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1.
J Diabetes ; 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32372543

RESUMO

BACKGROUND: Although evidence about skeletal muscle mass loss and type 2 diabetes risk has accumulated, little information is available on the combined effect of skeletal muscle mass and abdominal obesity on type 2 diabetes. We examined whether skeletal muscle mass and abdominal obesity were synergistically associated with the prevalence of type 2 diabetes. METHODS: Skeletal muscle mass and waist circumference (WC) were measured in 1515 Japanese aged 40-69 years. Relative muscle mass was calculated as percentage of total skeletal muscle mass in body weight (SMM%). Type 2 diabetes was identified as fasting serum glucose ≥7.0 mmol/L (126 mg/dL), non-fasting serum glucose ≥11.1 mmol/L (200 mg/dL), hemoglobin A1c ≥ 6.5%, and/or diabetes medication use. RESULTS: The multivariable-adjusted odds ratio (OR) of prevalent diabetes from the lowest to third quartiles of SMM% compared to the highest quartile was gradually higher in both sexes. The association between a high WC and prevalent diabetes was similar. The multivariable-adjusted OR (95% confidence intervals) for the prevalence of type 2 diabetes in the low skeletal muscle mass/high WC group was 3.19 (1.78-5.71) for men and 4.46 (2.09-9.51) for women compared with the high skeletal muscle mass/low WC group. The relative excess risk due to interaction was 2.2 (0.5-3.9) in men and 2.8 (0.2-5.3) in women for an excess burden of type 2 diabetes for low skeletal muscle mass and high WC. CONCLUSIONS: Low skeletal muscle mass and abdominal obesity were synergistically associated with presence of type 2 diabetes. This article is protected by copyright. All rights reserved.

2.
J Atheroscler Thromb ; 2020 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-32161250

RESUMO

AIM: The association between urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), an oxidative stress marker, and the incidence of cardiovascular disease (CVD) has not been confirmed because no previous studies evaluated 24-hour 8-OHdG excretion levels in the general population. We aimed to confirm the association between 24-hour urinary 8-OHdG levels and CVD risk among Japanese men and women. METHODS: A nested case-control study was performed based on a 24-hour urine collection in a community-based cohort study performed from 1996 to 2005. Seventy-six cases (55 men and 21 women) who experienced their first CVD incidence during the follow-up period (median: 5.9 years) were recruited. The controls were frequency-matched 1:2, with each case for sex, age, area of residence, and baseline year. The 8-OHdG level was measured by enzyme-linked immunosorbent assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression models adjusted for body mass index, ethanol intake, smoking status, and estimated glomerular filtration rate. RESULTS: The geometric mean and geometric standard deviation (SD) of 8-OHdG levels (nmol/day) for cases and controls were 35.5 (1.55) and 35.5 (1.54) for men and 32.1 (1.35) and 25.0 (1.39) for women, respectively. The multivariable OR (95% CI) of CVD incidence according to the 1-SD increment of the log-transformed 8-OHdG level was 2.08 (0.99-4.37) for women. The multivariable ORs (95% CIs) for the 1st (lowest) and 4th versus 2nd quartile according to 8-OHdG for men were 3.29 (1.02-10.61) and 2.77 (0.96-7.96), respectively. CONCLUSION: A high 8-OHdG level tended to be associated with CVD incidence among women.

