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Background: An association between birth weight and cardiovascular disease (CVD) in adulthood has been observed in many countries; however, only a few studies have been conducted in Asian populations. Methods: We used data from the baseline survey (2011-2016) of the Japan Public Health Center-based Prospective Study for the Next Generation Cohort, which included 114,105 participants aged 40-74 years. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were calculated from the prevalence of present and past histories of CVD and other lifestyle-related diseases, including hypertension, diabetes, hyperlipidemia, and gout, by birth weight, using Poisson regression. Results: The prevalence of CVD increased with lower birth weight, with the highest prevalence among those with birth weight under 1,500 grams (males 4.6%; females 1.7%) and the lowest one among those with birth weight at or over 4,000 g (males 3.7%: females 0.8%). Among 88,653 participants (41,156 males and 47,497 females) with complete data on possible confounders, birth weight under 1,500 g was associated with a higher prevalence of CVD (aPR 1.76; 95% CI, 1.37-2.26), hypertension (aPR 1.29; 95% CI, 1.17-1.42), and diabetes (aPR 1.53; 95% CI, 1.26-1.86) when a birth weight of 3,000-3,999 grams was used as the reference. Weaker associations were observed for birth weight of 1,500-2,499 grams and 2,500-2,999 grams, while no significant associations were observed for birth weight at or over 4,000 grams. The association between birth weight and the prevalence of hyperlipidemia was less profound, and no significant association was observed between birth weight and gout. Conclusion: Lower birth weight was associated with a higher prevalence of CVD, hypertension, and diabetes in the Japanese population. [ABSTRACT FROM AUTHOR]

Background: Associations of major risk factors for stroke with total and each type of stroke, as well as subtypes of ischemic stroke, and their population attributable fractions had not been examined comprehensively. Methods: Participants of the Japan Public Health Center-based prospective (JPHC) Study Cohort II without histories of cardiovascular disease and cancer (n = 14,797) were followed from 1993 through 2012. Associations of current smoking, hypertension, diabetes, overweight (body mass index =25 kg/m2), non-high-density lipoprotein cholesterol (non-HDLC) categories, low HDLC (<40 mg/dL), urine protein, and history of arrhythmia were examined in a mutually-adjusted Cox regression model that included age and sex. Population attributable fractions (PAFs) were estimated using the hazard ratios and the prevalence of risk factors among cases. Results: Subjects with hypertension were 1.63 to 1.84 times more likely to develop any type of stroke. Diabetes, low HDLC, current smoking, overweight, urine protein, and arrhythmia were associated with risk of overall and ischemic stroke. Hypertension and urine protein were associated with risk of intracerebral hemorrhage, while current smoking, hypertension, and low non-HDLC were associated with subarachnoid hemorrhage. Hypertension alone accounted for more than a quarter of stroke incidence, followed by current smoking and diabetes. High non-HDLC, current smoking, low HDLC, and overweight contributed mostly to large-artery occlusive stroke. Arrhythmia explained 13.2% of embolic stroke. Combined PAFs of all the modifiable risk factors for total, ischemic, and large-artery occlusive strokes were 36.7%, 44.5%, and 61.5%, respectively. Conclusion: Although there are differences according to subtypes, hypertension could be regarded as the most crucial target for preventing strokes in Japan. [ABSTRACT FROM AUTHOR]

Objectives: The association between alcohol consumption and dementia in Japanese is poorly understood, and use of single‐point alcohol assessment may cause measurement error. We explored this association in Japanese using repeated alcohol assessments. Methods: Participants in the Japan Public Health Center‐based Prospective Study (JPHC Study) since 1990 and who were alive in 2006 were followed from 2006 until 2016 for dementia ascertainment. Disabling dementia was identified through longterm care insurance records. Alcohol consumption was assessed at the 5‐year questionnaire survey (1995–1999) and drinking patterns were assessed on repeated follow‐up (2000–2003). We performed Cox proportional hazards models with age as the time‐scale with adjustment for various lifestyle factors and medical history using light consumption (<75 g ethanol/week, hereinafter “g”) as reference. Analysis considering death as a competing risk was also conducted. Results: Among 42,870 participants aged 54–84 years, 4802 cases of disabling dementia were newly diagnosed. Average years from alcohol assessment until dementia incidence was 14.9 years. Non‐drinkers and regular drinkers with ≥450 g at 5 years had adjusted HRs (95% CI) of 1.29 (1.12–1.47) and 1.34 (1.12–1.60). Patterns of long‐term abstinence, former drinking, and regular heavy weekly consumption of ≥450 g showed increased adjusted HRs of 1.61 (1.28–2.03), 2.54 (1.93– 3.35), and 1.96 (1.49–2.59), respectively. Competing risk analysis yielded similar results. Conclusions: In Japanese, non‐drinking and regular weekly consumption of ≥450 g from midlife were associated with high risk of disabling dementia compared with light drinking. [ABSTRACT FROM AUTHOR]

