T Okamura1, T Kadowaki, T Hayakawa, Y Kita, A Okayama, H Ueshima. 1. Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City, Shiga 520-2192, Japan. tokamura@belle.shiga-med.ac.jp
Abstract
OBJECTIVE: In a population with a markedly lower coronary mortality such as in Japan, the benefit of cholesterol screening may be different from Western populations. We attempted to assess the importance of cholesterol screening in Japan. DESIGN: A 13.2-year cohort study for cause-specific mortality. SETTING: Three hundred randomly selected districts throughout Japan in which the National Survey on Circulatory Disorders 1980 was performed. SUBJECTS: A total of 9216 community dwelling persons aged 30 years and over, with standardized serum cholesterol measurement and without a past history of cardiovascular disease. RESULTS: There were 1206 deaths, which included 462 deaths due to cardiovascular disease with 79 coronary heart diseases. Hypercholesterolemia (>6.21 mmol L-1) showed a significant positive relation to coronary mortality (relative risk; 2.93, 95% confidence interval; 1.52-5.63) but not to stroke. Although hypocholesterolemia (<4.14 mmol L-1) was significantly associated with an increased risk of liver cancer, noncardiovascular, noncancer disease and all-cause mortality, these associations, except for liver cancer, disappeared after excluding deaths in the first 5 years of the follow-up. The multivariate adjusted attributable risk of hypercholesterolaemia for coronary disease was 0.98 per 1000 person-years, which was threefold higher than that of hypocholesterolemia for liver cancer: 0.32 per 1000 person-years. The attributable risk percentage of hypercholesterolaemia was 66% for coronary heart disease. CONCLUSION: Similar to Western populations, it is recommended to provide screening for hypercholesterolaemia in Japan, especially for males, although its attributable risk for coronary disease might be small.
OBJECTIVE: In a population with a markedly lower coronary mortality such as in Japan, the benefit of cholesterol screening may be different from Western populations. We attempted to assess the importance of cholesterol screening in Japan. DESIGN: A 13.2-year cohort study for cause-specific mortality. SETTING: Three hundred randomly selected districts throughout Japan in which the National Survey on Circulatory Disorders 1980 was performed. SUBJECTS: A total of 9216 community dwelling persons aged 30 years and over, with standardized serum cholesterol measurement and without a past history of cardiovascular disease. RESULTS: There were 1206 deaths, which included 462 deaths due to cardiovascular disease with 79 coronary heart diseases. Hypercholesterolemia (>6.21 mmol L-1) showed a significant positive relation to coronary mortality (relative risk; 2.93, 95% confidence interval; 1.52-5.63) but not to stroke. Although hypocholesterolemia (<4.14 mmol L-1) was significantly associated with an increased risk of liver cancer, noncardiovascular, noncancer disease and all-cause mortality, these associations, except for liver cancer, disappeared after excluding deaths in the first 5 years of the follow-up. The multivariate adjusted attributable risk of hypercholesterolaemia for coronary disease was 0.98 per 1000 person-years, which was threefold higher than that of hypocholesterolemia for liver cancer: 0.32 per 1000 person-years. The attributable risk percentage of hypercholesterolaemia was 66% for coronary heart disease. CONCLUSION: Similar to Western populations, it is recommended to provide screening for hypercholesterolaemia in Japan, especially for males, although its attributable risk for coronary disease might be small.
Authors: Akira Sekikawa; Bradley J Willcox; Takeshi Usui; John Jeffrey Carr; Emma J M Barinas-Mitchell; Kamal H Masaki; Makoto Watanabe; Russell P Tracy; Marianne H Bertolet; Rhobert W Evans; Kunihiko Nishimura; Kim Sutton-Tyrrell; Lewis H Kuller; Yoshihiro Miyamoto Journal: J Womens Health (Larchmt) Date: 2013-09-28 Impact factor: 2.681
Authors: Akira Sekikawa; J David Curb; Hirotsugu Ueshima; Aiman El-Saed; Takashi Kadowaki; Robert D Abbott; Rhobert W Evans; Beatriz L Rodriguez; Tomonori Okamura; Kim Sutton-Tyrrell; Yasuyuki Nakamura; Kamal Masaki; Daniel Edmundowicz; Atsunori Kashiwagi; Bradley J Willcox; Tomoko Takamiya; Ken-Ichi Mitsunami; Todd B Seto; Kiyoshi Murata; Roger L White; Lewis H Kuller Journal: J Am Coll Cardiol Date: 2008-08-05 Impact factor: 24.094
Authors: S Kadowaki; T Okamura; A Hozawa; T Kadowaki; A Kadota; Y Murakami; K Nakamura; S Saitoh; Y Nakamura; T Hayakawa; Y Kita; A Okayama; H Ueshima Journal: Diabetologia Date: 2008-01-16 Impact factor: 10.122