Details of a Researcher - Okamura, Tomonori

Papers - Okamura, Tomonori

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Prediction of cardiovascular disease mortality by proteinuria and reduced kidney function

Nagata Masaharu, Ninomiya Toshiharu, Kiyohara Yutaka, Murakami Yoshitaka, Irie Fujiko, Sairenchi Toshimi, Miura Katsuyuki, Okamura Tomonori, Ueshima Hirotsugu

American Journal of Epidemiology 178 ( 1 ) 1 - 11 2013.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 0002-9262

There are limited studies addressing whether proteinuria and estimated glomerular filtration rate (eGFR) are independently associated with cardiovascular disease in Asia. Using data from 7 prospective cohorts recruited between 1980 and 1994 in Japan, we assessed the influence of proteinuria (≥1+ on dipstick) and reduced eGFR on the risk of cardiovascular disease mortality in 39,405 participants (40-89 years) without kidney failure. During a 10.1-year follow-up, 1,927 subjects died from cardiovascular disease. Proteinuria was associated with a 1.75-fold (95% confidence interval (CI): 1.44, 2.11) increased risk of cardiovascular disease mortality after adjustment for potential confounding factors. Additionally, the multivariate-adjusted hazard ratio of cardiovascular disease mortality increased linearly with lower eGFR levels (P_trend < 0.001): Subjects with eGFR of <45 mL/minute/1.73 m² had a 2.22-fold (95% CI: 1.60, 3.07) greater risk of cardiovascular disease mortality than those with eGFR of ≥90 mL/minute/1.73 m². Subjects with both proteinuria and eGFR of <45 mL/minute/1.73 m² had a 4.05-fold (95% CI: 2.55, 6.43) higher risk of cardiovascular disease mortality compared with those with neither of these risk factors. There was no evidence of interaction in the relationship between proteinuria and lower eGFR (P_interaction = 0.77). The present results suggest that proteinuria and lower eGFR are independent risk factors for cardiovascular disease mortality in the Japanese population. © The Author 2013. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.

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LOX-1 ligands containing apolipoprotein B and carotid intima-media thickness in middle-aged community-dwelling US Caucasian andJapanese men

Okamura Tomonori, Sekikawa Akira, Sawamura Tatsuya, Kadowaki Takashi, Barinas-Mitchell Emma, Mackey Rachel H., Kadota Aya, Evans Rhobert W., Edmundowicz Daniel, Higashiyama Aya, Nakamura Yasuyuki, Abbott Robert D., Miura Katsuyuki, Fujiyoshi Akira, Fujita Yoshiko, Murakami Yoshitaka, Miyamatsu Naomi, Kakino Akemi, Maegawa Hiroshi, Murata Kiyoshi, Horie Minoru, Mitsunami Kenichi, Kashiwagi Atsunori, Kuller Lewis H., Ueshima Hirotsugu

Atherosclerosis 229 ( 1 ) 240 - 245 2013.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 0021-9150

Objective: The serum level of LOX-1 ligand containing ApoB (LAB) may reflect atherogenicity better than LDL cholesterol (LDLC), total LDL particles and usual measurement of oxidized LDL. The association between LAB and intima-media thickness (IMT) of carotid artery was investigated by ultrasound in US and Japan men. Methods: Participants were 297 US Caucasian and 310 Japanese men, aged 40-49 years without past history of cardiovascular disease. Serum LAB levels were measured by ELISAs with recombinant LOX-1 and monoclonal anti-apolipoprotein B antibody. Results: Serum LAB levels [median (interquartile range), μg/L] were 1321 (936, 1730) in US Caucasians and 940 (688, 1259) in Japanese. For Caucasian men, average IMT was higher in higher LAB quartile, which was 0.653, 0.667, 0.688, and 0.702. mm, respectively (p for trend. =. 0.02). Linear regression analysis showed serum LAB was significantly associated with IMT after adjustment for LDLC or total LDL particles in addition to other traditional or novel risk factors for atherosclerosis such as C-reactive protein. However, there was no significant relationship between LAB and IMT in Japanese men. Conclusion: Serum LAB, a new candidate biomarker for residual risk, was associated with an increased carotid IMT in US Caucasian men independently of various risk factors; however, ethnic difference should be clarified in the future. © 2013 Elsevier Ireland Ltd.

