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Hirotsugu Ueshima

Publications and source records attributed to Hirotsugu Ueshima.

At least 19 recordsLinked to original sources
PubMed2006

The inverse relationship between serum high-density lipoprotein cholesterol level and all-cause mortality in a 9.6-year follow-up study in the Japanese general population.

In populations with higher high-density lipoprotein cholesterol (HDL-C) levels and lower coronary mortality than Western populations, such as in Japan, the beneficial effect of HDL-C on all-cause mortality may be different. Furthermore, prior studies have not focused on very high level of HDL-C. A total of 7175 community Japanese residents without a past history of cardiovascular disease in 300 randomly selected districts were followed for 9.6 years. During follow-up, there were 636 deaths. The multivariate adjusted hazard ratio (HR) of HDL-C for all-cause or cause-specific mortality was calculated using a Cox proportional hazard model adjusted for other cardiovascular risk factors. The all-cause mortality suggested an inverse, graded relation with HDL-C categories; HR for the very high HDL-C category (> or = 1.82 mmol/L), compared with the reference group (1.04-1.55 mmol/L), was 0.73 (95% confidence interval, C.I., 0.50-1.06) for men, 0.63 (95% C.I., 0.41-0.94) for women and 0.70 (95% C.I., 0.53-0.93) when men and women were combined. Serum HDL-C as a continuous variable showed a significant inverse association with all-cause mortality. The cardiovascular mortality indicated a non-significant but inverse graded relation with HDL-C categories. As in the many Western populations, serum HDL-C levels were inversely associated with all-cause mortality in the Japanese general population.

Biomarkers↗
PubMed2005

The determinants of plasma plasminogen activator inhibitor-1 levels differ for American and Japanese men aged 40-49.

BACKGROUND: Elevated plasma plasminogen activator inhibitor-1 (PAI-1) levels were associated with higher incidence of type II diabetes. Elucidating the determinants of PAI-1 in various ethnicities may help to understand the susceptibility to developing diabetes. The aim of our study was to compare PAI-1 levels between Americans and the Japanese in the post-war generation and to elucidate the determinants of the PAI-1 levels. METHODS: We conducted a cross-sectional study on a total of 198 men aged 40-49 in the US (Body mass index (BMI): 27.0+/-3.3 kg/m(2)) and Japan (BMI: 23.3+/-3.1 kg/m(2)). Examination included physique measurement (BMI and waist girth), blood analysis (lipid profiles, glucose, insulin, C-reactive protein, and PAI-1), and life-style assessment by self-administered questionnaires. RESULTS: PAI-1 levels were significantly lower in American than in Japanese men, even after adjustment for age, waist girth, cigarette smoking, habitual alcohol drinking, and other factors. In the Americans, waist girth, insulin, and cigarette smoking were significantly associated with PAI-1 levels, while waist girth and triglycerides were significantly associated with PAI-1 levels in the Japanese. CONCLUSIONS: PAI-1 levels were significantly lower in American than in Japanese men and the determinants of PAI-1 levels differ for American and Japanese men aged 40-49.

Adult↗
PubMed2005

Smoking and elevated blood pressure are the most important risk factors for subarachnoid hemorrhage in the Asia-Pacific region: an overview of 26 cohorts involving 306,620 participants.

BACKGROUND AND PURPOSE: The cause of subarachnoid hemorrhage (SAH) is poorly understood and there are few large cohort studies of risk factors for SAH. We investigated the risk of SAH mortality and morbidity associated with common cardiovascular risk factors in the Asia-Pacific region and examined whether the strengths of these associations were different in Asian and Australasian (predominantly white) populations. METHODS: Cohort studies were identified from Internet electronic databases, searches of proceedings of meetings, and personal communication. Hazard ratios (HRs) for systolic blood pressure (SBP), current smoking, total serum cholesterol, body mass index (BMI), and alcohol drinking were calculated from Cox models that were stratified by sex and cohort and adjusted for age at risk. RESULTS: Individual participant data from 26 prospective cohort studies (total number of participants 306,620) that reported incident cases of SAH (fatal and/or nonfatal) were available for analysis. During the median follow-up period of 8.2 years, a total of 236 incident cases of SAH were observed. Current smoking (HR, 2.4; 95% CI, 1.8 to 3.4) and SBP >140 mm Hg (HR, 2.0; 95% CI, 1.5 to 2.7) were significant and independent risk factors for SAH. Attributable risks of SAH associated with current smoking and elevated SBP (> or =140 mm Hg) were 29% and 19%, respectively. There were no significant associations between the risk of SAH and cholesterol, BMI, or drinking alcohol. The strength of the associations of the common cardiovascular risk factors with the risk of SAH did not differ much between Asian and Australasian regions. CONCLUSIONS: Cigarette smoking and SBP are the most important risk factors for SAH in the Asia-Pacific region.

