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Background: Experimental studies have reported that allopurinol protects hypertensive rats from left ventricular hypertrophy (LVH) with negligible effects on blood pressure (BP). Uric acid (UA) was thought to induce cardiomyocyte growth and interstitial fibrosis of the heart, partly via activation of the renin-angiotensin system. In the present study, the relationship between serum UA levels and electrocardiographically-diagnosed LVH (ECG-LVH) was examined in Japanese men not taking medication for hypertension (HTN), which could confound the association. Methods and Results: A total of 3,305 male workers aged 35-66 years (mean age ± SD, 48.0 ±7.1) were studied. LVH was defined as meeting the ECG criteria (ie, Sokolow-Lyon voltage and/or Cornell voltage QRS duration product). Subjects were divided into 3 groups by tertile of serum UA level. The highest tertile (UA range 0.39-0.65 mmol/L or 6.6-11.0 mg/dl) had a significantly increased prevalence of LVH compared with the lowest tertile independent of age, body mass index, serum creatinine level, HTN, diabetes and hyperlipidemia (odds ratio 1.58, 95% confidence interval 1.23-2.02, P

Background Epidemiological studies have demonstrated the association between low birth weight and increased adulthood risk for cardiovascular and metabolic diseases. However, the precise mechanism underlying the association remains poorly understood. We investigated the association between birth weight and adult white blood cell (WBC) count in a Japanese population. Methods and Results The subjects were 779 men and 209 women aged 35-64 years. The mean WBC count was 5,283 /μl (SD: 1,326). Birth weight was divided to 6 categories: 3,500 g. Estimated WBC counts were 5,729, 5,341, 5,301, 5,212, 5,013 and 5,372 for the subjects with birth weights of the above respective categories (p=0.015, trend p=0.016) by one-way analysis of covariance after adjustments for sex, age, height, body mass index (BMI), lifestyles, and chronic diseases. This association was pronounced among the subjects with a BMI

Background The association of white blood cell (WBC) count with all-cause and cardiovascular disease (CVD) mortality were examined in the National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged (NIPPON DATA) 90. Methods and Results A total of 6,756 Japanese residents (2,773 men and 3,983 women) throughout Japan without a history of CVD were followed for 9.6 years. A Cox proportional hazards regression model was used to estimate the relative risk (RR) and 95% confidence interval (CI). We documented 576 deaths with 161 deaths from CVD. Overall, after adjusting for several confounders including age, sex, body mass index at baseline, smoking status, alcohol consumption, regular exercise, diastlic blood pressure, total cholesterol, high-density lipoprotein-cholesterol and hemoglobin A1c, a graded association between WBC count and higher risk of all-cause mortality was observed (WBC of 9,000-10,000 cells/mm3 vs WBC of 4,000-4,900: RR =1.61, 95% CI: 1.07-2.40, p for trend =0.02). Elevated WBC count was almost significantly associated with high risk of CVD mortality (WBC of 9,000-10,000 vs WBC of 4,000-4,900: RR =1.79, 95% CI: 0.97-3.71). These associations strengthened among women. Stratified by smoking status, never-smokers with WBC counts of 9,000-10,000 had a 3.2 fold elevated risk for CVD death compared with those with WBC counts of 4,000-4,900. Conclusions The WBC count may have potential as a predictor for all-cause mortality, particularly CVD mortality. (Circ J 2007; 71: 479 - 485)

Background Low birth weight has been associated with adult hypertension in several Western populations. This association needs to be evaluated in Japanese people. Methods and Results A population-based cross-sectional study of 3,107 subjects (2,303 males and 804 females) aged 35-66 years was conducted. The participants responded to a questionnaire about their birth weights, blood pressure, medical history, parental history, and lifestyle factors. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and/or under treatment by anti-hypertensives. Multiple logistic regression analysis adjusted for age, sex, body mass index, parental history, and lifestyle revealed the adjusted odds ratios for hypertension were 1.26 (95% confidence interval: 0.88-1.80), 1.00 (reference), 0.89 (0.73-1.08) and 0.70 (0.49-1.00) in subjects in birth weight categories of

Background The relation between weight fluctuation and the risk of cardiovascular disease (CVD) is fairly consistent, although the physiologic basis for the relationship is uncertain. In the present study the association between long-term weight fluctuation and the development of metabolic syndrome (MS), a potent CVD risk factor, was investigated. Methods and Results A cross-sectional study of 664 Japanese men aged 40-49 years was conducted. The root mean square error around the slope of weight on age (weight - RMSE) was calculated by a simple linear regression model, in which the subject's actual weights at ages 20, 25, 30 years and 5 years prior to the study, as well as current weight, were dependent variables against the subject's age as the independent variable. Weight-RMSE was significantly and positively associated with the prevalence of each MS components (high blood pressure, hypertriglyceridemia, low-high density lipoprotein-cholesterol, high fasting glucose, and obesity). Such associations, as well as clustering of the MS component together with RMSE increase, were apparent among subjects with body mass index (BMI)

Background Phospholipid transfer protein (PLTP) can generate pre-β high-density lipoprotein (HDL), an efficient acceptor of peripheral cholesterol, by mediating a process called HDL conversion. The transfer of phospholipids to immature HDL is also essential in maintaining reverse cholesterol transport. The phospholipid transfer activity of PLTP has been associated with various patho-physiological conditions; however, little information is available concerning the relationship between PLTP mass and disease. Methods and Results Using a sandwich enzyme-linked immunosorbent assay, PLTP concentration was measured and related to the risk of developing cardiovascular disease in a worksite-based cohort of Japanese men (n=2,567). Multiple linear regression analysis showed significant associations between PLTP and HDL cholesterol, triglycerides, low-density lipoprotein cholesterol, and body mass index (standardized β=0.395, -0.191, -0.064, and -0.064, respectively; R2=0.31). During the follow-up period, there were 10 cases of coronary heart disease (CHD) and 7 of stroke. The multivariate adjusted relative risk of CHD was 0.46 (95% confidence interval, 0.20-1.07) for an increase of 1 standard deviation in the PLTP value (p=0.071). PLTP concentration was not related to the risk of stroke. Conclusions The results of this prospective study indicate that the serum PLTP concentration would serve as a predictor of CHD, independent of HDL cholesterol, triglycerides and other established risk factors. (Circ J 2004; 68: 11 - 16)

Background The role of inflammation in the genesis of cardiovascular disease has attracted attention and in the present study the association among metabolic syndrome (MS), white blood cell (WBC) count, and insulin concentration was investigated. Methods and Results A cross-sectional study of 3,594 Japanese men aged 34-69 years evaluated the MS components (high blood pressure, hypo-high density lipoprotein (HDL)-cholesterolemia, hypertriglyceridemia, hyperglycemia), as defined by the criteria given in the Third Report of the National Cholesterol Education Program Expert Panel on Detection Evaluation, and Treatment of High Blood Cholesterol in Adults, except for obesity [body mass index (BMI) ≥25 kg/m2]. WBC count had a positive correlation with BMI, blood pressure, triglyceride, glucose and insulin, and a negative correlation with HDL-cholesterol. The multi-adjusted means of WBC count and insulin concentration were significantly higher in MS subjects defined as having 3 or more of the components than in non-MS subjects with no more than 2 components. Both means also increased with the number of MS components (p