3.
Brain Behav ; 10(4): e01541, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32077640

RESUMO

OBJECTIVE: We aimed to investigate associations between cardiovascular reactivity to acute stress and sickness absence among Japanese male and female workers, in a prospective study. METHODS: Among healthy employed Japanese workers who underwent mental health checks between 2006 and 2009, data of 111 participants were analyzed. Changes in blood pressure, pulse rate, peripheral blood flow (PBF), and heart rate variability (HRV) (high frequency [HF] and low frequency [LF]) were calculated using differences between the two tasks, mirror drawing stress [MDS] and a maze task, and the postperiod value. Sickness absence through March 2010 was followed up by mail survey (average follow-up 2.3 years). Logistic regression analysis was used, adjusting for lifestyle factors. RESULTS: Among 12 participants who took sickness absences, eight were owing to mental problems. Changes in the LF during the MDS and maze tasks and LF-to-HF ratio during the MDS task were positively associated with all sickness absences (odds ratio [OR], 95% confidence interval [CI]: 2.09, 1.03-4.22; 2.04, 1.09-3.82; and 3.10, 1.46-6.58, respectively). Changes in PBF during the MDS task were also associated with increased risk of sickness absence (OR, 95% CI: 2.53, 1.10-5.81). CONCLUSION: Cardiovascular reactivity to acute stress should be considered at workers' health checks.

4.
J Atheroscler Thromb ; 2020 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-31932552

RESUMO

AIM: N-terminal pro-B-type natriuretic peptide (NT-proBNP), frequently used as a biochemical marker for detecting and monitoring heart failure, is also a risk marker for development of coronary heart disease and total stroke. However, studies that explore subtypes of ischemic stroke with regard to NT-proBNP are scarce. Here, we examined NT-proBNP and its impact upon subtypes of ischemic stroke (lacunar stroke, large-artery occlusive stroke and embolic stroke) among Japanese. METHODS: We measured NT-proBNP and categorized 4,393 participants of the Circulatory Risk in Communities Study into four groups (<55, 55-124, 125-399, and ≥ 400 pg/ml). We used a multivariable Cox proportional hazards model to examine association with risks of stroke and subtypes. RESULTS: During 4.7 years of follow-up, we identified 50 strokes, including 35 ischemic (15 lacunar, 6 largeartery occlusive, 10 embolic strokes) and 14 hemorrhagic strokes. NT-proBNP was associated with stroke risk: the multivariable hazard ratio of total strokes was 7.29 (2.82-18.9) for the highest and 2.78 (1.25-6.16) for the second highest NT-proBNP groups compared with the lowest group. The respective hazard ratios for the highest NT-proBNP group were 9.37 (3.14-28.0) for ischemic stroke and 6.81 (1.11-41.7) for lacunar stroke. Further adjustment for atrial fibrillation did not attenuate these associations. The associations were similarly observed for large-artery occlusive and embolic strokes. CONCLUSION: We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners.

5.
Hypertens Res ; 43(4): 313-321, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31988479

RESUMO

The role of serum uric acid as a predictor of stroke among the general Japanese population remains controversial. We conducted a prospective cohort study of 5235 men and 8185 women aged 40-79 years at baseline between 1985 and 1994 in four Japanese communities, who were initially free from stroke, coronary heart disease, and medication for hyperuricemia or gout. Cox proportional hazards models were used to estimate sex-specific hazard ratios of stroke and its types in relation to serum uric acid level. During a median follow-up of 23.1 years, we recorded 1018 (488 men and 530 women) incident strokes, including 222 (99 and 123) intraparenchymal hemorrhages, 113 (33 and 80) subarachnoid hemorrhages and 667 (347 and 320) ischemic strokes. After adjustment for age, community and known cardiovascular risk factors, the multivariable hazard ratios (95% CIs) in the highest vs. lowest quintile of serum uric acid were 1.45 (1.07-1.96) for total stroke, 1.20 (0.65-2.20) for intraparenchymal hemorrhage, 1.46 (0.69-3.09) for subarachnoid hemorrhage and 1.61 (1.07-2.41) for ischemic stroke in women. The corresponding multivariable hazard ratios (95% CIs) in men were 1.02 (0.74-1.35), 0.83 (0.40-1.72), 1.19 (0.38-3.75) and 1.00 (0.70-1.41). Furthermore, those positive associations with risks of total and ischemic strokes in women were more evident in nonusers of antihypertensive medication than the users. In conclusion, elevated serum uric acid level is an independent predictor of total stroke in women but not in men. The positive association in women was mostly attributable to ischemic stroke and was more pronounced among nonusers of antihypertensive medication.