Adult↗
PubMed2005

Association between fish consumption and all-cause and cause-specific mortality in Japan: NIPPON DATA80, 1980-99.

PURPOSE: Although high consumption of fish may be one of the contributing factors for Japanese longevity, no epidemiological study using Japanese data has tested this hypothesis. SUBJECTS AND METHODS: The relationship between fish consumption and all-cause as well as cause-specific mortality was analyzed using the database of NIPPON DATA80. At baseline in 1980, history, physical, and blood biochemical measurement and a nutritional survey by the food-frequency method were performed in randomly selected community-based subjects aged 30 years and over in Japan. After exclusion of subjects with significant comorbidities at baseline, we followed 3945 men and 4934 women for 19 years. Men and women were analyzed comprehensively. Age- and sex-adjusted and multivariate adjusted relative risk for all-cause or cause-specific mortality was calculated using a Cox proportional hazards model with delayed entry. RESULTS: During 19 years of followup, there were 1745 deaths. Subjects were divided into 5 groups according to fish consumption frequency. The multivariate Cox analyses showed that relative risks for subjects who ate fish more than twice daily compared with those of subjects who ate 1 to 2 times weekly were 0.99 (95% confidence intervals: 0.77-1.27) for all-cause, 1.26 (0.70-2.29) for stroke, 0.92 (0.20-4.23) for cerebral hemorrhage, 1.09 (0.48-2.43) for cerebral infarction, and 0.91 (0.35-2.35) for coronary heart disease mortality. CONCLUSION: Our results did not provide evidence in support of the fish hypothesis, perhaps because the majority of the Japanese subjects in the study ate fish more than the threshold level shown to be beneficial in the previous studies.

Adult↗
PubMed2005

Relation of long chain n-3 polyunsaturated fatty acid intake to serum high density lipoprotein cholesterol among Japanese men in Japan and Japanese-American men in Hawaii: the INTERLIPID study.

Epidemiologic evidence shows an inverse relationship between fish consumption and coronary heart disease (CHD) mortality. Associations between dietary intake of long chain n-3 polyunsaturated fatty acids (PUFA) and serum high density lipoprotein (HDL) cholesterol concentration are unknown. In this study, the association between n-3 PUFA (eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA)) intake and serum HDL cholesterol among Japanese men and women in Japan and Hawaii was examined. The study population consisted of Japanese ancestries from five research centers of the International Study of Macronutrients and Blood Pressure (INTERMAP) study, in Japan and Hawaii (672 men and 676 women), surveyed between 1996 and 1998. Four 24-h dietary recalls and one set of serum lipid measurements were performed. For men, n-3 PUFA intake and HDL cholesterol were higher in Japan than in Hawaii (n-3 PUFA: 1.32 g/day versus 0.47 g/day, p<0.001). For women, n-3 PUFA intake was higher in Japan than in Hawaii (p<0.001) but HDL cholesterol was not significantly different (p=0.752). After adjustment for age, body mass index, physical activity, number of cigarettes per day, alcohol intake, and hormone replacement therapy (for women), n-3 PUFA intake was positively associated with serum HDL cholesterol in men (4.6 mg/dl higher HDL cholesterol with 1%kcal higher n-3 PUFA intake, p=0.011). This association was not observed in women. This positive association of dietary n-3 PUFA with serum HDL cholesterol may partially explain the low mortality from CHD among Japanese men.

Adult↗
PubMed2005

Incidence of acute myocardial infarction in Takashima, Shiga, Japan.