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Prognostic values of bundle branch blocks for cardiovascular mortality in Japanese (24 year follow-up of NIPPON DATA80)

Nakamura Yasuyuki, Okamura Tomonori, Inohara Taku, Kohsaka Shun, Watanabe Makoto, Higashiyama Aya, Kadota Aya, Okuda Nagako, Ohkubo Takayoshi, Nagasawa Shin Ya, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu

Journal of Electrocardiology 46 ( 4 ) 360 - 365 2013.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 0022-0736

Aims Left bundle branch block (LBBB) is generally considered to be associated with a poorer prognosis in comparison with normal controls. However, there are some studies that showed no difference in prognosis of LBBB in comparison with normal controls. Methods and Results We studied prognostic values of BBBs on cardiovascular disease (CVD) and total mortality using the NIPPON DATA80 database with a 24-year follow-up. At the baseline in 1980, data were collected on study participants, ages 30 years and over, from randomly selected areas in Japan. We followed 9,090 participants (44% men, mean age 51). During the 24 year follow-up, there were 886 CVD, and 2,597 total mortality cases. Among participants, 0.2% of them were in LBBB, 1.3% in RBBB, 4.3% in other ventricular conduction defect (VCD) groups. The multivariate-adjusted hazard ratio (HR) using the Cox model including biochemical and other ECG variables revealed that LBBB was significantly positively associated with CVD (HR = 2.71, 95% confidence intervals [CI]: 1.35-5.45, P = 0.005), and total (HR = 2.07, 95%CI: 1.26-3.39, P = 0.004) mortality in men and women combined compared to participants without VCD. RBBB and other VCDs did not carry any significant risk for CVD or total mortality. Conclusions We found significant positive associations of LBBB with CVD and total mortality independent of confounding factors including other ECG changes. © 2013 Elsevier Inc.

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Interaction between dietary marine-derived n-3 fatty acids intake and J-point elevation on the risk of cardiac death

Hisamatsu Takashi, Miura Katsuyuki, Ohkubo Takayoshi, Yamamoto Takashi, Fujiyoshi Akira, Miyagawa Naoko, Kadota Aya, Takashima Naoyuki, Okuda Nagako, Matsumura Yasuhiro, Yoshita Katsushi, Kita Yoshikuni, Murakami Yoshitaka, Nakamura Yasuyuki, Okamura Tomonori, Horie Minoru, Okayama Akira, Ueshima Hirotsugu

Heart 99 ( 14 ) 1024 - 1029 2013.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 1355-6037

Objective: Higher marine-derived n-3 fatty acids (MDn3FAs) intake reduces the risk of sudden cardiac death via antiarrhythmic effects. The article evaluates whether MDn3FAs intake attenuates the increased risk of cardiac death associated with J-point elevation (JPE), characterised by an elevation of QRS-ST junction (J-point) ≥0.1 mV on electrocardiography. Design: A prospective population-based cohort study. Setting: The National Survey on Circulatory Disorders and the National Nutrition Survey of Japan. Participants: A total of 4348 community-dwelling men (mean age 49.3 years), without cardiovascular diseases at baseline, from randomly selected areas across Japan. Main outcome measures: Cardiac death (200 men) during the 24-year follow-up. Results: Dietary MDn3FAs intake was assessed using a dietary method to estimate individual intake of household-based weighed food records for 3 days. Cox models were used to calculate HRs and 95% CIs adjusted for possible confounding factors. JPE was present in 340 participants (7.8%). The median daily intake of MDn3FAs was 0.35%kcal (0.92 g/day). The risk of cardiac death was significantly higher in participants with JPE than in those without JPE in the low intake group (<0.35%kcal; adjusted HR 3.51; 95% CI 1.84 to 6.73; p<0.001), but not in the high intake group (≥0.35%kcal; adjusted HR 1.09; 95% CI 0.56 to 2.16; p=0.795). The interaction between dietary MDn3FAs intake and JPE on the risk of cardiac death was statistically significant (p=0.006). Conclusions: The increased risk of cardiac death associated with JPE may be attenuated by higher dietary MDn3FAs intake.