6.
Psychosom Med ; 82(2): 215-223, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31860529

RESUMO

OBJECTIVE: It has been suggested that urbanization, which has been expanding rapidly for the past several decades, increases the risk of cardiovascular disease (CVD) associated with psychological factors such as anger, but the evidence is limited. We examined the hypothesis that urbanicity modifies the association of anger expression with the risk of CVD. METHODS: A prospective study was conducted in 5936 residents of urban and rural communities aged 40 to 79 years who had completed an annual health checkup including a questionnaire on anger expression between 1995 and 1998. Associations of anger expression with the risk of CVDs were examined using Cox proportional hazards models, after adjusting for classical cardiovascular risk factors. RESULTS: During a median follow-up of 16.6 years, we identified 312 incident CVDs. The means (SDs) of anger expression were 24.7 (5.8) among urban residents and 24.6 (5.7) among rural participants (p = .87). Among urban residents, anger expression was positively associated with the risk of total CVD: the multivariable hazard ratio (95% confidence interval) was 1.27 (1.05-1.54). In contrast, no association was found among rural residents: the corresponding ratio (interval) was 0.96 (0.85-1.09), with a significant interaction between urban and rural residency with anger expression for incident CVD (p = .047). Similar associations were observed with the risk of CVD subtypes, including ischemic stroke and ischemic CVD. CONCLUSIONS: We found a positive association between anger expression and the risk of CVD among urban residents but not rural residents, suggesting that urbanicity enhances the anger-CVD association.

7.
Spine Surg Relat Res ; 3(4): 377-384, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31768459

RESUMO

Introduction: Chronic low back pain (CLBP), defined as low back pain persisting for at least 3 months, leads to limitations in the activities of daily living and decreased quality of life. Individualized self-exercise education could be a preferable treatment option, especially in community-dwelling people with CLBP. Previous studies, however, did not directly compare the effects of therapist-led self-exercise education and material-only education, and there are only a few studies investigating the effects of low-dose (comprising a few sessions) self-exercise education on CLBP. We present a protocol of community-based, randomized study to evaluate the effects of low-dose (comprising a few sessions), therapist-led self-exercise education on CLBP. Methods: Forty-eight participants with CLBP (men and women, aged 40-74 years) will be allocated to therapeutic self-exercise education programs, either a therapist-led group (2-week therapist's consultation and material use) or material-only group (material use only), in a randomized controlled trial. Pain intensity (NRS, numeric rating scale), pain disability (RDQ, Roland-Morris disability questionnaire), pain self-efficacy (PSEQ, pain self-efficacy questionnaire), and quality of life score (EQ-5D, European quality of life-5 dimensions) will be measured at baseline and at 4, 12, and 24 weeks. We will apply a repeated-measures design with mixed-effect models to estimate group differences from the baseline. Ethics/Trial registration number: The protocol was approved by the Ethics Committees of the Osaka Center for Cancer and Cardiovascular Disease Prevention and Osaka University. The trial registration number is registered on the University Hospital Medical Information Network (UMIN000024537).

8.
J Atheroscler Thromb ; 26(2): 145-153, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-29899172

RESUMO

AIMS: The frequency of breakfast intake has been reported to be inversely associated with the risk of cardiovascular events; however, it is uncertain what the impact of the energy and nutrient intakes from breakfast are. We assessed the association between these intakes from breakfast and the risk of stroke prospectively. METHODS: In a baseline survey of four Japanese communities between 1981 and 1990, we enrolled 3 248 residents (1 662 men and 1 586 women) aged 40-59 years who were free from stroke and heart disease and who responded to the 24-hour dietary recall survey. We assessed the dietary intake at breakfast, lunch, dinner, and other times separately. RESULTS: During the median 25-year follow-up, 230 individuals (147 men and 83 women) developed stroke. After adjustment for age, community, other dietary intakes, and lifestyle and physiological factors, the multivariable-adjusted hazard ratios (95% confidence intervals) of intracerebral hemorrhage for the highest versus lowest quartiles of energy intake from breakfast were 0.38 (0.15-0.99) in men and 1.36 (0.36-5.10) in women. For the major nutrients, a higher saturated or monounsaturated fat intake at breakfast was associated with a reduced risk of intracerebral hemorrhage in men, and remained statistically significant after further adjustment for intake of other major nutrients from breakfast. CONCLUSIONS: A higher intake of energy from breakfast, primarily saturated or monounsaturated fat, was associated with a reduced risk of intracerebral hemorrhage in Japanese men.