Objectives: Effective brief instructions for self-management of chronic knee pain are needed. Methods: Forty-six participants with chronic knee pain were randomly allocated into two programmes: material-based education alone or brief self-exercise education (brief-See), which comprised a 100-minute instruction for self-exercise combined with compact pain education. Total function (KOOS4, 4-subscale average of knee injury and osteoarthritis outcome score), pain intensity (NRS, numeric rating scale), self-efficacy (PSEQ, pain self-efficacy questionnaire), and health-related quality of life (EQ-5D, European quality of life-5 dimensions) were evaluated at baseline and 4 and 12 weeks after the initial intervention. A generalized mixed linear model estimated average group differences in changes from baseline and 95% confidence intervals (95% CIs) using intention-to-treat principle. Results: Compared to material-based education alone, the brief-See provided significant additional improvements of 9.4% (95% CI: 2.3 to 16.4) on the KOOS4 and 5.4 points (0.3 to 10.4) on the PSEQ at 12 weeks but did not on the NRS and EQ-5D. Adherence and satisfaction were favourable in the brief-See without any notable adverse event. Conclusions: Adding the brief-See to material-based education could be more acceptable and restore total function and self-efficacy, which could contribute to the self-management of chronic knee pain in primary care. [ABSTRACT FROM AUTHOR]

Objective: To examine whether the relationship between smoking cessation and risk of cardiovascular disease (CVD) was modified by weight gain.Methods: A total of 69 910 participants (29 650 men and 46 260 women) aged 45-74 years were grouped into six groups by smoking status in the first and 5-year surveys: sustained smokers, recent quitters according to postcessation weight gain (no weight gain, 0.1-5.0 kg, >5.0 kg), long-term quitters and never smokers. Quitting smoking within and longer than 5 years were defined as recent and long-term quitters, respectively. We used Cox proportional hazard models to estimate the HR for incident CVD, coronary heart disease (CHD) and stroke.Results: We identified 4023 CVDs (889 CHDs and 3217 strokes) during a median of 14.8 years of follow-up. Compared with sustained smokers, the multivariable HR (95% CI) for CVD was 0.66 (0.52 to 0.83) for recent quitters without weight gain, 0.71 (0.55 to 0.90) for recent quitters with weight gain of 0.1-5.0 kg, 0.70 (0.44 to 1.10) for recent quitters with weight gain of >5.0 kg, 0.56 (0.49 to 0.64) for long-term quitters, and 0.60 (0.55 to 0.66) for never smokers. The analysis restricted to men showed a similar association. Prespecified analysis by age suggested that recent quitters overall had a lower HR for CVD among those aged <60 years vs ≥60 years. Similar patterns of association were observed in CHD and stroke.Conclusions: Postcessation weight gain did not attenuate the protective association between smoking cessation and risk of CVD. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to develop and assess additional effects of brief self-exercise education (brief-See) for individuals with chronic low back pain (CLBP). The brief-See comprised 100-minute consultation, individualized self-exercise program, and direct short teaching. Methods: We conducted a 6-month, community-based, randomized, parallel-group trial in a community setting, and allocated into a brief-See or material-based education alone. Pain intensity (NRS, numeric rating scale), functional limitation (RDQ, Roland-Morris disability questionnaire), self-efficacy (PSEQ, pain self-efficacy questionnaire), and quality of life (EQ-5D, European quality of life-5 dimensions) were evaluated at 4, 12, and 24 weeks after the initial consultation. Results: The brief-See did not show additional improvement over material-based education on the NRS, but it did on the RDQ, PSEQ, and EQ-5D; the estimated mean group differences in changes from the baseline were -2.1 (-3.5 to -0.7, p=.005) on the RDQ, 6.9 (1.7-12.1, p=.010) on the PSEQ, and 0.07 (0.02-0.12, p=.004) on the EQ-5D. Conclusion: The 100 minutes' education program could be more acceptable, and restores functional limitation, self-efficacy, and quality of life in addition to the effects of material-based education. This has the potential to contribute to the management of CLBP in a community. [ABSTRACT FROM AUTHOR]