BACKGROUND: The incidence and mortality from ischemic heart disease (IHD) in Japan seem to be among the lowest of all the industrialized countries, but there are few reliable registers of acute myocardial infarction (AMI). METHODS AND RESULTS: To assess the incidence of AMI in Takashima County, Shiga, Japan, from 1988 to 1998 and compare the data with similar registers in the world, cases of AMI or sudden death presumed from myocardial ischemia were registered. The criteria of AMI were based on the WHO MONICA Projects. The medical records of all the hospitals inside as well as outside the county, the original death records in the health center, and the ambulance records in the county were investigated and 291 cases were registered (190 males, 101 females; average age (mean +/- SD), 69.5+/-12.2). The 28-day and 24-h case fatality was 38.1% and 33.0%, respectively. Age-adjusted annual incidence of AMI per 100,000 population aged between 25 and 74 years were 58.2 for men and 18.0 for women. The incidence of AMI showed a constant trend from 1988 to 1998. CONCLUSION: The results confirmed that Japan has the lowest incidence of AMI among the industrialized countries.

Adult↗
PubMed2005

A cross-sectional study of alcohol drinking and health-related quality of life among male workers in Japan.

BACKGROUND: Although light and moderate alcohol drinkers are likely to have better subjective health, the sub-scales for subjective health have not been well documented. METHODS: We studied 4,521 male workers aged 25 yr and older with no history of cancer or cardiovascular disease, in 12 occupational groups in Japan. Data were from the High-risk and Population Strategy for Occupational Health Promotion Study (HIPOP-OHP). Drinking status was classified according to daily alcohol intake or frequency of drinking. We assessed the health-related quality of life (HRQOL) based on scores for five scales of the SF-36. RESULTS: Decreased odds ratios of sub-optimal HRQOL conditions, defined as less than the median SF-36 scores, for Role-Physical and General Health were found among persons who consumed 1.0 to 22.9 g/d of alcohol. Odds ratios for sub-optimal Vitality conditions were lowered according to increased levels of alcohol intake. Role-Emotional scores were not associated with alcohol drinking. People who drank 5 to 6 d/wk had higher levels of Role-Physical and Vitality, and those who drank 1 to 2 d/wk had better Vitality and Mental Health scores than non-drinkers. When adjusted for age, marital status, working hours, physical activity at work, self-reported job stress, smoking, regular exercise, hypertension, hyperlipidemia, and diabetes, the associations were almost unchanged except for General Health. CONCLUSIONS: Associations of drinking patterns with subjective health varied in five sub-scales of the SF-36. Overall, alcohol drinkers rated their health as good in comparison with non-drinkers.

Adult↗
PubMed2005

A nineteen-year cohort study on the relationship of electrocardiographic findings to all cause mortality among subjects in the national survey on circulatory disorders, NIPPON DATA80.

BACKGROUND: Electrocardiogram (ECG) is one of the most popular tools for daily clinics and health checkup, and has been used for the National Survey on Circulatory Disorders to assess the health status in Japanese people. The meaningfulness to predict mortality from all causes among people with ECG abnormality is to be clarified using national samples. METHODS: ECG findings recorded among 9,638 subjects for National Survey on Circulatory Disorders 1980 in Japan, were classified using the Minnesota Codes (mc). Their relationships to all cause mortality over 19 years were examined using Cox proportional hazard models adjusting for sex, age, systolic blood pressure, blood glucose, and smoking habits. RESULTS: Subjects with abnormal Q-QS findings showed significantly high hazard ratios ( 3.71(mc1-1) and 1.57 (mc1-3)) for mortality to the subjects who were free from any major ECG findings. Hazard ratios were 1.37 (mc2-1) to 4.16 (mc2-5) for axis deviation, and 1.34 (mc3-1) to 1.35 (mc3-3) for left high R waves. Those were 1.63 (mc4-3) to 2.59 (mc4-1) for ST depression, and 1.54 (mc5-3) to 2.33 (mc5-1) for T abnormality. The lower the second number of the Minnesota Codes was, the higher hazard ratio was observed in the Q-QS, ST, T codes. The hazard ratios of junction-type ST depression (mc4-4), and low T waves (mc5-4, 5-5) were not significant. CONCLUSIONS: ECG findings defined by the Minnesota Codes were useful to predict the risk for mortality from all causes even after adjusting for the other major risk factors, and the results supported a usefulness of the ECG for health check-ups.