Assuntos
Desjejum , Dieta/efeitos adversos , Ingestão de Energia , Nutrientes/efeitos adversos , Acidente Vascular Cerebral/etiologia , Adulto , Pesquisa Participativa Baseada na Comunidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Vigilância da População , Prognóstico , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/metabolismo , Acidente Vascular Cerebral/patologia
9.
J Epidemiol ; 29(3): 83-91, 2019 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-30584233

RESUMO

The Circulatory Risk in Communities Study (CIRCS) is an ongoing community-based epidemiological study of lifestyle-related disease involving dynamic prospective cohorts of approximately 12,000 adults from five communities of Japan: Ikawa, Ishizawa and Kita-Utetsu (Akita Prefecture), Minami-Takayasu (Osaka Prefecture), Noichi (Kochi Prefecture), and Kyowa (Ibaraki Prefecture). One of the most notable features of CIRCS is that it is not only an observational cohort study to identify risk factors for cardiovascular diseases (CVD), such as stroke, coronary heart disease, and sudden cardiac death, but it also involves prevention programs for CVD. Using basic, clinical, epidemiological, and statistical techniques, CIRCS has clarified characteristics of CVD and the related risk factors to develop specific methodologies towards CVD prevention in Japanese middle-aged or older adults for more than half a century.


Assuntos
Doenças Cardiovasculares/epidemiologia , Estilo de Vida , Características de Residência/estatística & dados numéricos , Adulto , Idoso , Doenças Cardiovasculares/prevenção & controle , Estudos Epidemiológicos , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
10.
Circ J ; 82(12): 3013-3020, 2018 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-30318502

RESUMO

BACKGROUND: Few prospective studies have explored the association between fatty acids (FA) and risk of CAD. Understanding of the role of each individual serum FA as a coronary risk or protective factor is still limited. The aim was to investigate which serum FA are associated with the incidence of CAD in Japanese subjects. Methods and Results: A prospective nested case-control study of 40-85-year-old Japanese subjects was undertaken using frozen serum samples collected from 12,840 participants who participated in cardiovascular risk surveys from 1984 to 1998 for 1 community and 1989-1997 for 2 other communities. Three control subjects per case were matched by sex, age, community, year of serum storage and fasting status. By 2005 we had identified 152 incident cases of CAD. Mean n-3-polyunsaturated and saturated FA did not differ between cases and controls, while mean n-6-polyunsaturated FA was higher in controls compared with cases. The multivariable OR of CAD for the highest vs. lowest quartiles of miristic acid (14:0), palmitic acid (16:0), palmitoleic acid (16:1), and linoleic acid (18:2) were 2.8 (95% CI: 1.5-5.2), 2.7 (95% CI: 1.4-5.5), 3.2 (95% CI: 1.7-6.1) and 0.4 (95% CI: 0.2-0.7), respectively. CONCLUSIONS: High serum miristic acid, palmitic acid and palmitoleic acid have an adverse effect, and high serum linoleic acid had a protective effect, on the risk of CAD.