Background: This study aimed to describe the status of alcohol consumption and drug use among young adults as well as their determinants. Methods: We conducted a cross-sectional study of 356 young adults (aged 18 to 24 years) living in Palau in 2013. The prevalence of self-reported alcohol and marijuana usage were compared within and between sexes, age groups, ethnicities, and education levels. Results: The proportion of current drinking was higher in people aged 21-24 than in those aged 18-20 (73.2% vs. 60.9%, p = 0.09 in men and 48.3% vs. 30.0%, p = 0.02 in women), while that of marijuana use did not differ between the age groups. The proportions of current drinking and marijuana use were higher in Palauan than in other ethnicities (current drinking: 70.6% vs. 40.6%, p = 0.005 in men and 38.8% vs. 16.6%, p = 0.04 in women; lifetime marijuana use: 80.0% vs. 52.9%, p = 0.02 in men and 56.1% vs. 30.6%, p = 0.09 in women). The proportion of frequent (3 times or more) marijuana users was higher for the lower educated than for the higher educated (62.5% vs. 32.1%, p < 0.001 in men and 33.9% vs. 24.4%, p = 0.12 in women). Conclusions: Sex, age, ethnicity, and education were significant determinants of alcohol and marijuana use. [ABSTRACT FROM AUTHOR]

Objective: Tub bathing is considered to have a preventive effect against cardiovascular disease (CVD) by improving haemodynamic function. However, no prospective studies have investigated the long-term effects of tub bathing with regard to CVD risk.Methods: A total of 30 076 participants aged 40-59 years with no history of CVD or cancer were followed up from 1990 to 2009. Participants were classified by bathing frequency: zero to two times/week, three to four times/week and almost every day. The HRs of incident CVD were estimated using Cox proportional hazards models after adjusting for traditional CVD risk factors and selected dietary factors.Results: During 538 373 person-years of follow-up, we documented a total of 2097 incident cases of CVD, comprising 328 coronary heart diseases (CHDs) (275 myocardial infarctions and 53 sudden cardiac deaths) and 1769 strokes (991 cerebral infarctions, 510 intracerebral haemorrhages, 255 subarachnoid haemorrhages and 13 unclassified strokes). The multivariable HRs (95% CIs) for almost daily or every day versus zero to two times/week were 0.72 (0.62 to 0.84, trend p<0.001) for total CVD; 0.65 (0.45 to 0.94, trend p=0.065) for CHD; 0.74 (0.62 to 0.87, trend p=0.005) for total stroke; 0.77 (0.62 to 0.97, trend p=0.467) for cerebral infarction; and 0.54 (0.40 to 0.73, trend p<0.001) for intracerebral haemorrhage. No associations were observed between tub bathing frequency and risk of sudden cardiac death or subarachnoid haemorrhage.Conclusion: The frequency of tub bathing was inversely associated with the risk of CVD among middle-aged Japanese. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to identify the extent of tobacco cessation training content, including the introduction of a comprehensive programme; and the presence of tobacco-related topics, including new tobacco products, school years and course of training, educators, and attitudes and policies relevant to tobacco education in pharmacy schools in Japan. Design A cross-sectional survey. Setting All pharmacy schools in Japan with a 6-year course of training were invited to participate. Methods Pharmacy schools in Japan that agreed to participate in a web-based survey asking about tobacco cessation training, and attitudes and policies relevant to tobacco education. Primary and secondary outcome measures The primary outcome was the number of pharmacy schools that introduced comprehensive tobacco cessation training in their curriculum. The secondary outcome was to clarify the curriculum coverage of 9 basic knowledge and 10 tobacco cessation-specific topics, including new tobacco products. Results Of the 75 pharmacy schools with a 6-year course in Japan, 52 (74%) responded to the survey. While 27 (52%) schools reported that comprehensive tobacco cessation training would be beneficial, only 1 school had introduced it as a one-credit elective course in the fifth year. Basic knowledge topics for tobacco cessation listed in or related to the Model Core Curriculum were covered by 44%-65% of the schools, while practical skills were covered in 10%-19% of the schools. Only seven schools (14%) introduced the topic of new tobacco products in their curriculum. Conclusions This study revealed that comprehensive tobacco cessation training is not generally offered in pharmacy schools in Japan. The Model Core Curriculum should revise its standards to implement updated tobacco cessation training programmes to keep up with new tobacco products and to train pharmacy students on counselling users of such products. [ABSTRACT FROM AUTHOR]

