (1.06-1.54), 1.81 (1.34-2.44), and 1.30 (1.14-1.49), respectively. Conclusion: γ-GTP may be a risk factor for total CVD mortality independent of alcohol drinking status in Japanese men and women.

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The relationship between very high levels of serum high-density lipoprotein cholesterol and cause-specific mortality in a 20-year follow-up study of japanese general population

Hirata Aya, Okamura Tomonori, Sugiyama Daisuke, Kuwabara Kazuyo, Kadota Aya, Fujiyoshi Akira, Miura Katsuyuki, Okuda Nagako, Ohkubo Takayoshi, Okayama Akira, Ueshima Hirotsugu, Saitoh Shigeyuki, Sakata Kiyomi, Hozawa Atsushi, Hayakawa Takehito, Nakamura Yoshikazu, Nishi Nobuo, Kasagi Fumiyoshi, Murakami Yoshitaka, Izumi Toru, Matsumura Yasuhiro, Ojima Toshiyuki, Tamakoshi Koji, Nakagawa Hideaki, Kita Yoshikuni, Miyamatsu Naomi, Yoshita Katsushi, Miyamoto Yoshihiro, Kodama Kazunori, Kiyohara Yutaka

Journal of Atherosclerosis and Thrombosis 23 ( 7 ) 800 - 809 2016

Research paper (scientific journal), ISSN 1340-3478

Aims: There is no community-based cohort study to examine the effect of very high level of highdensity lipoprotein cholesterol (HDL-C) on coronary heart disease (CHD) and other cause-specific mortality. Therefore, we investigated the relationship between HDL-C including very high level and cause-specific mortality in a 20-year cohort study of the representative sample of Japanese. Methods: We followed 7,019 individuals from the Japanese general population (2,946 men and 4,073 women). We defined HDL-C levels as follow: low (HDL-C

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Underweight young women without later weight gain are at high risk for osteopenia after midlife

Tatsumi Yukako, Higashiyama Aya, Kubota Yoshimi, Sugiyama Daisuke, Nishida Yoko, Hirata Takumi, Kadota Aya, Nishimura Kunihiro, Imano Hironori, Miyamatsu Naomi, Miyamoto Yoshihiro, Okamura Tomonori

Journal of Epidemiology 26 ( 11 ) 572 - 578 2016

Research paper (scientific journal), ISSN 0917-5040

Background: Although underweight young women are targets for interventions to prevent low bone mineral density (BMD), the relationship between change in body mass index (BMI) from youth to older age and BMD has not been widely investigated in community dwellers. Methods: In 749 healthy Japanese women aged 40-74 years, BMD was measured by quantitative ultrasound and anthropometric measurements, and BMI was calculated from body weight and height. The BMI of participants at age 20 years was estimated by self-reported body weight and their present height. They were classified into four groups according to the presence of underweight (BMI <18.5 kg/m²) at 20 and/or at present. Logistic regression models were used to estimate multivariate-adjusted odds ratios (ORs) of the presence of underweight at 20 and/or at present for osteopenia (BMD T score <-1 standard deviations) compared with participants with BMI ≥18.5 kg/m² both at 20 and at present. Results: The participants who were underweight both at 20 and at present had a higher OR for osteopenia compared with those with BMI ≥18.5 kg/m² at 20 and at present (OR 3.94; 95% confidence interval [CI], 1.97-7.89). Those underweight only at present also had significantly increased OR of developing osteopenia (OR 2.95; 95% CI, 1.67-5.24). The OR of those underweight only at 20 was 0.87 (95% CI, 0.51-1.48). Conclusions: Current underweight was associated with increased risk for osteopenia among Japanese women, especially in those who were underweight both at 20 and at present. To prevent low BMD in the future, maintaining appropriate body weight might be effective for young underweight women.

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Predicting Coronary Heart Disease Using Risk Factor Categories for a Japanese Urban Population, and Comparison with the Framingham Risk Score: The Suita Study.

