High serum total cholesterol levels is a risk factor of ischemic stroke for general Japanese population: The JPHC study

Background:High serum total cholesterol levels represent a risk factor of ischemic stroke in Western countries. However, this association has not been thoroughly investigated in Asian populations where the incidence of stroke is high.Methods:Participants were 11,727 men and 21,742 women aged 40–69 years, all free of cardiovascular disease and cancer at baseline. During the median 12-year follow-up, we documented 612 ischemic stroke (293 lacunar infarction, 107 large-artery occlusive infarctions, and 168 embolic infarctions).Results:Excess risk of ischemic stroke was observed in men with serum total cholesterol levels of ≥6.21 mmol/L than those with the lowest category (<4.65 mmol/L), but not in women. The multivariable hazard ratios (HRs) and 95% confidence interval (95% CI) were 1.63 (1.14–2.35) for men and 1.03 (0.69–1.55) for women. The corresponding HRs of large-artery occlusive infarction were 2.86 (1.31–6.27) for men and 0.75 (0.28–2.01) for women. Serum total cholesterol levels were not associated with risk of lacunar or embolic infarction for either sex.Conclusions:High serum total cholesterol is a risk factor of ischemic stroke, specifically large-artery occlusive infarction for Japanese men

High Sodium Intake Strengthens the Association between Angiotensinogen T174M Polymorphism and Blood Pressure Levels among Lean Men and Women: a Community-Based Study

Evidence on the effect of salt intake on the interaction between angiotensinogen (AGT) T174M polymorphism and high blood pressure is sparse. We therefore conducted a large population-based cross-sectional study of 2,823 men and women aged 30-74 in a Japanese farming community to examine associations between AGT polymorphism and blood pressure levels stratified by age (30-64 and 65-74), body mass index (BMI; median), and salt intake (median) estimated by 24-h urine collection and dietary questionnaire. Our a priori hypothesis is that individuals, particularly younger and non-overweight individuals, with the 174M allele have elevated blood pressure levels in response to higher sodium intake, and thus the association between T174M polymorphism and blood pressure is more evident among individuals with higher sodium intake than those with lower sodium intake. There were no differences in systolic or diastolic blood pressure levels (SBP or DBP) between the TT and TM+MM genotype groups overall. However, the mean difference in DBP between the TM+MM and TT groups was +1.0 mmHg in subjects of younger age (p =0.06), +1.7 mmHg in non-overweight subjects (BMI<23.5 kg/m2, p =0.01), and +2.3 mmHg in younger and non-overweight subjects (p =0.002). Furthermore, among younger and non-overweight subjects, blood pressure differences were larger for those with higher urinary sodium excretion (+3.1 mmHg, p =0.03), those with a higher sodium/potassium excretion ratio (+4.1 mmHg, p =0.007), those with higher present sodium intake score (+3.0 mmHg, p =0.003), and those with higher past sodium intake score (+3.4 mmHg, p <0.001). In conclusion, AGT T174M polymorphism was associated with higher DBP levels in younger and non-overweight Japanese. This association was more evident among subjects with higher sodium intake

Ankle-Arm Blood Pressure Index and Cardiovascular Risk Factors in Elderly Japanese Men

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Relationships between Sleep-Disordered Breathing and Blood Pressure and Excessive Daytime Sleepiness among Truck Drivers

Sleep-disordered breathing is a risk factor for hypertension, cardiovascular disease and accidents in the general population, but little is known about this correlation among professional truck drivers. To examine the relationships of sleep-disordered breathing with blood pressure levels and excessive daytime sleepiness among truck drivers, we conducted a population-based cross-sectional study of 1,313 subjects aged 20−69 years registered in the Japanese Trucking Association. The 3% oxygen desaturation index was selected as an indicator of sleep-disordered breathing, representing the number of desaturation events per hour of recording time in which blood oxygen fell by ≥3% by overnight pulse oximetry. The Epworth Sleepiness Scale was used to estimate excessive daytime sleepiness. There were significant positive associations between the 3% oxygen desaturation index levels and both diastolic blood pressure levels and Epworth Sleepiness Scale scores. The multivariate odds ratio of hypertension was 2.0 (1.1−3.6) for a 3% oxygen desaturation index of ≥15 in reference with a 3% oxygen desaturation index of <5. This association was more evident among those aged ≥40 years and overweight subjects. Further, the multivariate odds ratio of an Epworth Sleepiness Scale of ≥11 was 2.3 (1.1−4.9) for a 3% oxygen desaturation index of ≥15 in reference with a 3% oxygen desaturation index of <5. This association was more evident among those aged ≥40 years. The associations of sleep-disordered breathing severity with diastolic blood pressure levels and excessive daytime sleepiness suggest the need for sleep-disordered breathing screening among truck drivers for prevention of hypertension and potential traffic accidents

Aldosterone Synthase Gene T−344C Polymorphism Sodium and Blood Pressure in a Free-Living Population: A Community-Based Study

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Alpha-adducin G460W polymorphism, urinary sodium excretion, and blood pressure in community-based samples