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Concordance of CKD stages in estimation by the CKD-EPI equation and estimation by the MDRD equation in the Japanese general population

Ohsawa Masaki, Tanno Kozo, Itai Kazuyoshi, Turin Tanvir Chowdhury, Okamura Tomonori, Ogawa Akira, Ogasawara Kuniaki, Fujioka Tomoaki, Onoda Toshiyuki, Yoshida Yuki, Omama Shin Ichi, Ishibashi Yasuhiro, Nakamura Motoyuki, Makita Shinji, Tanaka Fumitaka, Kuribayashi Toru, Koyama Tomiko, Sakata Kiyomi, Okayama Akira

International Journal of Cardiology 165 ( 2 ) 377 - 379 2013.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 0167-5273

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Treated and untreated hypertension, hospitalization, and medical expenditure

Nakamura Koshi, Miura Katsuyuki, Nakagawa Hideaki, Okamura Tomonori, Okuda Nagako, Nishimura Kunihiro, Yasumura Seiji, Sakata Kiyomi, Hidaka Hideki, Okayama Akira

Journal of Hypertension 31 ( 5 ) 1032 - 1042 2013.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 0263-6352

Lippincott Williams &Wilkins.OBJECTIVE: This study investigated the effect of hypertension on hospitalization risk and medical expenditure according to treatment status in a Japanese population. METHODS: A total of 314 622 beneficiaries of the medical insurance system in Japan, aged 40-69 years, without a history of cardiovascular, cerebrovascular, or end-stage renal disease were classified into seven blood pressure categories. These categories were used to compare the risk of undergoing hospitalization in the 1 year after the baseline survey and to examine the percentage of inpatient medical expenditure attributable to overall hypertension relative to total medical expenditure in the study population. RESULTS: During the follow-up period, 6.6% of men and 5.1% of women were hospitalized. In men and women aged 40-54 years, cases of hypertension, especially grade 3 untreated hypertension, led to more frequent hospitalization, compared with optimal blood pressure. Individuals who were hospitalized, especially long-term, incurred considerably higher medical expenditure compared with those who were not hospitalized, regardless of their hypertension status. In women aged 55-69 years, there was little variation in hospitalization risk across blood pressure categories. The inpatient medical expenditure attributable to overall hypertension represented 7.2 and 6.9% of the total medical expenditure for men aged 40-54 and 55-69 years, whereas it represented 2.8 and 3.8% for women, respectively. CONCLUSION: Although cases of hypertension were an economic burden especially in men, grade 3 untreated hypertension was more likely to incur extremely high medical expenditure as a result of hospitalization, compared with other cases. © 2013 Wolters Kluwer Health

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Ethnic difference in liver fat content

Azuma Koichiro, Curb J. David, Kadowaki Takashi, Edmundowicz Daniel, Kadowaki Sayaka, Masaki Kamal H., El-Saed Aiman, Nishio Yoshihiko, Seto Todd B., Okamura Tomonori, Cetinel Cemal, Kadota Aya, Sutton-Tyrrell Kim, Miura Katsuyuki, Evans Rhobert W., Takamiya Tomoko, Maegawa Hiroshi, Miljkovic Iva, Kuller Lewis H., Ueshima Hirotsugu, Kelley David E., Sekikawa Akira