Assuntos
Doença da Artéria Coronariana/sangue , Ácidos Graxos/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
11.
Hypertens Res ; 41(12): 1054-1062, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30333520

RESUMO

This study aimed to assess the association of cigarette smoking with radial augmentation index among the Asian general population. We conducted a cross-sectional population-based study including 1593 men and 2671 women aged 40-79 years. Smoking status was ascertained through interviews, and the number of pack-years was calculated. The radial augmentation index was defined as the ratio of central pulse pressure to brachial pulse pressure, as measured using an automated tonometer: the HEM-9000AI (Omron Healthcare co., Kyoto, Japan). There was a higher prevalence of an increased radial augmentation index among current male smokers who smoked ≥ 30 cigarettes/day and all female smokers than among never smokers. After adjusting for known risk factors of atherosclerosis, the multivariable odds ratio (OR) [95% confidence interval (CI)] for a high radial augmentation index for current male smokers who smoked ≥30 cigarettes/day compared with never smokers was 1.9 (1.1-3.4). The multivariable OR (95% CI) for a high radial augmentation index for former female smokers and current female smokers compared with never smokers was 1.8 (1.2-2.7) and 2.5 (1.6-3.9), respectively. Moreover, smoking pack-years was positively associated with a high radial augmentation index in both sexes. There were no relationship between smoking status and high central or brachial pulse pressures among subjects of either sex. In conclusion, cigarette smoking and cumulative smoking exposure were positively associated with an increased radial augmentation index in men who smoked heavily and in women.


Assuntos
Pressão Sanguínea/fisiologia , Fumar Cigarros/efeitos adversos , Hipertensão/etiologia , Rigidez Vascular/fisiologia , Adulto , Idoso , Fumar Cigarros/fisiopatologia , Estudos Transversais , Feminino , Humanos , Hipertensão/fisiopatologia , Japão , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais
12.
Vet Rec ; 2018 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-29483150

RESUMO

OBJECTIVE: To assess the association between low serum creatinine levels and an increased risk of type 2 diabetes mellitus and dysglycemia. RESEARCH DESIGN AND METHODS: We conducted a retrospective cohort study of 3313 Japanese male workers aged 30-55 years, who underwent annual health check-ups during 2001-2008 and showed no type 2 diabetes mellitus, and underwent follow-up examinations until March 2013. Dysglycemia was defined as a fasting plasma glucose concentration of ≥110 mg/dL (6.1 mmol/L), or a non-fasting plasma glucose concentration of ≥140 mg/dL (7.8 mmol/L). A Cox proportional model was used to calculate HRs and 95% CIs for developing type 2 diabetes mellitus or dysglycemia. RESULTS: During the median 6.7-year follow-up, there were 207 cases of incident type 2 diabetes mellitus and 596 cases of incident dysglycemia, including 115 cases of type 2 diabetes mellitus among the subjects with normal glucose concentrations at baseline. After adjustment for age, body mass index and known diabetes risk factors, the multivariable HR of type 2 diabetes mellitus for the lowest category of serum creatinine (<0.7 mg/dL) vs the highest category (0.9-1.1 mg/dL) was 1.9 (95% CI 1.2 to 2.9; P for trend 0.03). The multivariable HRs of dysglycemia for the lowest category of serum creatinine versus the highest category was 1.5 (95% CI 1.1 to 1.9; P for trend 0.01). CONCLUSIONS: Low serum creatinine levels were associated with an increased risk of type 2 diabetes mellitus and dysglycemia.

