Takahiro Nakashima1,2, Soshiro Ogata2, Teruo Noguchi3, Yoshio Tahara4, Daisuke Onozuka2, Satoshi Kato5, Yoshiki Yamagata6, Sunao Kojima7, Taku Iwami8, Tetsuya Sakamoto9, Ken Nagao10, Hiroshi Nonogi11, Satoshi Yasuda12, Koji Iihara13, Robert Neumar1, Kunihiro Nishimura2. 1. Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA. 2. Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral Cardiovascular Centre, Suita, Japan. 3. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan tnoguchi@ncvc.go.jp. 4. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan. 5. H.U. Group Research Institute G.K, Tokyo, Japan. 6. National Institute for Environmental Studies, Tsukuba, Japan. 7. Department of General Internal Medicine 3, Kawasaki Medical School, Kurashiki, Japan. 8. Health Service, Kyoto University, Kyoto, Japan. 9. Department of Emergency Medicine, Teikyo University, Itabashi-ku, Japan. 10. Cardiovascular Centre, Nihon University Hospital, Tokyo, Japan. 11. Shizuoka General Hospital, Shizuoka, Japan. 12. Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. 13. National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.