Nishimura K, Okamura T, Watanabe M, Nakai M, Takegami M, Higashiyama A, Kokubo Y, Okayama A, Miyamoto Y

Journal of atherosclerosis and thrombosis 23 ( 9 ) 1138 - 9 2016

Research paper (scientific journal), ISSN 1340-3478

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Serum Uric Acid and Mortality Form Cardiovascular Disease: EPOCH-JAPAN Study.

Zhang W, Iso H, Murakami Y, Miura K, Nagai M, Sugiyama D, Ueshima H, Okamura T, EPOCH-JAPAN GROUP.

Journal of atherosclerosis and thrombosis 23 ( 12 ) 1365 - 1366 2016

Research paper (scientific journal), ISSN 1340-3478

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Predicting Coronary Heart Disease Using Risk Factor Categories for a Japanese Urban Population, and Comparison with the Framingham Risk Score: The Suita Study.

Nishimura K, Okamura T, Watanabe M, Nakai M, Takegami M, Higashiyama A, Kokubo Y, Okayama A, Miyamoto Y

Journal of atherosclerosis and thrombosis 23 ( 9 ) 1138 - 9 2016

Research paper (scientific journal), ISSN 1340-3478

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Serum Uric Acid and Mortality Form Cardiovascular Disease: EPOCH-JAPAN Study.

Zhang W, Iso H, Murakami Y, Miura K, Nagai M, Sugiyama D, Ueshima H, Okamura T, EPOCH-JAPAN GROUP.

Journal of atherosclerosis and thrombosis 23 ( 12 ) 1365 - 1366 2016

Research paper (scientific journal), ISSN 1340-3478

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Associations of serum LDL particle concentration with carotid intima-media thickness and coronary artery calcification

Zaid Maryam, Miura Katsuyuki, Fujiyoshi Akira, Abbott Robert D., Hisamatsu Takashi, Kadota Aya, Arima Hisatomi, Kadowaki Sayaka, Torii Sayuki, Miyagawa Naoko, Suzuki Sentaro, Takashima Naoyuki, Ohkubo Takayoshi, Sekikawa Akira, Maegawa Hiroshi, Horie Minoru, Nakamura Yasuyuki, Okamura Tomonori, Ueshima Hirotsugu

Journal of Clinical Lipidology 10 ( 5 ) 1195 - 1202.e1 2015.12

Research paper (scientific journal), ISSN 1933-2874

Background: Low-density lipoprotein particle (LDL-P) has recently been found to be a stronger predictor of cardiovascular disease (CVD) than LDL-cholesterol (LDL-C). Objectives: Whether LDL-P is associated with subclinical atherosclerosis, independent of LDL-C, as well as other lipid measures has not been fully examined. We aimed to analyze LDL-P associations with measures of subclinical atherosclerosis. Methods: We examined 870 Japanese men randomly selected from Kusatsu City, Shiga, Japan, aged 40-79 years from 2006-2008, free of clinical CVD and not using lipid-lowering medication. Cross-sectional associations of lipid measures with carotid intima-media thickness (cIMT) and coronary artery calcification (CAC; >0 Agatston score) were examined. Results: LDL-P was significantly positively associated with cIMT and maintained this association after adjustments for LDL-C and other lipid measures. Although these lipid measures were positively associated with cIMT, model adjustment for LDL-P removed any significant relationships. Higher LDL-P was associated with a significantly higher odds ratio of CAC and further adjustment for LDL-C did not affect this relationship. In contrast, the LDL-C association with CAC was no longer significant after adjustment for LDL-P. Other lipid measures attenuated associations of LDL-P with CAC. Likewise, associations of these measures with CAC were attenuated when model adjustments for LDL-P were made. Conclusions: In a community-based sample of Japanese men, free of clinical CVD, LDL-P was a robust marker for subclinical atherosclerosis, independent of LDL-C and other lipid measures. Associations of LDL-C and other lipid measures with either cIMT or CAC were generally not independent of LDL-P.