13.
Circ J ; 82(6): 1598-1604, 2018 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-29445058

RESUMO

BACKGROUND: The effect of postprandial glucose on the risk of cardiovascular disease has been emphasized, but it is controversial whether nonfasting glucose is related to incident stroke and its types.Methods and Results:We investigated the associations of nonfasting glucose with incident stroke and its types among 7,198 participants aged 40-74 years from the Circulatory Risk in Communities Study, enrolled in 1995-2000. We estimated multivariable hazard ratios (HR) using Cox proportional hazard models. Over a median follow-up of 14.1 years, 291 cases of total stroke (ischemic strokes: 191 including 109 lacunar infarctions) were identified. Nonfasting glucose concentration was associated with greater risk of incident total stroke, ischemic stroke and lacunar infarction when modeled categorically (for prediabetic type: 7.8-11.0 mmol/L vs. normal type: <7.8 mmol/L among all subjects, HR for lacunar infarction was 2.02, 95% confidence interval (CI): 1.19, 3.43) or continuously (per one standard deviation increment among all subjects, HR for lacunar infarction was 1.29, 95% CI: 1.15, 1.45). Diabetic type showed similar results. Population attributable fractions of nonfasting hyperglycemia were 13.2% for ischemic stroke and 17.4% for lacunar infarction. CONCLUSIONS: Nonfasting glucose concentration, either as a diagnosis of prediabetic and diabetic types or as a continuous variable, proved to be an independent predictor significantly attributed to incident total stroke, especially ischemic stroke and lacunar infarction, in the general population.


Assuntos
Glicemia/análise , Período Pós-Prandial , Acidente Vascular Cerebral/sangue , Adulto , Idoso , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/sangue , Estado Pré-Diabético/diagnóstico , Modelos de Riscos Proporcionais , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral Lacunar/sangue , Acidente Vascular Cerebral Lacunar/etiologia
14.
J Atheroscler Thromb ; 25(9): 836-845, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29415955

RESUMO

AIMS: Smoking impairs endothelial function as an acute effect. However, few population-based studies have examined the association between smoking status and endothelial function or the dose-response and duration-response association of smoking with endothelial function. We examined whether smoking habits were associated with impaired endothelial function depending on smoking dose and duration. METHODS: We conducted a cross-sectional study of 910 men and women aged 30-79 years from 2013 to 2016. Statistical analyses of the data were conducted between 2016 and 2017. Endothelial function was assessed by brachial artery flow-mediated dilation (FMD) measurement. Low FMD was defined in two ways as the cutoff point based on the lowest quartile of %FMD (<5.1%) and median of %FMD (<6.8%), regarding as impaired endothelial function. We investigated the smoking status in terms of cigarettes consumed per day and the duration of smoking. RESULTS: Heavy and chronic smokers were associated with a high prevalence of impaired endothelial function. Those associations did not change substantially after adjustment for other cardiovascular risk factors. Among all participants, the multivariable-adjusted ORs (95% CIs) of low FMD (<5.1%) with reference to never smokers were 2.23 (1.00-5.14) for current heavy smokers of ≥ 30 cigarettes per day, 1.83 (1.04-3.20) for heavy smokers of ≥ 40 pack-years, and 2.16 (1.15-4.06) for chronic smokers of ≥ 40 years. For low FMD (<6.8%) those values was 2.17 (1.01-5.05), 1.70 (1.01-2.86), and 1.98 (1.07-3.69), respectively. CONCLUSIONS: Similar associations were observed among only men. Heavy or long-term tobacco smoking may induce impaired endothelial function.


Assuntos
Artéria Braquial/fisiopatologia , Endotélio Vascular/fisiopatologia , Fumar Tabaco , Vasodilatação , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Fatores de Risco
15.
Atherosclerosis ; 263: 244-248, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28683363

RESUMO

BACKGROUND AND AIMS: Limited evidence is available on the association between markers of arterial stiffness and the prevalence of atrial fibrillation among Asian populations. Therefore, we examined those associations in the Japanese population. METHODS: We conducted a cross-sectional population-based study of 4264 men and women aged 40-79 years. The augmentation index (AI), a marker of arterial stiffness, was calculated as the ratio of central pulse pressure/brachial pulse pressure, where the AI and central aortic pressure were measured by an automated tonometer: the HEM-9000AI device (Omron Healthcare co., Kyoto, Japan). Atrial fibrillation was estimated by the Minnesota codes using resting electrocardiograph (ECG). RESULTS: The prevalence of atrial fibrillation and total arrhythmia were higher with larger AI values. These associations did not change after adjustment for known cardiovascular risk factors. The multivariable odd ratios (95% confidence intervals) in the highest versus lowest tertiles of AI were 3.4 (1.4-8.6, p for trend = 0.008) for atrial fibrillation and 1.8 (1.2-2.7, p for trend = 0.004) for total arrhythmia. There was no association of central or brachial pulse pressure levels with the prevalence of atrial fibrillation or total arrhythmia. CONCLUSIONS: AI values, but not brachial or central pulse pressures, were positively associated with the prevalence of atrial fibrillation and total arrhythmia, independent of cardiovascular risk factors.