Obesity Research and Clinical Practice 7 ( 3 ) 2013.05

Joint Work, Accepted, ISSN 1871-403X

Background: We recently reported that Japanese had higher liver fat at a lower level of BMI compared with non-Hispanic whites (NHW). Objective: We hypothesize that ethnic difference in fat storage capacity contributes to this ethnic difference in liver fat. Design: To examine this, we assessed liver fat among 244 Japanese-American aged 40-49, using regional computed-tomography images, along with metabolic variables. Results: Despite the similar BMI between Japanese-Americans and NHW men, Japanese-Americans had more liver fat (liver to spleen attenuation ratio: 1.03 ± 0.22 for Japanese-Americans, and 1.07 ± 0.15 for NHW men; p < 0.05) and tended to have a greater disposition for fatty liver with an increase in BMI than NHW, indicating a clear difference between the two groups. In addition, liver fat is less in Japanese-Americans compared with Japanese men (1.03 ± 0.22 vs. 1.01 ± 0.16; p < 0.05), despite of a much higher BMI. These ethnic differences support the hypothesis that higher fat storage capacity indeed seems to be associated with less liver fat. In all the groups, liver fat content strongly correlated with triglycerides, homeostasis model assessment-insulin resistance, and C-reactive protein (CRP). Nevertheless, these metabolic variables were worse in Japanese-Americans, despite of less liver fat, compared with Japanese. Moreover, CRP levels were least among Japanese with highest liver fat, and highest among NHW men with least liver fat, despite of a strong positive association between CRP and fatty liver within each population. Conclusions: Fat content in the liver is intermediate for Japanese-Americans compared with Japanese and NHW men, which supports the hypothesis of less fat storage capacity among Japanese, closely linked to ethnic difference in predisposition to fatty liver. © 2011 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

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Public awareness of early symptoms of stroke and information sources about stroke among the general japanese population

Miyamatsu Naomi, Okamura Tomonori, Nakayama Hirofumi, Toyoda Kazunori, Suzuki Kazuo, Toyota Akihiro, Hata Takashi, Hozawa Atsushi, Nishikawa Tomofumi, Morimoto Akiko, Ogita Mihoko, Morino Ayumi, Yamaguchi Takenori

Cerebrovascular Diseases 35 ( 3 ) 241 - 249 2013.04

Research paper (scientific journal), Joint Work, Accepted, ISSN 1015-9770

Background: It is important that the general population be aware of the early symptoms, since it has been shown that early arrival to hospitals leads better prognosis of stroke patients. However, the general population is not well informed about the early symptoms of stroke. This study was conducted to clarify which stroke symptoms are less well known and which information sources are related to awareness of stroke symptoms. Methods: A multiple-choice, mail-in survey involving 5,540 randomly selected residents, aged 40-74 years, of 3 cities in Japan was conducted. Their knowledge about stroke symptoms and their information sources were surveyed; information sources were classified as mass media (television/newspaper/radio) and personal communication sources (posters/leaflets/internet/health professionals/family and/or friends). 'Awareness' was defined as selecting all 5 of the correct stroke symptoms from among 10 listed symptoms with decoy choices. The estimated fraction of the possible impact due to each source on the whole population was also calculated by odds ratios (ORs) and the proportion of respondents who selected each source (Pe). The combined effects of mass media and personal communication sources on awareness were also assessed. Results: Of the 5,540 residents, only 23% selected all 5 correct symptoms. Visual disturbance was the least known of the 5 symptoms (35%). All sources were positively related to awareness, with ORs (Pe) of: television, 1.58 (72.5%); newspaper, 1.79 (48.0%); radio, 1.74 (13.3%); posters, 1.73 (7.6%); leaflets, 1.50 (24.7%); Internet, 1.66 (5.6%); health professionals, 1.33 (34.8%), and family/friends, 1.21 (44.6%). The estimated fraction of the possible impact due to each source was higher for mass media (television, 0.31 and newspaper, 0.28) than personal communication sources (Internet, 0.04 and leaflets, 0.12). Mass media only and mass media/personal communication sources were significantly associated (ORs: 1.66, 2.75, respectively). Conclusions: As a single method of public education, television could be the most effective strategy. Moreover, the combined approach involving mass media and personal communication sources might have a synergistic effect. Less well-known symptoms, such as visual disturbances, should be noted in public education campaigns. Copyright © 2013 S. Karger AG, Basel.