Adult↗
PubMed2005

Proteinuria is a prognostic marker for cardiovascular mortality: NIPPON DATA 80, 1980-1999.

BACKGROUND: Proteinuria has been considered to be a prognostic marker for persons with diabetes mellitus, but only a limited number of studies about the relationship between proteinuria and mortality among general population has been available. METHODS: The subjects were 10,897 individuals who participated in the National Cardiovascular Survey conducted in 1980 and who were aged 30 years or older living in 300 districts that had been randomly selected throughout Japan. The vital records were confirmed in 1999 and 7,203 subjects (3,180 males and 4,023 females) without a history of hypertension, stroke, heart disease, renal disease, or diabetes mellitus at the start of the study were investigated. RESULTS: There were 126,825 person-years of follow-up. During the observed period of time, 371 died of cardiovascular causes, including 171 stroke deaths and 74 coronary deaths. The risk of proteinuria for cardiovascular mortality was greater than unity for those with a normal serum creatinine level, after adjusting for age and other cardiovascular disease risk factors. CONCLUSIONS: When contrasted with other cardiovascular disease risk factors, urinary protein is an independent risk factor for cardiovascular death among the Japanese population.

Adult↗
PubMed2005

Health effects of cadmium exposure in the general environment in Japan with special reference to the lower limit of the benchmark dose as the threshold level of urinary cadmium.

OBJECTIVES: This study investigates renal dysfunction in areas without known environmental cadmium pollution and calculates the threshold level of urinary cadmium. METHODS: Urinary total protein, beta2-microglobulin (beta2-MG), and N-acetyl-beta-D-glucosaminidase (NAG), used as indicators of renal dysfunction, and urinary cadmium concentration, used as an indicator of cadmium exposure, were measured in two sets of 24-hour urine samples from each of 828 participants (410 men, 418 women), aged 40-59 years and living in three areas without any known environmental cadmium pollution. In multiple regression and logistic regression analyses the association between indicators of cadmium exposure and indicators of renal dysfunction were studied. The lower 95% confidence limit of the dose (benchmark dose) corresponding to a 5% (BMDL5) or 10% (BMDL10) level of each indicator of renal dysfunction above the background level) was calculated as the threshold level of urinary cadmium. RESULTS: With all the expressed units [g creatinine(-1) and day(-1)] in the multiple regression analysis, the partial regression coefficients showed a significant association between urinary cadmium concentration and total protein, beta2-MG, and NAG for both genders, except for total protein for women (g creatinine(-1) and day(-1). The same results were obtained for both genders in the logistic regression analysis. The BMDL10 was 0.6-1.2 microg/g creatinine and 0.8-1.6 microg/day for the men and 1.2-3.6 microg/g creatinine, and 0.5-4.7 microg/day for the women. CONCLUSIONS: Cadmium exposure and the levels of the indicators of renal dysfunction were associated among the men and women aged 40-59 years in areas without any known environmental cadmium pollution. The threshold level of urinary cadmium in Japan seems to be almost the same as in Belgium and Sweden.

Acetylglucosaminidase↗
PubMed2005

[Do the Japanese drink less alcohol than other peoples?: the finding from INTERMAP].

It has been pointed out that Japanese men drink more than American and British men. In this presentation, we report the comparison of drinking habits from the findings of the International Study of Macro-nutrients and Blood Pressure (INTERMAP) conducted during 1997-99 in Japan, China, the United States of America (U.S.), and the United Kingdom (U.K.). INTERMAP was conducted with highly standardized procedures including dietary assessment, blood pressure measurement and questionnaires to clarify and compare their relationship in randomly selected 4680 men and women aged 40-59 years from 17 centers in the four countries. For alcohol drinking habits, four times of 24-hour dietary recall studies and two times of one-week recall studies were conducted. The drinking prevalence of Japanese men was the highest among the four countries. For women, it was also higher than in U.S. but lower than in U.K. Abstinence rates in U.S. were extremely higher than those of Japanese (19, 20% vs. 1, 4% in men and women, U.S. vs. Japan, respectively). Japanese men consumed the average of 27 g per day of alcohol and it was the highest among the populations. Energy intake from alcohol per total energy intake was also the highest in Japanese men. Health professionals in Japan need to recognize from the findings of INTERMAP and other studies such as INTERSALT that Japanese men drink more alcohol than Americans and British counterparts.

