Mortality from Aortic Disease in Relation with Sleep Duration at Night and Daytime Napping: The Japan Collaborative Cohort Study.

AIMS: Few studies have investigated the impact of sleep duration at night and daytime napping on mortality from aortic disease. In this study, we examined the associations of sleep duration at night with daytime napping and mortality from aortic disease. METHODS: We followed 67,269 participants (26,826 men and 40,443 women, aged 40-79 years) who were not night shift workers and had no history of stroke, heart disease, or cancer. The baseline survey was conducted in 1988-1990, and follow-up continued until the end of 2009. Sleep duration at night was classified into three categories: ≤ 6, 7, and ≥ 8 hours/day. We also asked the presence or absence of daytime napping. Hazard ratios (HRs) for mortality from aortic disease with 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model. RESULTS: During an average 16.3-year follow-up period, we observed 87 deaths from aortic dissection and 82 from aortic aneurysms. There was no association between sleep duration at night and mortality from aortic disease, but daytime napping was associated with an increased risk of mortality from total aortic disease; the multivariable-adjusted HRs were 1.48 [95% CIs: 1.08-2.02]. Furthermore, the stratified analysis revealed a stronger association with medium sleep duration (7 hours at night) compared to the other shorter and longer sleep duration: the multivariable-adjusted HR for aortic disease, 2.02 [1.16-3.52]. CONCLUSION: Daytime napping but not sleep duration at night was associated with an increased risk of mortality from aortic disease.

Smoking cessation and the odds of developing hypertension in a working-age male population; the impact of body weight changes.

BACKGROUND: Smoking elevates blood pressure (BP) whereas smoking cessation increases body weight (BW), which predisposes new quitters to the development of hypertension. This study aimed to investigate the effect of smoking cessation and subsequent BW change on the odds of developing hypertension. METHODS: A total of 10,354 Japanese male workers without hypertension who underwent a baseline annual medical checkup were followed up for three years to detect the development of hypertension. They were divided into six groups according to their smoking status (non-smokers, new quitters, or continuous smokers) and BW change (≥3 kg or <3 kg) during the follow-up period. Logistic regression analysis was used to calculate odds ratio (OR) for developing hypertension. RESULTS: During the follow-up period, 1,032 participants (mean age, 38.4 ± 8.8 years) developed hypertension. After adjusting for multiple potential confounders, the odds of developing hypertension were significantly higher in new quitters with BW gains ≥3 kg (OR, 2.95, 95% confidence interval [CI], 1.37-6.35) compared to non-smokers with BW gains <3 kg. However, increased odds of developing hypertension were not observed in those with BW gains <3 kg (OR, 0.90, 95% CI, 0.52-1.58). Continuous smokers were at increased odds of developing hypertension regardless of their BW changes (BW gain <3 kg, OR, 1.35, 95% CI, 1.13-1.61 vs BW gain ≥3 kg, OR, 1.90, 95% CI, 1.43-2.52). CONCLUSIONS: The odds of developing hypertension were increased in new quitters only when their BW gain was not controlled after smoking cessation.

Second Derivative of the Finger Photoplethysmogram Predicts the Risk of Developing Hypertension in Middle-Aged Men.

AIM: Increased arterial stiffness impairs the functional and structural properties of arteries, which in turn elevates blood pressure (BP). The aim of this study was to test whether indices obtained from the second derivative of the finger photoplethysmogram (SDPTG), a marker of arterial stiffness, predict future development of hypertension in middle-aged men. METHODS: The SDPTG was measured in 902 men without hypertension (mean age 44±6 years) at an annual medical checkup. The development of hypertension was monitored for a maximum of 4 years. Two indices of arterial stiffness were calculated from the SDPTG waveforms: b/a, an index of large elastic arterial stiffness, and d/a, an index of systemic arterial stiffness, including the structural and functional properties of small and muscular arteries and peripheral circulation. A Cox proportional hazards model was used to examine whether the b/a and d/a ratios were independent predictors of future development of hypertension. RESULTS: During the follow-up period, 124 individuals developed hypertension, defined as a systolic/diastolic BP ≥ 140/90 mm Hg or the use of antihypertensive medications. The hazard ratio for the development of hypertension significantly increased in the lowest quartile of the d/a ratio (2.84, 95% confidence interval: 1.58-5.13, p＜0.001) compared with the highest quartile, after adjusting for multiple potential confounders. In contrast, the b/a ratio did not show significant hazard ratios for the development of hypertension. CONCLUSIONS: The d/a ratio, calculated from the SDPTG waveforms, predicted the risk of future development of hypertension in this study population.

Nationwide Analysis of the Relationship Between Low Ambient Temperature and Acute Aortic Dissection-related Hospitalizations.

AIMS: Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency. Therefore, identifying modifiable risk factors for AAD is of great public health significance. An association between ambient temperature (AT) and AAD has been reported; however, not all findings have been elucidated. This study examined the association between AAD-related hospitalization and AT using data from the Japanese Registry of All Cardiac and Vascular Diseases Diagnostic Procedure Combination (JROAD-DPC), which is a nationwide claims-based database. METHODS: This nationwide time-stratified case-crossover study evaluated data of hospitalized patients with AAD from 1,119 certified hospitals between 2012 and 2020 using the JROAD-DPC database. Conditional logistic regression and distributed lag non-linear models were used to investigate the association between average daily temperature and AAD-related hospitalization. RESULTS: Among the 96,812 cases analyzed. The exposure-response curve between AT and AAD-related hospitalization showed an increase in the odds ratio for lower temperatures, with a peak at timed -10°C (odds ratio: 2.28, 95% confidence interval: 1.92-2.71, compared with that at 20°C). The effects of temperature on lag days 0 and 1 were also significant.Stratified analyses showed a greater association between AT and AAD-related hospitalization for the following variables: older age (≥75 years), female sex (44.4%, the mean age ± SD was 76 ± 12 years), low body mass index (<22), winter season, and warmer regions. CONCLUSIONS: Low AT is associated with an increased risk of AAD-related hospitalization. Several susceptible groups are affected by cold temperatures and have a higher risk of hospitalization.

This study examined the association between hospitalization due to acute aortic dissection (AAD) and ambient temperature using data from the Japanese Registry of All Cardiac and Vascular Diseases Diagnostic Procedure Combination, which is a nationwide claims-based database. Key findings:Low ambient temperature is associated with an increased risk of AAD-related hospitalization, with a greater association with older age and female sex.Other predisposing factors for the above association include lower body mass index, winter seasons, and warmer regions.