Passive smoking and mortality from aortic dissection or aneurysm

Evidence on the association between passive smoking and risk of aortic dissection or aneurysm is limited. This study aimed to investigate whether passive smoking increases risk of mortality from aortic dissection or aneurysm.The Japan Collaborative Cohort (JACC) Study is a prospective community-based cohort study begun in 1988-90 and followed up to the end of 2009. We examined 48,677 individuals (mean age, 56 years; women, 46%) without history of stroke, coronary heart disease, or cancer, who provided valid responses to a lifestyle questionnaire including questions on active and passive smoking. We used 3 categories (passive smoking out of home, passive smoking at home, and passive smoking out of or at home combined) to divide never-smokers into 3 exposure groups: low, intermediate, and high exposures, respectively. The endpoint was underlying cause of death from aortic dissection or aneurysm.During the median 19-year follow-up of 48,677 study participants, 66 died of aortic dissection, and 75 of aortic aneurysm. Multivariable hazard ratios (95% confidence intervals) for the high passive-smoking group as compared with the low passive-smoking group were 2.45 (1.02-5.88) out of home, 1.82 (0.84-3.96) at home, and 2.35 (1.09-5.09) out of or at home combined. The corresponding hazard ratios for current smokers as compared with the low passive-smoking group were 3.97 (2.14-7.39), 3.41 (1.84-6.32) and 4.09 (1.99-8.39), respectively.Out-of-home passive smoking and out-of- or at-home combined passive smoking were associated with increased mortality from aortic dissection or aneurysm

Green tea consumption and risk of hematologic neoplasms: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study)

PurposeExperimental studies suggested that green tea may have an anticancer effect on hematologic neoplasms. However, few prospective studies have been conducted.MethodsA total of 65,042 individuals aged 40–79 years participated in this study and completed a self-administered questionnaire about their lifestyle and medical history at baseline (1988–1990). Of these, 52,462 individuals living in 24 communities with information on incident hematologic neoplasms available in the cancer registry, who did not have a history of cancer and provided valid information on frequency of green tea consumption, were followed through 2009. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of hematologic neoplasms according to green tea consumption were analyzed.ResultsThe incidence of hematologic neoplasms during a median follow-up of 13.3 years was 323. Compared with the never-drinkers of green tea, the multivariate HRs and 95% CIs for total hematologic neoplasms in green tea drinkers of ≤ 2 cups/day, 3–4 cups/day, and ≥ 5 cups/day were 0.65 (0.42–1.00), 0.73 (0.47–1.13), and 0.63 (0.42–0.96), respectively. The association was more prominent for acute myeloid leukemias and follicular lymphomas.ConclusionsThe present cohort study suggests a protective effect of green tea against hematologic neoplasms, especially acute myeloid leukemias

The criteria for metabolic syndrome and the national health screening and education system in Japan

Two major definitions of metabolic syndrome have been proposed. One focuses on the accumulation of risk factors, a measure used by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI); the other focuses on abdominal obesity, a measure used by the International Diabetes Federation (IDF) and the Japanese government. The latter definition takes waist circumference (WC) into consideration as an obligatory component, whereas the former does not. In 2009, the IDF, NHLBI, AHA, and other organizations attempted to unify these criteria; as a result, WC is no longer an obligatory component of those systems, while it remains obligatory in the Japanese criteria. In 2008, a new Japanese cardiovascular screening and education system focused on metabolic syndrome was launched. People undergoing screening are classified into three groups according to the presence of abdominal obesity and the number of metabolic risk factors, and receive health educational support from insurers. This system has yielded several beneficial outcomes: the visibility of metabolic syndrome at the population level has drastically improved; preventive measures have been directed toward metabolic syndrome, which is expected to become more prevalent in future generations; and a post-screening education system has been established. However, several problems with the current system have been identified and are under debate. In this review, we discuss topics related to metabolic syndrome, including (1) the Japanese criteria for metabolic syndrome; (2) metabolic syndrome and the universal health screening and education system; and (3) recent debates about Japanese criteria for metabolic syndrome

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

Alcohol consumption and mortality from aortic disease among Japanese men: The Japan Collaborative Cohort study

Background and aimsOnly a few population-based prospective studies have examined the association between alcohol consumption and abdominal aortic aneurysm, and the results are inconsistent. Moreover, no evidence exists for aortic dissection. We examined the effect of alcohol consumption on risk of mortality from aortic diseases.MethodsA total of 34,720 men from the Japan Collaborative Cohort study, aged 40–79 years, without history of cardiovascular disease and cancer at baseline 1988 and 1990 were followed up until the end of 2009 for their mortality and its underlying cause. Hazard ratios of mortality from aortic diseases were estimated according to alcohol consumption categories of never-drinkers, ex-drinkers, regular drinkers of ≤30 g, and >30 g ethanol per day.ResultsDuring the median 17.9-year follow-up period, 45 men died of aortic dissection and 41 men died of abdominal aortic aneurysm. Light to moderate drinkers of ≤30 g ethanol per day had lower risk of mortality from total aortic disease and aortic dissection compared to never-drinkers. The respective multivariable hazard ratios (95% confidence intervals) were 0.46 (0.28–0.76) for total aortic disease and 0.16 (0.05–0.50) for aortic dissection. Heavy drinkers of >30 g ethanol per day did not have reduced risk of mortality from total aortic disease, albeit had risk variation between aortic dissection and abdominal aortic aneurysm.ConclusionsLight to moderate alcohol consumption was associated with reduced mortality from aortic disease among Japanese men.Available online 21 September 2017, In Pres

Absolute and Attributable Risks of Heart Failure Incidence in Relation to Optimal Risk Factors

Epidemiologic studies have shown that a large proportion of coronary heart disease and stroke events are explained by borderline or elevated risk factors, and that adults with optimal risk factors greatly avoid these events. The degree to which this applies to heart failure incidence is not well documented

Associations of Daily Walking Time With Pneumonia Mortality Among Elderly Individuals With or Without a Medical History of Myocardial Infarction or Stroke: Findings From the Japan Collaborative Cohort Study

Background: The association between daily walking and pneumonia mortality, stratified by the presence of disease conditions, such as myocardial infarction (MI) or stroke, was investigated.Methods: The study participants were 22,280 Japanese individuals (9,067 men and 13,213 women) aged 65–79 years. Inverse propensity weighted competing risk model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for pneumonia mortality.Results: After a median of 11.9 years of follow-up, 1,203 participants died of pneumonia. Participants who did not have a history of MI or stroke and who walked for 1 hour/day or more were less likely to die from pneumonia (HR 0.90; 95% CI, 0.82–0.98) than those walked for 0.5 hours/day. A similar inverse association of pneumonia and walking (0.5 hours/day) was observed among participants with a history of MI (HR 0.66; 95% CI, 0.48–0.90). Among the participants with a history of stroke, those who walked for 0.6–0.9 hours/day were less likely to die because of pneumonia (HR 0.65; 95% CI, 0.43–0.98).Conclusions: Regular walking for ≥1 hour/day may reduce the risk of pneumonia mortality in elderly individuals with or without cardiovascular disease history

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