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Alcohol consumption and cardiovascular disease incidence in men with and without hypertension

Higashiyama Aya, Okamura Tomonori, Watanabe Makoto, Kokubo Yoshihiro, Wakabayashi Ichiro, Okayama Akira, Miyamoto Yoshihiro

Hypertension Research 36 ( 1 ) 58 - 64 2013.01

Research paper (scientific journal), Joint Work, Accepted, ISSN 0916-9636

The relationship between alcohol consumption and the risk for cardiovascular disease (CVD) is U-shaped, whereas alcohol drinking is linearly associated with blood pressure, and the CVD risk also increases linearly according to blood pressure level. Accordingly, we investigated the net effect of alcohol consumption and hypertension on CVD and its subtypes in this study. A 13-year prospective study of 2336 Japanese men who were free from CVD was performed; ex-drinkers were excluded. The participants were divided into eight groups classified by the combination of the presence of hypertension (systolic/diastolic blood pressure ≥140/90 mm Hg) and alcohol consumption (never-, current-(light, moderate and heavy) drinkers). Multivariate-adjusted hazard ratios (HRs) for the incidence of CVD, coronary artery disease (CAD) and stroke due to the combination of hypertension and alcohol consumption were calculated and compared with non-hypertensive never-drinkers. The HRs for CVD and its subtypes were higher in hypertensives than those in non-hypertensives; in hypertensives without medication for hypertension, the relationship between alcohol consumption and the risks for CVD and CAD was U-shaped, with the highest and most significant increase in never-drinkers. The risk for total stroke was the highest in heavy-drinkers, which was significant. In non-hypertensives, there was no evident increase or decrease in the HRs for CVD and its subtypes in drinkers. Accordingly, controlling blood pressure is important to prevent CVD. In hypertensives, heavy drinking should be avoided to prevent CVD, although light-to-moderate drinking could be protective for CAD. Furthermore, in non-hypertensives, drinkers may need to continuously monitor their blood pressure. © 2013 The Japanese Society of Hypertension All rights reserved.

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Influence of cigarette smoking on coronary artery and aortic calcium among random samples from populations of middle-aged Japanese and Korean men.

Hirooka N, Kadowaki T, Sekikawa A, Ueshima H, Choo J, Miura K, Okamura T, Fujiyoshi A, Kadowaki S, Kadota A, Nakamura Y, Maegawa H, Kashiwagi A, Masaki K, Sutton-Tyrrell K, Kuller LH, Curb JD, Shin C.

J Epidemiol Community Health 67 ( 2 ) 119-24, 2013. 2013

Research paper (scientific journal), Joint Work, Accepted

The clustering of cardiovascular disease risk factors and their impacts on annual medical expenditure in Japan: community-based cost analysis using Gamma regression models.

Murakami Y,Okamura T,Nakamura K, Miura K, Ueshima H.

BMJ Open 3 ( 3 ) e002234 2013

Research paper (scientific journal), Joint Work, Accepted

Ethnic difference in liver fat content: A cross-sectional observation among Japanese American in Hawaii, Japanese in Japan, and non-Hispanic whites in United States.

Azuma K, Curb JD, Kadowaki T, Edmundowicz D, Kadowaki S, Masaki KH, El-Saed A, Nishio Y, Seto TB, Okamura T, Cetinel C, Kadota A, Sutton-Tyrrell K, Miura K, Evans RW, Takamiya T, Maegawa H, Miljkovic I, Kuller LH, Ueshima H, Kelley DE, Sekikawa A.