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Advance in cardiac CT

Yamada Yoshitake, Matsumoto Shunsuke, Suzuki Tatsuya, Hashimoto Masahiro, Okamura Teppei, Sugiura Hiroaki, Jinzaki Masahiro, Yamada Minoru

Respiration and Circulation 63 ( 12 ) 1199 - 1207 2015.12

ISSN 0452-3458

Erratum

Nagai Masato, Ohkubo Takayoshi, Murakami Yoshitaka, Takashima Naoyuki, Kadota Aya, Miyagawa Naoko, Saito Yoshino, Nishi Nobuo, Okuda Nagako, Kiyohara Yutaka, Nakagawa Hideaki, Nakamura Yoshikazu, Fujiyoshi Akira, Abbott Robert D., Okamura Tomonori, Okayama Akira, Ueshima Hirotsugu, Miura Katsuyuki

Hypertension Research 38 ( 11 ) 798 2015.11

ISSN 0916-9636

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Secular trends of the impact of overweight and obesity on hypertension in Japan, 1980-2010

Hypertension Research 38 ( 11 ) 790 - 795 2015.11

Research paper (scientific journal), ISSN 0916-9636

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.

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Smoking increases the risk of all-cause and cardiovascular mortality in patients with chronic kidney disease

Nakamura Koshi, Nakagawa Hideaki, Murakami Yoshitaka, Kitamura Akihiko, Kiyama Masahiko, Sakata Kiyomi, Tsuji Ichiro, Miura Katsuyuki, Ueshima Hirotsugu, Okamura Tomonori

Kidney International 88 ( 5 ) 1144 - 1152 2015.11

Research paper (scientific journal), ISSN 0085-2538

Little is known about the magnitude and nature of the combined effect of chronic kidney disease (CKD) and smoking on cardiovascular diseases. We studied this in a Japanese population using a pooled analysis of 15,468 men and 19,154 women aged 40-89 years enrolled in 8 cohort studies. The risk of mortality from all-causes and cardiovascular disease was compared in 6 gender-specific categories of baseline CKD status (non-CKD or CKD) and smoking habits (lifelong never smoked, former smokers, or currently smoking). CKD was defined as a decreased level of estimated glomerular filtration rate (under 60 ml/min per 1.73 m 2) and/or dipstick proteinuria. Hazard ratios were estimated for each category, relative to never smokers without CKD. During the follow-up period (mean 14.8 years), there were 6771 deaths, 1975 of which were due to cardiovascular diseases. In both men and women, current or former smokers with CKD had the first or second highest crude mortality rates from all-cause and cardiovascular diseases among the 6 categories. After adjustment for age and other major cardiovascular risk factors, the hazard ratios in male and female current smokers with CKD were 2.26 (95% confidence interval, 1.95-2.63) and 1.78 (1.36-2.32) for all-causes, and 2.66 (2.04-3.47) and 1.71 (1.10-2.67) for cardiovascular diseases, respectively. Thus, coexistence of CKD and smoking may markedly increase the risk of all-cause and cardiovascular mortality.

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Metabolomic profiling reveals novel biomarkers of alcohol intake and alcohol-induced liver injury in community-dwelling men

Harada Sei, Takebayashi Toru, Kurihara Ayako, Akiyama Miki, Suzuki Asako, Hatakeyama Yoko, Sugiyama Daisuke, Kuwabara Kazuyo, Takeuchi Ayano, Okamura Tomonori, Nishiwaki Yuji, Tanaka Taichiro, Hirayama Akiyoshi, Sugimoto Masahiro, Soga Tomoyoshi, Tomita Masaru