Adult↗
PubMed2005

[The influence of alcohol drinking on medical care expenditures among National Health Insurance beneficiaries].

Heavy alcohol drinking is an important risk factor for some lifestyle-related diseases. However, the relationship between drinking habits and medical care expenditures has not been elucidated in a Japanese general population. We examined this relationship in a 9-year cohort study. Study participants were 2039 National Health Insurance beneficiaries aged 40-69 years living in a rural Japanese community. The baseline survey, with medical check-up, was performed in 1989 or 1990 and the subjects' drinking habits were estimated by questionnaire. Medical care use and costs were monitored by linkage with the National Health Insurance claim history files at baseline survey through the end of March 2000. Men who were daily heavy drinkers (ethanol intake > or =69 g per day) had significantly higher medical costs compared to participants who drank less, within 5 years after baseline. This difference was 2000 yen per month after adjusting for age, body mass index, smoking, systolic blood pressure, glycosuria, serum total cholesterol and alanine aminotransferase. Daily heavy male drinkers also had a higher hazard ratio for total mortality compared to occasional drinkers, by the Cox proportional hazard model (hazard ratio: 1.81), although it did not reach statistical significance (P = 0.153). In women, medical costs were almost the same for occasional and daily drinkers. Total medical costs among Japanese men aged 20 years and over may be decreased by about 8400 billon yen per year if we assume a 20% decrease in daily heavy drinkers. To reduce national medical costs, it is important to promote a program for heavy drinkers, as described in the "Health Japan 21" initiative, the Japanese national health promotion guidelines for the first 10 years of the 21st century.

Adult↗
PubMed2004

Evaluation of measures of urinary albumin excretion in epidemiologic studies.

Twenty-four-hour urinary albumin excretion (UAE) is considered the gold standard for determining albumin level in epidemiologic studies, but this measure is inconvenient and often unavailable. Simpler alternatives include the albumin:creatinine ratio (ACR) and urinary albumin concentration (UAC) obtained from a single sample. The authors assessed the strengths and weaknesses of ACR and UAC as alternatives to UAE using albumin measurements from two 24-hour urine samples collected in 1996-1999 from 4,678 participants aged 40-59 years in the International Study of Macronutrients and Blood Pressure (17 population samples from four countries). The authors compared ACR and UAC with regard to correlations with UAE, daily within-person variability, and associations with known predictors of UAE. Rank-order correlations of ACR with UAE were 0.949 and 0.942 for men and women, respectively, versus 0.881 and 0.816 for UAC. Mean within-person coefficients of variation were 34.0-40.0% for the three measures, with the smallest values being observed for UAC. Average correlations with blood pressure were similar for UAE, ACR, and UAC, but the correlation with body mass index was lower for ACR (0.118 for ACR and 0.188 for UAC vs. 0.211 for UAE) because of high correlation between body mass index and creatinine level. Thus, UAC and ACR are acceptable alternatives to the more complex UAE, and the simpler UAC may be preferable to ACR in some respects.

Adult↗
PubMed2004

Much lower prevalence of coronary calcium detected by electron-beam computed tomography among men aged 40-49 in Japan than in the US, despite a less favorable profile of major risk factors.

BACKGROUND: Since World War II (WWII), exposures to westernized lifestyle have occurred in many non-Western countries, including Japan. National surveys showed that risk factor profiles for atherosclerosis around 1990 were similar in men in the post WWII birth cohorts in the US and Japan. We compared the degree of coronary calcium and other factors in men in the post WWII birth cohort: men aged 40-49 in the US and Japan. METHODS: We conducted a cross-sectional study examining randomly selected 100 men from Kusatsu, Japan, and 100 men from Allegheny County, US. Coronary calcium was assessed using electron-beam computed tomography. RESULTS: Systolic blood pressure, total cholesterol, low density lipoprotein (LDL)-cholesterol, and smoking rates were higher among the Japanese (122.6 +/- 14.1 versus 113.7 +/- 9.6 mmHg, P < 0.01; 5.72 +/- 0.90 versus 4.99 +/- 0.81 mmol/l (220.9 +/- 34.6 versus 192.8 +/- 31.3 mg/dl), P < 0.01; 3.52 +/- 1.01 versus 3.10 +/- 0.78 mmol/l (136.0 +/- 39.0 versus 119.7 +/- 30.0 mg/dl), P < 0.01; and 48 versus 15%, P < 0.01, respectively). Triglycerides and fibrinogen were similar. High density lipoprotein (HDL)-cholesterol was higher among the Japanese. Body mass index, fasting insulin, and C-reactive protein were higher among the Americans. Prevalence of coronary artery calcium score >0 was strikingly lower among the Japanese than the Americans (13% versus 47%, P < 0.01). CONCLUSIONS: Much lower prevalence of coronary calcium despite a less favourable profile of many major independent risk factors in the Japanese might imply that there are strong protective factors against atherosclerosis in the Japanese. Further investigation is of critical importance.