Obes Res Clin Pract 7 ( 3 ) e198-205 2013

Research paper (scientific journal), Joint Work, Accepted

動脈硬化性疾患の絶対リスクの評価と脂質管理目標．

岡村智教、杉山大典．

日本臨床 (日本臨床社) 71 ( 増刊号3 ) 29-35. 2013

Research paper (scientific journal), Joint Work

Influence of cigarette smoking on coronary artery and aortic calcium among random samples from populations of middle-aged Japanese and Korean men

Hirooka Nobutaka, Kadowaki Takashi, Sekikawa Akira, Ueshima Hirotsugu, Choo Jina, Miura Katsuyuki, Okamura Tomonori, Fujiyoshi Akira, Kadowaki Sayaka, Kadota Aya, Nakamura Yasuyuki, Maegawa Hiroshi, Kashiwagi Atsunori, Masaki Kamal, Sutton-Tyrrell Kim, Kuller Lewis H., Curb J. David, Shin Chol

Journal of Epidemiology and Community Health 67 ( 2 ) 119 - 124 2013

Research paper (scientific journal), Joint Work, Accepted, ISSN 0143-005X

Background: Cigarette smoking is a risk factor of coronary heart disease. Vascular calcification such as coronary artery calcium (CAC) and aortic calcium (AC) is associated with coronary heart disease. The authors hypothesised that cigarette smoking is associated with coronary artery and aortic calcifications in Japanese and Koreans with high smoking prevalence. Methods: Random samples from populations of 313 Japanese and 302 Korean men aged 40e49 years were examined for calcification of the coronary artery and aorta using electron beam CT. CAC and AC were quantified using the Agatston score. The authors examined the associations of cigarette smoking with CAC and AC after adjusting for conventional risk factors and alcohol consumption. Current and past smokers were combined and categorised into two groups using median pack-years as a cut-off point in each of Japanese and Koreans. The never-smoker group was used as a reference for the multiple logistic regression analyses. Results: The ORs of CAC (score $10) for smokers with higher pack-years were 2.9 in Japanese (p<0.05) and 1.3 in Koreans (non-significant) compared with neversmokers. The ORs of AC (score $100) for smokers with higher pack-years were 10.4 in Japanese (p<0.05) and 3.6 in Koreans (p<0.05). Conclusion Cigarette smoking with higher pack-years is significantly associated with CAC and AC in Japanese men, while cigarette smoking with higher pack-years is significantly associated with AC but not significantly with CAC in Korean men.

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Absolute risk of cardiovascular disease and lipid management targets

Teramoto Tamio, Sasaki Jun, Ishibashi Shun, Birou Sadatoshi, Daida Hiroyuki, Dohi Seitaro, Egusa Genshi, Hiro Takafumi, Hirobe Kazuhiko, Iida Mami, Kihara Shinji, Kinoshita Makoto, Maruyama Chizuko, Ohta Takao, Okamura Tomonori, Yamashita Shizuya, Yokode Masayuki, Yokote Koutaro

Journal of Atherosclerosis and Thrombosis 20 ( 9 ) 689 - 697 2013

Research paper (scientific journal), Joint Work, Accepted, ISSN 1340-3478

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The clustering of cardiovascular disease risk factors and their impacts on annual medical expenditure in japan

Murakami Yoshitaka, Okamura Tomonori, Nakamura Koshi, Miura Katsuyuki, Ueshima Hirotsugu