Environmental Health and Preventive Medicine 21 ( 1 ) 18 - 26 2015.10

Research paper (scientific journal), ISSN 1342-078X

Objective: Metabolomics is a promising approach to the identification of biomarkers in plasma. Here, we performed a population-based, cross-sectional study to identify potential biomarkers of alcohol intake and alcohol-induced liver injury by metabolomic profiling using capillary electrophoresis-mass spectrometry (CE-MS). Methods: Fasting plasma samples were collected from 896 Japanese men who participated in the baseline survey of the Tsuruoka Metabolomics Cohort Study, and 115 polar metabolites were identified and absolutely quantified by CE-MS. Information on daily ethanol intake was collected through a standardized, self-administered questionnaire. The associations between ethanol intake and plasma concentration of metabolites were examined. Relationships between metabolite concentrations or their ratios and serum liver enzyme levels in the highest ethanol intake group (>46.0 g/day) were then examined by linear regression analysis. Replication analysis was conducted in 193 samples collected from independent population of this cohort. Results: Nineteen metabolites were identified to have an association with daily alcohol consumption both in the original and replication population. Three of these metabolites (threonine, glutamine, and guanidinosuccinate) were found to associate well with elevated levels of serum liver enzymes in the highest ethanol intake group, but not in the non-drinker group. We also found that the glutamate/glutamine ratio had a much stronger relation to serum γ-glutamyltransferase, aspartate transaminase, and alanine transaminase than glutamate or glutamine alone (standardized beta = 0.678, 0.558, 0.498, respectively). Conclusions: We found 19 metabolites associated with alcohol intake, and three biomarker candidates (threonine, guanidinosuccinate and glutamine) of alcohol-induced liver injury. Glutamate/glutamine ratio might also be good biomarker.

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Participants with treated hyperlipidemia may be more health conscious

Hozawa Atsushi, Okamura Tomonori

Journal of Atherosclerosis and Thrombosis 22 ( 10 ) 1025 - 1026 2015.10

ISSN 1340-3478

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Participants with treated hyperlipidemia may be more health conscious

Hozawa Atsushi, Okamura Tomonori

Journal of Atherosclerosis and Thrombosis 22 ( 10 ) 1030 - 1039 2015.10

ISSN 1340-3478

Continuous decline in mortality from coronary heart disease in Japan despite a continuous and marked rise in total cholesterol

Sekikawa Akira, Miyamoto Yoshihiro, Miura Katsuyuki, Nishimura Kunihiro, Willcox Bradley J., Masaki Kamal H., Rodriguez Beatriz, Tracy Russell P., Okamura Tomonori, Kuller Lewis H.

International Journal of Epidemiology 44 ( 5 ) 1614 - 1624 2015.10

Research paper (scientific journal), ISSN 0300-5771

Background: The Seven Countries Study in the 1960s showed very low mortality from coronary heart disease (CHD) in Japan, which was attributed to very low levels of total cholesterol. Studies of migrant Japanese to the USA in the 1970s documented increase in CHD rates, thus CHD mortality in Japan was expected to increase as their lifestyle became Westernized, yet CHD mortality has continued to decline since 1970. This study describes trends in CHD mortality and its risk factors since 1980 in Japan, contrasting those in other selected developed countries. Methods: We selected Australia, Canada, France, Japan, Spain, Sweden, the UK and the USA. CHD mortality between 1980 and 2007 was obtained from WHO Statistical Information System. National data on traditional risk factors during the same period were obtained from literature and national surveys. Results: Age-adjusted CHD mortality continuously declined between 1980 and 2007 in all these countries. The decline was accompanied by a constant fall in total cholesterol except Japan where total cholesterol continuously rose. In the birth cohort of individuals currently aged 50-69 years, levels of total cholesterol have been higher in Japan than in the USA, yet CHD mortality in Japan remained the lowest: >67% lower in men and > 75% lower in women compared with the USA. The direction and magnitude of changes in other risk factors were generally similar between Japan and the other countries. Conclusions: Decline in CHD mortality despite a continuous rise in total cholesterol is unique. The observation may suggest some protective factors unique to Japanese.

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Serum polyunsaturated fatty acid composition and serum high-sensitivity C-reactive protein levels in healthy Japanese residents

Kubota Yoshimi, Higashiyama A., Imano H., Sugiyama D., Kawamura K., Kadota A., Nishimura K., Miyamatsu N., Miyamoto Y., Okamura T.

