Sadanobu Kagamimori

High-Density Lipoprotein Cholesterol and Risk of Stroke in Japanese Men and Women The Oyabe Study

Background and Purpose— Evidence of an inverse relationship between serum high-density lipoprotein cholesterol (HDL-C) and the risk of stroke is sparse in Asians and in women. The purpose of this investigation was to examine the relationship in a long-term cohort study of Japanese men and women among whom stroke occurrence is higher than in Western countries. Methods— A prospective cohort study was performed involving 4989 participants (1523 men, 3466 women) 35 to 79 years of age at baseline with ≈10 years of follow-up in a rural area of Japan. End points included all stroke incidence and ischemic stroke incidence. Results— During follow-up, 132 participants developed stroke, including 81 ischemic stroke cases. Age-adjusted incidence rates per 10 000 person-years for all stroke in subjects with low HDL-C (<30 mg/dL [0.78 mmol/L]) were 103.4 in men and 49.3 in women, which were remarkably higher than in subjects with high HDL-C (≥60 mg/dL [1.56 mmol/L]) (26.4 in men and 15.5 in women). A similar relationship was observed for ischemic stroke. Multivariate-adjusted relative risks for all stroke incidence and ischemic stroke incidence were 2.89 (95% CI, 1.35 to 6.20) and 2.92 (95% CI, 1.17 to 7.32), respectively, for low versus high HDL-C participants. The relationships were independent of sex, age, body mass index, blood pressure, serum total cholesterol, alcohol consumption, and smoking. Conclusions— This 10-year follow-up study of Japanese men and women demonstrated that lower HDL-C levels were related significantly and independently to increased risk of all stroke incidence and ischemic stroke incidence.

Association of Sleep Quality and Free Time Leisure Activities in Japanese and British Civil Servants

Association of Sleep Quality and Free Time Leisure Activities in Japanese and British Civil Servants: Ali Nasermoaddeli, et al. Department of Welfare Promotion and Epidemiology, Toyama Medical and Pharmaceutical University—Sleep disturbance as a pervasive health problem can directly affect the physical and psychological well‐being of individuals. Factors that positively relate to sleep quality can therefore improve healthy functioning. We examined whether leisure time activities are associated with sleep quality in two culturally different samples of civil servants. In this cross‐sectional study we evaluated 1,682 Japanese, in Toyama prefecture (T) city, and 6,914 British civil servants from the Whitehall II study undertaken in London. The Japanese version of Pittsburgh sleep quality index (PSQI‐J) was used in T city and Jenkins’ sleep problem scale was used in the Whitehall II study. Setting a validated cut‐off point of 5.5 for the PSQI‐J global score and the upper tertile point for the Jenkins’ sleep problem scale, we conducted logistic regression analysis to assess the association between leisure time activities and sleep quality. In both populations, those who participated in voluntary activities in clubs or organizations were significantly less likely to have poor sleep quality with Odds ratios (OR) and 95% confidence intervals (95%CI) of 0.73 (95%CI; 0.56–0.97) and 0.85 (95%CI; 0.76–0.95) in Japanese and British civil servants, respectively. Similar findings were apparent for visiting friends and relatives (ORs 0.60 (95%CI; 0.46–0.80) and 0.71 (95%CI; 0.56–0.90) for Japanese and British subjects, respectively). Our findings suggest that engagement in social leisure activities is associated with better sleep quality and consequently better general well‐being.

Job Strain and Sleep Quality in Japanese Civil Servants with Special Reference to Sense of Coherence

Job Strain and Sleep Quality in Japanese Civil Servants with Special Reference to Sense of Coherence: Ali Nasermoaddeli, et al. Department of Welfare Promotion and Epidemiology, Toyama Medical and Pharmaceutical University—The combination of poor sleep quality and high job strain may provoke poor health status. Meanwhile, a sense of coherence (SOC), composed of comprehensibility, manageability and meaningfulness has been associated with adoptive measures in responding to life stress. In this study we investigated the impact of job strain on the sleep quality in civil servants and the extent to which SOC affects their sleep quality. In this cross‐sectional study we evaluated 1682 civil servants working in departments related to the municipality of T city in Toyama prefecture, Japan, in the spring of 2001. Using the validated Japanese versions of Pittsburgh sleep quality index (PSQI‐J), SOC‐13 and a self‐reported questionnaire providing information on psychosocial stress in the workplace, we conducted logistic regression analysis to assess the impact of low and high SOC (differentiating by the median score) on sleep quality in different levels of job strain. Using a cut‐off point of 5.5 in the PSQI‐ J global score, high job strain subjects were less likely to have good sleep quality (Odds ratio=0.62; 95% confidence interval: 0.44‐0.86) compared with those with lower levels of strain at the workplace after adjusting for potential confounders. Compared with high job strain/low SOC subjects, high job strain/high SOC civil servants were likely to have better sleep quality (Odds ratio=2.12; 95%CI: 1.08‐4.19) after adjusting for age, sex, employment category, level of education and negative affectivity. Increasing psychological stress at the workplace may decrease sleep quality in Japanese civil servants, but a high sense of coherence may attenuate the adverse impact of job strain on sleep quality.