Adult↗
PubMed2004

Estimating laboratory precision of urinary albumin excretion and other urinary measures in the International Study on Macronutrients and Blood Pressure.

Microalbuminuria is a risk factor for renal failure, stroke, and cardiovascular disease. However, estimating laboratory precision for albumin excretion is problematic because of its highly skewed distribution and the presence of values below assay detection limits. The authors used 781 quality control pairs from 24-hour urine samples collected between 1996 and 1999 in the International Study on Macronutrients and Blood Pressure (INTERMAP) to compare percentage of technical error (%TE), the usual estimate of laboratory precision, with the mean and median values of within-pair coefficients of variation (CVs) for urinary albumin concentration and other urinary variables. In INTERMAP, %TE was larger than mean CV for all variables. Exclusion of potentially mislabeled samples reduced this difference; for example, for sodium, estimates of %TE and mean and median CV were 2.37%, 0.75%, and 0.28%, respectively, for all 781 pairs and 0.84%, 0.48%, and 0.27%, respectively, with possibly mislabeled pairs excluded. For urinary albumin concentration, exclusion of one mislabeled pair changed estimates for %TE and mean CV from 29.6% and 20.8% to 20.6% and 20.6%, while median CV was unchanged at 9.4%. After exclusion of urinary albumin concentration pairs with values below the detection limit, estimates were 15.4%, 11.4%, and 6.4%, respectively. Results indicate that mean and median CV are not equivalent to %TE and that values below the detection limit can markedly affect estimates and should be excluded.

Adult↗
PubMed2004

Cigarette smoking as a risk factor for stroke death in Japan: NIPPON DATA80.

BACKGROUND AND PURPOSE: Some previous Japanese cohort studies failed to show an association between smoking and stroke risk. Because such an association has been noted in other populations, this issue should be re-examined in a recent representative Japanese cohort with a higher total cholesterol level. METHODS: A total of 9638 men and women aged 30 years and older without a history of cardiovascular disease (CVD) at baseline in 1980 were followed-up for 14 years. RESULTS: We observed 203 stroke deaths (107 cerebral infarctions, 45 cerebral hemorrhages, and 51 others), 191 heart disease deaths, and 413 CVD deaths. The average serum total cholesterol level was approximately 4.91 mmol/L. Cox proportional hazard ratios were calculated adjusting for age, systolic blood pressure, and other conventional risk factors. The hazard ratios for men who smoked 1 to 20 cigarettes/day for all strokes, cerebral infarction, and cerebral hemorrhage were 1.60 (95% CI, 0.91 to 2.79), 2.97 (CI, 1.27 to 6.98), and 0.42 (CI, 0.16 to 1.09), respectively, and for those who smoked > or =21 cigarettes/day, they were 2.17 (CI, 1.09 to 4.30), 3.26 (CI, 1.11 to 9.56), and 0.68 (CI, 0.20 to 2.33), respectively. For women who smoked > or =21 cigarettes/day, the hazard ratio for all strokes was 3.91 (CI, 1.18 to 12.90). For CVD, all heart disease, and ischemic heart disease, the hazard risks of smoking were significant (1.49 to 4.25) for men but not significant for women. CONCLUSIONS: Smoking in a cohort with moderate serum total cholesterol level was a potent risk factor for stroke, especially cerebral infarction, for both men and women, and for CVD and ischemic heart disease for men.

Adult↗