Journal of Nutrition, Health and Aging 19 ( 7 ) 719 - 728 2015.08

Research paper (scientific journal), Joint Work, Accepted, ISSN 1279-7707

Background/Objectives: Serum polyunsaturated fatty acid (PUFA) composition reflects dietary intake and is related to risks for cardiovascular diseases. We hypothesized that serum n-3 PUFA composition, especially including long-chain n-3 PUFA such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is associated with inflammatory status, which is related to increased risk for cardiovascular diseases. Subjects/Methods: We investigated the relationship between serum PUFA composition and high-sensitivity C-reactive protein (hs-CRP) levels in a cross-sectional study among 1,102 healthy men and women aged 40–74 years who reside in Kobe City. Multiple linear regression models that predict hs-CRP level were prepared to confirm the contribution of serum total n-3 PUFA, long-chain n-3 PUFA, EPA and DHA compositions after adjusting for other PUFAs and atherosclerotic risk factors. Results: The serum n-3 PUFA, particularly long-chain n-3 PUFA, compositions were inversely associated with the hs-CRP levels. The standardized regression coefficient was −0.089 (p < 0.01) for total n-3 PUFA, −0.091 (p < 0.01) for long-chain n-3 PUFA, −0.071 (p = 0.03) for EPA, and −0.068 (p = 0.04) for DHA. The n-6 PUFA compositions were also inversely associated with the hs-CRP levels (−0.169 [p < 0.01] for total n-6 PUFA and −0.159 [p < 0.01] for linoleic acid). Conclusions: The serum n-3 PUFA compositions were inversely related with the hs-CRP levels, similar associations were also observed in n-6 PUFA compositions. Our results suggest that dietary PUFA intake was inversely associated with attenuated inflammation in healthy Japanese population.

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Interaction of blood pressure and body mass index with risk of incident Atrial fibrillation in a Japanese urban cohort

Kokubo Yoshihiro, Watanabe Makoto, Higashiyama Aya, Nakao Yoko M., Kobayashi Takashi, Watanabe Takuya, Okamura Tomonori, Okayama Akira, Miyamoto Yoshihiro

American Journal of Hypertension 28 ( 11 ) 1355 - 1361 2015.08

Research paper (scientific journal), ISSN 0895-7061

BACKGROUND AND PURPOSE To prevent stroke, strategies for atrial fibrillation (AF) prevention and an early detection of AF by electrocardiogram are essential. However, only a limited prospective studies have examined the risk factors for AF, even in blood pressure (BP) and body mass index (BMI), which are not clear among general populations. We investigated the impacts of BP and BMI on the risk of incident AF in a general population. METHODS A total of 6,906 participants (30-84 years) in the Suita Study were prospectively followed up for incident AF. Participants were diagnosed with AF if AF or atrial flutter was present on an electrocardiogram from a routine health examination (every 2 years) or if AF was indicated as a present illness from health examinations and/or medical records during follow-up. Adjusted Cox proportional hazard ratios (HRs) were calculated. RESULTS During the 12.8-year follow-up, 253 incident AF events occurred. Compared with the systolic BP (SBP) <120mm Hg and normal-weight, the adjusted HRs (95% confidence intervals; CIs) of incident AF in the systolic hypertension and the overweight (BMI ≥ 25kg/m²) groups were 1.74 (1.22-2.49) and 1.35 (1.01-1.80), respectively. Compared with SBP <120mm Hg and normal weight, the adjusted HRs (95% CIs) of incident AF in the SBP = 120-139mm Hg with overweight and the systolic hypertension with normal or overweight were 1.72 (1.01-2.91), 1.66 (1.10-2.50), and 2.31 (1.47-3.65), respectively (P for interaction = 0.04). CONCLUSIONS Systolic prehypertension and overweight are associated with incident AF in Japanese population. The association between SBP and AF may be evident by overweight.

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