Assuntos
Fibrilação Atrial/fisiopatologia , Frequência Cardíaca , Rigidez Vascular , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Fibrilação Atrial/diagnóstico , Estudos Transversais , Eletrocardiografia , Feminino , Humanos , Japão/epidemiologia , Modelos Logísticos , Masculino , Manometria , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prevalência , Fatores de Risco
17.
Atherosclerosis ; 259: 46-50, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28285093

RESUMO

BACKGROUND AND AIMS: Endothelial dysfunction is considered the first stage in the development of atherosclerosis and cardiovascular disease, and brachial flow-mediated dilation (FMD) is a measure of endothelial function. It is uncertain which of central systolic aortic pressure (CAP) or brachial systolic blood pressure (SBP) is more strongly associated with FMD. Therefore, we examined the correlations of CAP and SBP with FMD in Japanese men. METHODS: The study subjects comprised 507 male volunteers aged 30-79 years that were residents in two communities under the Circulatory Risk in Communities Study (CIRCS) between 2013 and 2015. The low percent change of FMD (%FMD) ≤5.0%, after 5 min of reactive hyperemia evaluated by the brachial artery diameter, was used to assess endothelial dysfunction. Values of CAP and SBP were divided into tertiles, with the lowest tertile used as a reference. RESULTS: After adjustment for cardiovascular risk factors, the multivariable odds ratio (95% CI) of low FMD for the highest versus lowest tertile of CAP was 1.5 (0.9-2.6) for total subjects and 1.4 (0.5-3.8) for those with, and 2.4 (1.2-4.8) for those without antihypertensive medication use. The corresponding odd ratios for the highest versus lowest tertile of SBP were 0.9 (0.5-1.5), 0.8 (0.3-2.2), and 1.3 (0.7-2.5), respectively. CONCLUSIONS: Higher CAP levels were associated with low FMD for men without antihypertensive medication, but such an association was not found for SBP levels.


Assuntos
Aorta/fisiopatologia , Pressão Arterial , Aterosclerose/fisiopatologia , Artéria Braquial/fisiopatologia , Hipertensão/fisiopatologia , Vasodilatação , Adulto , Fatores Etários , Idoso , Anti-Hipertensivos/uso terapêutico , Pressão Arterial/efeitos dos fármacos , Aterosclerose/diagnóstico , Estudos Transversais , Humanos , Hiperemia/fisiopatologia , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Fluxo Sanguíneo Regional , Fatores de Risco , Fatores Sexuais , Vasodilatação/efeitos dos fármacos
18.
Heart Asia ; 9(1): 36-43, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28176973

RESUMO

OBJECTIVE: The prognostic importance of changes in ischaemic ECG abnormalities over time (especially ST-T abnormalities) among Asians has not been fully investigated. We examined the associations between changes in ischaemic abnormalities upon serial ECG (improvement, persistence, deterioration) and cardiovascular disease (CVD) risk. METHODS: A prospective study cohort was conducted with 9374 men and women aged 40-69 years in four communities. Participants had multiple ECGs at study entry and during the next 10 years, and were followed up for a median period of 23.0 years. Total CVD (stroke and coronary heart disease) was ascertained under systematic surveillance. ECG abnormalities were defined by the Minnesota Code, ST depression (Code4), abnormal T wave (Code5) and categorised into nine groups (no-no, no-minor, no-major, minor-no, minor-minor, minor-major, major-no, major-minor, major-major) by comparison with the point of entrance and maximum change. RESULTS: We documented 1196 CVD events. Compared with no-no abnormality, no-minor, minor-major and major-major in Code4, HRs (95% CI) adjusted for cardiovascular risk factors were 1.19 (1.00-1.42), 1.57 (1.15-2.12) and 1.87 (1.42-2.47). Similar results were observed in Code5. CONCLUSIONS: Changes in ischaemic ECG abnormalities from none to minor, and minor to major, as well as persistent major abnormalities, were associated with an increased risk of CVD.