BMJ Open 3 ( 3 ) 2013

Research paper (scientific journal), Joint Work, Accepted

Objective: The clustering of cardiovascular disease (CVD) risk factors is a serious threat for increasing medical expenses. The age-specific proportion and distribution of medical expenditure attributable to CVD risk factors, especially focused on the elderly, is thus indispensable for formulating public health policy given the extent of the ageing population in developed countries. Design: Cost analysis using individuals' medical expenses and their corresponding health examination measures. Setting: Shiga prefecture, Japan, from April 2000 to March 2006. Participants: 33 213 participants aged 40 years and over. Main outcome measures: Mean medical expenditure per year. Methods: Gamma regression models were applied to examine how the number of CVD risk factors affects mean medical expenditure. The four CVD risk factors analysed in this study were defined as follows: hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg), hypercholesterolaemia (serum total cholesterol ≥240 mg/dl), high blood glucose (casual blood glucose ≥200 mg/dl) and smoking (current smoker). Sex-specific and age-specific investigations were carried out on the elderly (aged 65 and over) and nonelderly (aged 40-64) populations. Results: The mean medical expenditure (per year) for the no CVD risk-factor group was only 110 000 yen at age 50 (men, 110 708 yen; women, 107 109 yen), but this expenditure was 6-7 times higher for 80-year-olds who have three or four CVD risk factors (men, 603 351 yen; women, 765 673 yen). The total overspend (excess fraction) was larger for the non-elderly (men, 15.4%; women, 11.1%) than that for the elderly (men, 0.1%; women, 5.2%) and largely driven by people with one or two CVD risk factors, except for elderly men. Conclusions: The age-specific proportion and distribution of medical expenditure attributable to CVD risk factors showed that a high-risk approach for the elderly and a population approach for the majority are both necessary to reduce total medical expenditure in Japan.

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Fatty acid intakes and coronary heart disease mortality in Japan

Nakamura Yasuyuki, Kiyohara Yutaka, Okuda Nagako, Okamura Tomonori, Higashiyama Aya, Watanabe Makoto, Kadota Aya, Nagasawa Shin ya, Miyagawa Naoko, Ohkubo Takayoshi, Kita Yoshikuni, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu

Current Nutrition and Food Science 9 ( 1 ) 26 - 32 2013

Research paper (scientific journal), Joint Work, Accepted, ISSN 1573-4013

Associations between dietary fatty acid intakes and risk of coronary heart disease (CHD) are not entirely consistent in prospective studies in the U.S. and Europe. Such studies in Japan are rare. The objective of this study was to examine the association between dietary total, saturated (SFA), and polyunsaturated (PUFA) fatty acids, cholesterol intake and CHD mortality using the dataset of NIPPON DATA90. At the baseline in 1990, we performed blood biochemical measurements and a nutritional survey on participants from 300 randomly selected districts. After exclusion of participants with a history of CHD and/or stroke at the baseline, we followed 7,819 community residents (3,254 men and 4,565 women, age ≥ 30) for 15 years. We estimated individual nutrient intakes among family members by weighed food records in three consecutive representative days. During the follow-up, there were 42 CHD deaths in men and 30 in women. Mean daily SFA and PUFA % calorie intakes were 5.90±1.36%, and 5.59±1.30%, respectively in men, and 6.48±1.53%, and 6.08±1.14% in women. A Cox analysis adjusted for age, vegetable and fruit intakes, and other confounders in women found that SFA intake was significantly associated with CHD mortality (hazards ratio per one quintile increment=1.34, 95% confidence intervals: 1.02-1.74, P=0.03), while no such association was noted in men. No associations were found between other fat intakes and CHD mortality in men or women. In conclusion, SFA intake was positively associated with CHD mortality independent of confounders in women, but not in men. © 2013 Bentham Science Publishers.

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Consumption of dairy products and death from cardiovascular disease in the Japanese General Population

Kondo Imako, Ojima Toshiyuki, Nakamura Mieko, Hayasaka Shinya, Hozawa Atsushi, Saitoh Shigeyuki, Ohnishi Hirofumi, Akasaka Hiroshi, Hayakawa Takehito, Murakami Yoshitaka, Okuda Nagako, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu, Okamura Tomonori, Sakata Kiyomi, Nakamura Yosikazu, Matsumura Yasuhiro, Nishi Nobuo, Kasagi Fumiyoshi, Izumi Toru, Tamakoshi Koji, Nakagawa Hideaki, Ohkubo Takayoshi, Kita Yoshikuni, Nakamura Yasuyuki, Yoshita Katsushi, Kadota Aya, Kodama Kazunori, Kiyohara Yutaka