Association between Sense of Coherence and Heart Rate Variability in Healthy Subjects

ObjectivesThis report investigates whether there is any association between sense of coherence (SOC), as a coping measure in confronting stressful conditions, and heart rate variability (HRV), as a measure of the cardiac autonomic nervous system during the daily life pattern.MethodsSixteen healthy university students (14 males and 2 females) filled in the validated Japanese version of the SOC-13 questionnaire before being informed about the study protocol. For each participant, we calculated 5-minute HRV indices using logarithmically transformed data on frequency domains for HRV derived by 24-hour Holter monitoring. Frequency domains for HRV recordings were investigated for the 24-hour time periods.ResultsThe correlation coefficient between the SOC scores and the high frequency power of HRV (0.15–0.40) was positively significant during the resting sitting position (r≥0.60, P<0.05). After grouping SOC scores by the median, the high frequency domain of HRV was higher in high SOC subjects for most of the 24-hour time period.ConclusionA higher SOC could modulate the parasympathetic tone of cardiac autonomic activity, especially during the resting sitting position.

Psychosocial stressors in inter-human relationships and health at each life stage: A review.

Currently, psychosocial stressors’ impacts on health are increasing. Among these stressors, this review focused on inter-human relationships. Since social supports could be protective against ill health, consequences contributing to psychosocial stressors are discussed here in relation to social supports for each stage of childhood, adulthood and elderly status.For childhood, parental divorce/isolation, and child abuse/neglect appeared to be determinants of healthy development at either the initial or later stages. According to prospective studies, such stressors, especially those occurring until around 3 years of age, were associated with later adverse life quality in adulthood. Therefore, nationwide preventive strategies were developed in each country to monitor protective social programs.For adulthood, job strain was focused on Karasek’s job strain model, effort-reward imbalance, employment grade and working hours. These psychosocial stressors were shown to affect not only the physical health but also the mental health of working people. These days, since Karoshi and even suicide related to excessive workloads are taking a toll on workplace organization, stress-coping abilities such as a sense of coherence were introduced from the individual-social interaction aspect.For elderly status, retirement, caring for the elderly, and spouse bereavement were discussed as psychosocial stressors. Some evidence indicates that these stressors could be determiants of health. Finally, social supports have been demonstrated to promote health and protect the elderly against diseases and death.

Adverse health experience in male workers during the boom economy in Japan.

The existence of different mortality rate gradients for the various occupational groups is well known. In general, higher grade employees have lower mortality rates, but such a gradient could be influenced by their socio-economic status. We selected eight male occupational groups (farmers, foresters and fishermen; craftsmen, production process workers and other laborers including mining workers since 1990; sales workers; transportation and communication workers; service, sport and recreation workers; clerical workers; professional technical workers and artists; administrators and managers) for whom agespecific mortality rates are available from reports of vital statistics on occupational and industrial aspects issued by the Ministry of Health and Welfare, Japan, and ageadjusted mortality rates were calculated based on the 1985 population as the reference group. Changes and differences in age-adjusted mortality rates between the Japanese male occupational groups were reviewed over three recent decades (Figure). In contrast to a declining trend in mortality rates since 1965, in 1990 (end of the boom economy period) transportation and communication workers had the worst position for the mortality rate with a more marked divergence (150.4% increase compared to 1985) than the other seven groups. Percentage changes in mortality rates for other seven occupational groups showed an increase of 0.3% to 39.6% between 1985 and 1990 (Table), and there were larger differences between the occupational groups than in the past. Changes in Tokyo stock prices and freight transport volumes, obtained from the related white books, were also superimposed in the Figure. In parallel to the steep increase in stock prices recorded in Tokyo between 1985 and 1990, freight transport