Background: Randomized controlled studies have investigated the short-term effect of soy product intake on blood pressure (BP) in normotensive people. To our knowledge, no prospective studies exist on the effect of habitual intake of fermented soy products, separate from total soy products, on BP in the general population.Objective: We examined the association between the habitual intake of soy products, including fermented soy products, and the development of high BP during a 5-y period among participants in a population-based prospective cohort study in Japan.Methods: The study included normotensive participants aged 40-69 y at baseline (926 men and 3239 women) who completed 2 questionnaires and whose BP was measured at the baseline survey between 1993 and 1994 and the 5-y follow-up in the Japan Public Health Center-Based Prospective Study Cohort II. The intake of soy products was assessed with a food-frequency questionnaire. High BP was defined as systolic blood pressure ≥130 mm Hg, diastolic blood pressure ≥85 mm Hg, or antihypertensive medication use. ORs and 95% CIs of high BP by frequency of soy products (miso, natto, and tofu) consumption, intake of total and fermented soy products, and intake of isoflavones from total and fermented soy products were estimated with the use of multiple logistic regression analysis.Results: Multivariable-adjusted ORs of high BP for the highest compared with the lowest tertile of total and fermented soy product intake were 1.03 (95% CI: 0.84, 1.25; P-trend = 0.786) and 0.72 (95% CI: 0.56, 0.92; P-trend = 0.009), respectively. The frequency of nonfermented soy product (tofu) intake was not associated with the development of high BP (P-trend = 0.597).Conclusions: The intake of fermented soy products, but not total or nonfermented soy products, was inversely associated with developing high BP in men and women with normal BP. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: To determine the maternal predictive factors for fetal congenital heart block (CHB) in pregnancy in mothers positive for anti-SS-A antibodies. Methods: The Research Team for Surveillance of Autoantibody-Exposed Fetuses and Treatment of Neonatal Lupus Erythematosus, the Research Program of the Japan Ministry of Health, Labor and Welfare, performed a national survey on pregnancy of mothers positive for anti-SS-A antibodies. We analyzed 635 pregnant mothers who tested positive for anti-SS-A antibodies before conception but had no previous history of fetal CHB. We performed univariate and multivariate analysis (models 1, 2, and 3 using different set of independent variables) investigated the relation between risk of fetal CHB and maternal clinical features. Results: Of the 635 pregnant mothers, fetal CHB was detected in 16. Univariate analysis showed that fetal CHB associated with use of corticosteroids before conception (OR 3.72, p=0.04), and negatively with use of corticosteroids (equivalent doses of prednisolone (PSL), at -10 mg/day) after conception before 16-week gestation (OR 0.17, p=0.03). In multivariate analysis, model 1 identified the use of corticosteroids before conception (OR 4.28, p=0.04) and high titer of anti-SS-A antibodies (OR 3.58, p=0.02) as independent and significant risk factors, and model 3 identified use of corticosteroids (equivalent doses of PSL, at -10 mg/day) after conception before 16-week gestation as independent protective factor against the development of fetal CHB (OR 0.16, p=0.03). Other maternal clinical features did not influence the development of fetal CHB. Conclusion: The results identified high titers of anti-SS-A antibodies and use of corticosteroids before conception as independent risk factors, and use of corticosteroids (equivalent doses of PSL, at -10 mg/day) after conception before 16-week gestation as an independent protective factor for fetal CHB. [ABSTRACT FROM AUTHOR]