Journal of Epidemiology 23 ( 1 ) 47 - 54 2013

Research paper (scientific journal), Joint Work, Accepted, ISSN 0917-5040

Background: Recent Western studies show an inverse association between milk and dairy product intake and cardiovascular disease (CVD). We studied the association between consumption of milk and dairy products and CVD death in Japan. Methods: Men and women aged 30 years or older were followed for 24 years. All had participated in a national nutrition survey in 300 health districts throughout Japan in 1980. The Cox proportional hazards model was used to assess mortality risk according to tertiles of milk and dairy product intake, with the high consumption group as reference. Hazard ratios (HRs) per 100-g/day increase in consumption were also estimated. Results: During the 24-year follow-up period, there were 893 CVD deaths, 174 deaths from coronary heart disease (CHD), and 417 stroke deaths among 9243 participants. For women, the HRs for death from CVD, CHD, and stroke in the low consumption group were 1.27 (95% CI: 0.99-1.58; P for trend = 0.045), 1.67 (0.99-2.80; P = 0.02), and 1.34 (0.94-1.90; P = 0.08), respectively, after adjustment for age, body mass index, smoking status, alcohol drinking habits, history of diabetes, use of antihypertensives, work category, and total energy intake. With each 100-g/day increase in consumption of milk and dairy products, HRs tended to decrease for deaths from CVD (HR, 0.86; 95% CI, 0.74-0.99), CHD (0.73; 0.52-1.03), and stroke (0.81; 0.65-1.01) in women. No significant association was observed in men. Conclusions: Consumption of milk and dairy products was inversely associated with CVD death among women in Japan. © 2012 by the Japan Epidemiological Association.

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Treatment B) drug therapy

Journal of Atherosclerosis and Thrombosis 20 ( 12 ) 850 - 860 2013

Research paper (scientific journal), Joint Work, Accepted, ISSN 1340-3478

Small dense low-density lipoproteins cholesterol can predict incident cardiovascular disease in an urban Japanese cohort

Arai Hidenori, Kokubo Yoshihiro, Watanabe Makoto, Sawamura Tatsuya, Ito Yasuki, Minagawa Asako, Okamura Tomonori, Miyamato Yoshihiro

Journal of Atherosclerosis and Thrombosis 20 ( 2 ) 195 - 203 2013

Research paper (scientific journal), Joint Work, Accepted, ISSN 1340-3478

Aim: Several lines of evidence indicate that small dense low-density lipoproteins (sd-LDL) are more atherogenic than large buoyant LDL; however, few prospective studies have addressed the role of sd-LDL in cardiovascular disease (CVD). We therefore examined the association between sd-LDL cholesterol (sd-LDL-C) and CVD in a Japanese cohort. Methods: An 11.7-year prospective study was performed using a general population aged 30-79 without a history of cardiovascular disease. Direct LDL-C and sd-LDL-C were measured in samples from 2034 participants (968 men and 1066 women). Results: During the follow-up period, there were 116 incident cases of CVD. The multivariableadjusted hazard ratios (HRs) of sd-LDL-C for CVD were calculated using a proportional hazards regression model after adjusting for age, hypertension, diabetes, use of lipid-lowering drugs, body mass index, and current smoking and alcohol drinking, and found that increasing quartiles of sd-LDL-C were associated with increased risk of CVD. We also determined that age and sex-adjusted HRs per 10 mg/dL of sd-LDL-C and HRs for CVD, stroke, cerebral infarction, and coronary artery disease were 1.21 (95% CI: 1.12-1.31), 1.17 (95% CI: 1.05-1.30), 1.15 (95% CI: 1.00-1.33), and 1.29 (95% CI: 1.14-1.45), respectively. Conclusions: It was demonstrated that sd-LDL-C was significantly associated with CVD in a Japanese population, providing evidence of sd-LDL-C as an important biomarker to predict CVD.

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