H. Ueshima

What cause of mortality can we predict by cholesterol screening in the Japanese general population

Abstract.  Okamura T, Kadowaki T, Hayakawa T, Kita Y, Okayama A, Ueshima H (Shiga University of Medical Science, Shiga, Japan; Iwate Medical University, Morioka, Iwate, Japan). What cause of mortality can we predict by cholesterol screening in the Japanese general population? J Intern Med 2003; 253: 169–180.

A “natural experiment” in cardiovascular epidemiology in the early 21st century

Despite similar traditional risk factors, morbidity and mortality rates from coronary heart disease in western and non-western cohorts remain substantially different. Careful study of such cohorts may help identify novel risk factors for CHD, and contribute to the formulation of new preventive strategies

Different effects of blood pressure on mortality from stroke subtypes depending on BMI levels: A 19-year cohort study in the Japanese general population - NIPPON DATA80

To evaluate the relationship between blood pressure and cerebrovascular death depending on body mass index (BMI) levels, we analysed a database of 9338 subjects from the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged, which was originally conducted a baseline survey in 1980 and followed up in 1999. Relative risk (RR) and a 95% confidence interval (CI) of death from total stroke, cerebral infarction, and intracerebral haemorrhage after adjusting for age, sex, serum cholesterol, albumin, glucose, the use of antihypertensive agents, a past history of diabetes, BMI, smoking, and drinking were estimated with the Cox-proportional hazard model in the BMI tertile groups of a representative Japanese population. Cutoff points of BMI tertiles are 21.2 and 23.8 kg/m2. The results indicated that a 10 mmHg systolic blood pressure (SBP) increase was associated with mortality from intracerebral haemorrhage at low and middle BMI groups (RR= 1.38 and 1.23; 95% CI=1.17–1.62 and 1.03–1.47, respectively). SBP was positively associated with mortality from cerebral infarction in middle and high BMI groups (RR=1.19 and 1.21; 95% CI=1.06–1.33 and 1.06–1.38, respectively). The effects of diastolic blood pressure on intracerebral haemorrhage and infarction had the same tendency as those of SBP. These results suggested that the causal effect of blood pressure on stroke subtypes might be modified by BMI.

Is there any circadian variation consequence on acute case fatality of stroke? Takashima Stroke Registry, Japan (1990–2003)

Turin TC, Kita Y, Rumana N, Nakamura Y, Takashima N, Ichikawa M, Sugihara H, Morita Y, Hirose K, Okayama A, Miura K, Ueshima H. Is there any circadian variation consequence on acute case fatality of stroke? Takashima Stroke Registry, Japan (1990–2003). 
Acta Neurol Scand: 2012: 125: 206–212. 
© 2011 John Wiley & Sons A/S.

Both angiotensinogen M235T and α-adducin G460W polymorphisms are associated with hypertension in the Japanese population

Both angiotensinogen M235T and α -adducin G460W polymorphisms are associated with hypertension in the Japanese population

Relationship between non-high-density lipoprotein cholesterol and the long-term mortality of cardiovascular diseases: NIPPON DATA 90

BACKGROUND Non-high-density lipoprotein (HDL) cholesterol level, generally less affected by fasting status or serum triglyceride levels, may be useful for predicting future cardiovascular events in daily clinical practice. This study aimed to investigate the role of non-HDL cholesterol in the development of fatal coronary events and stroke in the general Japanese population. METHODS AND RESULTS From the NIPPON DATA 90 prospective cohort study, 8383 participants were followed up for 20years since 1990. After exclusion of 666 cases without lipid or covariates data, 561 cases who were 75years old or older, 274 cases with history of cardiovascular disease, and 181 cases with lipid-lowering treatment, 6701 participants were included in this analysis. Non-HDL cholesterol was defined as total cholesterol minus HDL cholesterol. Outcomes were death from coronary heart disease and stroke. During the period, 69 participants died from coronary heart disease and 112 from stroke. Compared with participants with non-HDL cholesterol level <3.9mmol/L, age- and sex-adjusted hazard ratios for mortality by coronary heart disease in those with non-HDL cholesterol levels of 3.9-4.3mmol/L, 4.4-4.8mmol/L and ≥4.9mmol/L were 1.27 (95% confidence interval [CI] 0.65-2.49), 1.81 (95% CI 0.92-3.55) and 2.40 (95% CI 1.30-4.43), respectively (P trend=0.010). This association remained significant even after adjusting for other cardiovascular risk factors (P trend=0.010). There was no clear association between non-HDL cholesterol levels and mortality by stroke (P trend=0.052). CONCLUSIONS Among the general Japanese population, non-HDL cholesterol levels were clearly associated with future mortality by coronary heart disease, but not by stroke.