19.
Clin Nutr ; 36(3): 793-797, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27265182

RESUMO

BACKGROUND & AIMS: It has been hypothesized that ω-3 polyunsaturated fatty acids have anti-atherosclerotic and neuronal protective functions and may benefit prevention of dementia, but the epidemiological evidence, especially for α-linolenic acid, is quite limited. The aim of this study was to examine whether serum ω-3 polyunsaturated fatty acids are associated with risk of dementia. METHODS: We performed an intracohort case-control study nested in a community-based cohort, the Circulatory Risk in Communities Study, involving 7586 Japanese individuals aged 40-74 years at the baseline period of 1984-1994. Omega-3 polyunsaturated fatty acid constituents (α-linolenic, eicosapentaenoic, and docosahexaenoic acids) in serum total lipid were measured in 315 cases of incident disabling dementia in the above-mentioned cohort between 1999 and 2004, and in 630 controls whose age, sex, area, and baseline year were matched with the cases. RESULTS: As we had postulated, serum α-linolenic acid was inversely associated with risk of disabling dementia: the multivariate odds ratios (95% confidence intervals) were 0.57 (0.39-0.85), 0.51 (0.34-0.76), and 0.61 (0.41-0.90) for persons with the second, third, and highest quartiles of serum α-linolenic acid, respectively, as compared with the lowest quartile (P for trend = 0.01). Associations of other ω-3 fatty acids with disabling dementia were not statistically significant. CONCLUSIONS: Serum α-linolenic acid was inversely associated with risk of disabling dementia. Although the causality needs to be confirmed by randomized control trials, we identified serum α-linolenic acid as a biomarker that predicts future dementia.


Assuntos
Demência/sangue , Demência/diagnóstico , Ácidos Graxos Ômega-3/sangue , Ácido alfa-Linoleico/sangue , Adulto , Idoso , Biomarcadores/sangue , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
20.
J Atheroscler Thromb ; 24(5): 518-529, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-27667328

RESUMO

AIM: Data for long-term trends in blood pressures, body mass index (BMI), and their relations are needed to set future intervention priorities for prevention of cardiovascular disease. The objective of this study was to investigate these trends revealed by repeated cross-sectional surveys conducted from 1963 to 2013 in a Japanese community. METHODS: Men and women aged 40-79 years who participated in annual cardiovascular checkups were enrolled, and the number of participants ranged between 1,776 and 2,366 with consistently high participation rates for both sexes aged 60-69 years. Sex- and age-specific mean systolic and diastolic blood pressures were calculated using mixed effects modeling for repeated measurement, and the prevalence of hypertension with and without obesity (BMI ≥ 25 kg/m2) were also calculated. RESULTS: Sex- and age-specific mean systolic and diastolic blood pressures declined irrespective of antihypertensive medication use in both men and women from 1963-1966 to 2009-2013, while mean BMI increased among men of all ages and women of ages 60-69 and 70-79 years. For both sexes aged 60-69 years, the prevalence of hypertension with obesity increased, but the prevalence of hypertension without obesity was still higher that with obesity. CONCLUSIONS: Despite the transition to increased BMI levels, targeting non to obese hypertension remains important in addition to targeting obese hypertension for cardiovascular disease prevention.


Assuntos
Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Hipertensão/complicações , Obesidade/complicações , Adulto , Fatores Etários , Idoso , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Saúde Pública
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