Aims Coping strategies may be significantly associated with health outcomes. This is the first study to investigate the association between baseline coping strategies and cardiovascular disease (CVD) incidence and mortality in a general population cohort. Methods and results The Japan Public Health Center-based prospective Study asked questions on coping in its third follow-up survey (2000-04). Analyses on CVD incidence and mortality included 57 017 subjects aged 50-79 without a history of CVD and who provided complete answers on approach- and avoidance-oriented coping behaviours and strategies. Cox regression models, adjusted for confounders, were used to determine hazard ratios (HRs) according to coping style. Mean follow-up time was 7.9 years for incidence and 8.0 years for mortality. The premorbid use of an approach-oriented coping strategy was inversely associated with incidence of stroke (HR ¼ 0.85; 95% CI, 0.73-1.00) and CVD mortality (HR ¼ 0.74; 95% CI, 0.55-0.99). Stroke subtype analyses revealed an inverse association between the approach-oriented coping strategy and incidence of ischaemic stroke (HR ¼ 0.79; 95% CI, 0.64-0.98) and a positive association between the combined coping strategy and incidence of intra-parenchymal haemorrhage (HR ¼ 2.03; 95% CI, 1.01-4.10). Utilizing an avoidance coping strategy was associated with increased mortality from ischaemic heart disease (IHD) only in hypertensive individuals (HR ¼ 3.46; 95% CI, 1.07-11.18). The coping behaviours fantasizing and positive reappraisal were associated with increased risk of CVD incidence (HR ¼ 1.24; 95% CI, 1.03-1.50) and reduced risk of IHD mortality (HR ¼ 0.63; 95% CI, 0.40-0.99), respectively. Conclusion An approach-oriented coping strategy, i.e. proactively dealing with sources of stress, may be associated with significantly reduced stroke incidence and CVD mortality in a Japanese population-based cohort. [ABSTRACT FROM AUTHOR]

Background: Although several cross-sectional and intervention studies showed that sodium intake or excretion was associated with blood pressure levels, no prospective study has examined the long-term association between sodium excretion in spot urine and blood pressure changes.Methods: We conducted a prospective study of 889 normotensive subjects (295 men and 594 women, mean age 57.3 years) who underwent the baseline survey including spot urine test in 2005 and the follow-up survey in 2009 to 2011 (mean follow-up period: 5.8 years). We examined the association between sodium concentration in spot urine, a validated index of sodium excretion occurring over 24-h, and blood pressure changes between baseline and follow-up survey in all, non-overweight (body mass index(BMI) ≤ 25 kg/m(2)) and overweight normotensives.Results: For all subjects, sodium concentrations in spot urine were not associated with either systolic or diastolic blood pressure changes. When stratified by BMI at baseline survey, sodium concentrations were positively associated with systolic blood pressure changes in non-overweight subjects, but not in overweight subjects. After adjustment for age, sex, BMI, alcohol intake status, current smoking and estimated glomerular filtration rate, the multivariable-adjusted mean values of the systolic blood pressure change among non-overweight subjects was +7.3 mmHg in the highest quartiles of sodium concentrations, while it was +3.9 mmHg in the lowest quartile (P for difference = 0.021, P for trend = 0.040). After further adjustment of baseline blood pressure levels, the association was slightly weakened; the multivariable-adjusted mean values of the systolic blood pressure changes were +7.0 mmHg and +4.2 mmHg (P for difference = 0.047, P for trend = 0.071).Conclusions: High sodium concentrations in spot urine were associated with subsequent systolic blood pressure increases among non-overweight normotensive individuals. (272 words). [ABSTRACT FROM AUTHOR]

Aims The long-term prognosis of subjects with supraventricular premature complexes (SVPCs) remains unclear in the general population. The aim of this study was to examine the prognostic significance of SVPCs in community-based health checkups. Methods and results We assessed 63 197 individuals (mean age, 58.8±9.9 years; 67.6%women)whoparticipated in annual community-based health checkups in 1993 and were followed until 2008. The primary endpoint was stroke death, cardiovascular death (CVD), or all-cause death during a 14-year mean follow-up, and the secondary endpoint was first atrial fibrillation (AF) event in subjects without self-reported heart diseases or AF at baseline. Compared with subjects without SVPCs, the multivariate-adjusted hazard ratios (HRs) [95% confidence interval (CI)] of stroke death, CVD, and allcause death in subjects with SVPCs were 1.24 (0.98–1.56) for men and 1.63 (1.30–2.05) for women, 1.22 (1.04– 1.44) for men and 1.48 (1.25–1.74) for women, and 1.08 (0.99–1.18) for men and 1.21 (1.09–1.34) for women, respectively. Atrial fibrillation occurred in 386 subjects during the follow-up (1.05/1000 person-years). The presence of SVPCs at baseline was the significant predictor of AF onset [HRs (95% CI): 4.87 (3.61–6.57) for men and 3.87 (2.69–5.57) for women]. Propensity score matched analyses also revealed the presence of SVPCs was significantly associated with increased risks of AF incidence and CVD even after adjusting the potential confounders. Conclusion The presence of SVPCs in 12-lead electrocardiograms was a strong predictor of AF development, and associated with increased risk of CVD in general population. [ABSTRACT FROM AUTHOR]