BackgroundThere is limited evidence on the gene–environmental interaction among α-adducin G460W gene polymorphism, sodium intake, and blood pressure (BP) levels in a general population. One hypothesis is that the association between G460W polymorphism and BP is more evident among persons with higher sodium intake than those with lower sodium intake.MethodsWe conducted a population-based cross-sectional study of 2823 men and women aged 30 to 74 years in a Japanese rural community to examine the association of the α-adducin G460W polymorphism with BP levels stratified by salt intake, as estimated by 24-h urine collection and dietary questionnaire.ResultsThere was no difference in systolic or diastolic BP levels among the GG, GW, and WW groups for women, but for men, mean systolic BP tended to be higher in the WW group than in the GG group. When we stratified men according to sodium excretion/intake, mean systolic BP was significantly higher in the WW group than in the GG group among men with higher urinary sodium excretion (138.8 v 133.6 mm Hg, P = .02) and tended to be higher among men with higher previous sodium intake. No genetic association was found among women or among men with lower urinary sodium excretion or lower sodium intake.ConclusionsThe α-adducin WW genotype was associated with higher systolic BP among men with a higher sodium intake

High Sodium Intake Strengthens the Association of ACE I/D Polymorphism with Blood Pressure in a Community

BackgroundLimited evidence is available on a gene–environment interaction of angiotensin-converting enzyme (ACE) gene I/D polymorphism and high blood pressure (BP) with salt intake among general populations. We hypothesized that persons with the I allele of the ACE gene have elevated BP levels in response to a higher sodium intake, and thus the association of ACE I/D polymorphism with BP levels was stronger among persons with a higher sodium intake than those with a lower sodium intake.MethodsWe conducted a population-based cross-sectional study of 2823 men and women aged 30 to 74 years in a Japanese rural community to examine the association of the ACE I/D polymorphism with BP levels stratified by salt intake, as estimated by 24-h urine collection and dietary questionnaire. Polymorphism of the ACE I/D was detected by an allele-specific polymerase chain reaction.ResultsThere was no significant difference in BP levels among DD, ID, and II groups for either sex or total samples. However, mean difference in diastolic BP levels for II versus DD groups was +3.0 mm Hg (P = .003) among persons with higher sodium excretion, +1.8 mm Hg (P = .04) among those with higher present sodium intake score, and +1.7 mm Hg (P = .06) among those with higher past sodium intake score.ConclusionsA high sodium intake strengthens the association of ACE I/D polymorphism with BP levels in community-based samples. Key Words: ACE; genetics; molecular epidemiology; salt sensitivity; gene–environment interaction; hypertension; sodium excretion; renin-angiotensin syste

Body Fat Distribution and the Risk of Hypertension and Diabetes among Japanese Men and Women

To identify anthropometrical indices of body fat distribution for predicting the risk of hypertension and diabetes,a population-based prospective study was designed. Subjects in two communities (n=2,422 and3,195), who were free of hypertension and diabetes, respectively, were followed-up. The area and genderspecificrisk of hypertension and diabetes were compared among tertiles of body mass index (BMI) andbody fat distribution, including waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio(WHtR), and subscapular skinfold-thickness (SSF). During the 10-year follow-up for hypertension and diabetes,the incident cases of hypertension were 72 for Yao men, 125 for Kyowa men, 160 for Yao women and193 for Kyowa women and those of diabetes were 27, 64, 37 and 77, respectively. One SD differences in BMIand WC were associated with 1.2 to1.6-fold higher risk of hypertension, and that of SSF was associated with1.4 to 1.6-fold higher risk of diabetes for both men and women in Yao and for women, but not men, inKyowa. One SD differences of BMI, WC and WHtR were also associated with 1.4 to 2.0-fold higher risk ofdiabetes for Yao and Kyowa women. In conclusion, the significant predictors for hypertension were BMI andWC and those for diabetes were BMI and SSF in both genders in both communities, except for men inKyowa. WC and WHtR were also predictors for diabetes in women but not in men

Cigarette Smoking and Risk of Disabling Dementia in a Japanese Rural Community: A Nested Case-Control Study

Background: Previous prospective cohort studies have examined the association between smoking and the risk of dementia, but the results were inconsistent. Methods: A prospective, nested, case-control study was conducted to examine the association between cigarette smoking and risk of disabling dementia within the cohort of 6,343 men and women aged 35-85 years. Incident dementia was documented in 208 men and women (95 cases with and 113 cases without a history of stroke). Two control subjects per case were selected by matching for sex, age and year of examination. Results: The multivariable odds ratios (95% CI) for current versus never smokers were 2.3 (1.1-4.7) for total dementia, 2.6 (0.8-8.2) for dementia with a history of stroke and 2.2 (0.8-5.7) for dementia without it, yielding no effect of stroke history on the smoking-dementia association. A dose-response relationship was noted between the years of cigarette smoking and the risk of total dementia, and a significant excess risk was found for smoking duration of ge45 years. Conclusions: The present prospective study suggests that long-term cigarette smoking may raise the risk of disabling dementia

Competing for Shareable Arms in Multi-Player Multi-Armed Bandits

Competitions for shareable and limited resources have long been studied with strategic agents. In reality, agents often have to learn and maximize the rewards of the resources at the same time. To design an individualized competing policy, we model the competition between agents in a novel multi-player multi-armed bandit (MPMAB) setting where players are selfish and aim to maximize their own rewards. In addition, when several players pull the same arm, we assume that these players averagely share the arms' rewards by expectation. Under this setting, we first analyze the Nash equilibrium when arms' rewards are known. Subsequently, we propose a novel SelfishMPMAB with Averaging Allocation (SMAA) approach based on the equilibrium. We theoretically demonstrate that SMAA could achieve a good regret guarantee for each player when all players follow the algorithm. Additionally, we establish that no single selfish player can significantly increase their rewards through deviation, nor can they detrimentally affect other players' rewards without incurring substantial losses for themselves. We finally validate the effectiveness of the method in extensive synthetic experiments.Comment: ICML 202