Background: Rice consumption has been associated with risk of type 2 diabetes, but its relation with cardiovascular disease (CVD) is limited. Objective: We examined the association between rice consumption and risk of CVD incidence and mortality in a Japanese population. Design: This was a prospective study in 91,223 Japanese men and women aged 40-69 y in whom rice consumption was determined and updated from 3 self-administered food-frequency questionnaires, each 5 y apart. Follow-up for incidence was from 1990 to 2009 in cohort I and 1993 to 2007 in cohort II and for mortality was from 1990 to 2009 in cohort I and 1993 to 2009 in cohort II. HRs and 95% CIs of CVD incidence and mortality were calculated according to quintiles of cumulative average rice consumption. Results: In 15-18 y of follow-up, we ascertained 4395 incident cases of stroke, 1088 incident cases of ischemic heart disease (IHD), and 2705 deaths from CVD. Rice consumption was not associated with risk of incident stroke or IHD; the multivariable HR (95% CI) in the highest compared with lowest rice consumption quintiles was 1.01 (0.90, 1.14) for total stroke and 1.08 (0.84, 1.38) for IHD. Similarly, there was no association between rice consumption and risk of mortality from CVD; the HR (95% CI) for mortality from total CVD was 0.97 (0.84, 1.13). There were no interactions with sex or effect modifications by body mass index for any endpoint. Conclusion: Rice consumption is not associated with risk of CVD morbidity or mortality. [ABSTRACT FROM AUTHOR]

Background: Soft drink intake has been associated with obesity and diabetes, but its relation with risk of cardiovascular disease (CVD) is limited. Objective: We examined the association between soft drink intake and risk of CVD in a Japanese population. Design: This was a prospective study in 39,786 Japanese men and women aged 40-59 y in which soft drink intake was determined by using a self-administered food-frequency questionnaire. Follow-up was from 1990 to 2008. HRs and 95% CIs of incidence were calculated according to categories of soft drink intake. Results: During 18 y of follow-up, we ascertained 453 incident cases of ischemic heart disease (IHD) and 1922 cases of stroke, including 859 hemorrhagic and 1047 ischemic strokes. Soft drink intake was positively associated with risk of total stroke and more specifically ischemic stroke for women; the multivariable HR (95% CI) in the highest soft drink intake (almost every day) category compared with the lowest intake (never or rarely) category was 1.21 (0.88, 1.68; P-trend = 0.02) for total stroke and 1.83 (1.22, 2.75; P-trend = 0.001) for ischemic stroke. That association did not change significantly after the exclusion of early incident cases within 3-9 y from baseline. A nonsignificant inverse trend for risks of total and ischemic strokes was shown for men, and it was weakened after the exclusion of early incident cases or after the exclusion of participants with baseline comorbidities. Soft drink intake was not associated with risk of IHD or hemorrhagic stroke for either sex. Conclusion: Soft drink intake is associated with higher risk of ischemic stroke for women. [ABSTRACT FROM AUTHOR]

To examine the relationship between systemic immune status and carotid atherosclerosis in elderly men, differential leukocyte counts and lymphocyte subpopulations were measured in 557 apparently healthy Japanese men aged 60–75 years. Each individual also underwent high-resolution ultrasonography for measurement of intima-media thickness (IMT) of the common carotid arteries. The increased numbers of circulating lymphocyte subpopulations, including memory T cells (CD4+CD45RO+T cells) and late-phase activated B cells (CD19+CD80+B cells) correlated significantly and positively with the mean IMT of the common carotid artery after adjustment for age, smoking, and other cardiovascular risk factors. The positive associations of CD19+CD80+B and CD4+CD45RO+ T cell counts with mean IMT were more evident among nonsmokers, hypertensives, and men with lower HDL-cholesterol levels. The present epidemiological study provided the evidence that alterations in lymphocyte subpopulations, in particular memory T cells and late-phase activated B cells concur with carotid atherosclersosis among free-living elderly men. [ABSTRACT FROM AUTHOR]