92 results on '"Takahisa Murakami"'
Search Results
2. The long-term reproducibility of the white-coat effect on blood pressure as a continuous variable from the Ohasama Study
- Author
-
Michihiro Satoh, Tomoya Yoshida, Hirohito Metoki, Takahisa Murakami, Yukako Tatsumi, Takuo Hirose, Kyosuke Takabatake, Megumi Tsubota-Utsugi, Azusa Hara, Kyoko Nomura, Kei Asayama, Masahiro Kikuya, Atsushi Hozawa, Yutaka Imai, and Takayoshi Ohkubo
- Subjects
Medicine ,Science - Abstract
Abstract There is little information about the reproducibility of the white coat effect, which was treated as a continuous variable. To investigate a long-term interval reproducibility of the white-coat effect as a continuous variable. We selected 153 participants without antihypertensive treatment (men, 22.9%; age, 64.4 years) from the general population of Ohasama, Japan, to assess the repeatedly measured white-coat effect (the difference between blood pressures at the office and home) in a 4-year interval. The reproducibility was assessed by testing the intraclass correlation coefficient (two-way random effect model-single measures). The white-coat effect for systolic/diastolic blood pressure slightly decreased by 0.17/1.56 mmHg at the 4-year visit on average. The Bland–Altman plots showed no significant systemic error for the white-coat effects (P ≥ 0.24). The intraclass correlation coefficient (95% confidence interval) of the white-coat effect for systolic blood pressure, office systolic blood pressure, and home systolic blood pressure were 0.41 (0.27–0.53), 0.64 (0.52–0.74), and 0.74 (0.47–0.86), respectively. Change in the white-coat effect was mainly affected by a change in office blood pressure. Long-term reproducibility of the white-coat effect is limited in the general population without antihypertensive treatment. The change in the white-coat effect is mainly caused by office blood pressure variation.
- Published
- 2023
- Full Text
- View/download PDF
3. The prevalence of psychological distress during pregnancy in Miyagi Prefecture for 3 years after the Great Eas t Japan Earthquake
- Author
-
Kaou Tanoue, Zen Watanabe, Hidekazu Nishigori, Noriyuki Iwama, Michihiro Satoh, Takahisa Murakami, Kousuke Tanaka, Satomi Sasaki, Kasumi Sakurai, Mami Ishikuro, Taku Obara, Masatoshi Saito, Junichi Sugawara, Nozomi Tatsuta, Shinichi Kuriyama, Takahiro Arima, Kunihiko Nakai, Nobuo Yaegashi, Hirohito Metoki, and Japan Environment and Children’s Study (JECS) Group
- Subjects
Psychological distress ,Negative life events ,Earthquake ,Tsunami ,Pregnant women ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background To examine changes in psychological distress prevalence among pregnant women in Miyagi Prefecture, which was directly affected by the Great East Japan Earthquake and tsunami, and compare it with the other, less damaged areas of Japan. Methods This study was conducted in conjunction with the Japan Environment and Children`s Study. We examined 76,152 pregnant women including 8270 in Miyagi Regional Center and 67,882 in 13 other regional centers from the all-birth fixed data of the Japan Environment and Children’s Study. We then compared the prevalence and risk of distress in women in Miyagi Regional Center and women in the 13 regional centers for 3 years after the disaster. Results Women in the Miyagi Regional Center suffered more psychological distress than those in the 13 regional centers: OR 1.38 (95% CI, 1.03–1.87) to 1.92 (95% CI, 1.42–2.60). Additionally, women in the inland area had a consistently higher prevalence of psychological distress compared to those from the 13 regional centers: OR 1.67 (95% CI, 1.18–2.38) to 2.19 (95% CI, 1.60–2.99). Conclusions The lack of pre-disaster data in the Japan Environment and Children’s Study made it impossible to compare the incidence of psychological distress before and after the March 2011 Great East Japan Earthquake. However, 3 years after the Great East Japan Earthquake, the prevalence of pregnant women with psychological distress did not improve in Miyagi Regional Center. Further, the prevalence of mental illness in inland areas was consistently higher than that in the 13 regional centers after the disaster.
- Published
- 2021
- Full Text
- View/download PDF
4. Association of fish intake with menstrual pain: A cross-sectional study of the Japan Environment and Children's Study.
- Author
-
Emi Yokoyama, Takashi Takeda, Zen Watanabe, Noriyuki Iwama, Michihiro Satoh, Takahisa Murakami, Kasumi Sakurai, Naomi Shiga, Nozomi Tatsuta, Masatoshi Saito, Masahito Tachibana, Takahiro Arima, Shinichi Kuriyama, Hirohito Metoki, and Nobuo Yaegashi
- Subjects
Medicine ,Science - Abstract
The relationship between fish eating habits and menstrual pain is unknown. Elucidating this relationship can inform dietary guidance for reproductive age women with menstrual pain. The aim of this study was to clarify the relationship between fish intake frequency/preference and menstrual pain. This cross-sectional study was conducted at the Miyagi Regional Center as an adjunct study of the Japan Environment and Children's Study, and 2060 eligible women (mean age, 31.9 years) participated. Fish intake frequency ("< 1 time/week," "1 time/week," "2-3 times/week," or "≥ 4 times/week"), preference ("like," "neutral," or "dislike"), and menstrual pain (no/mild or moderate-to-severe) were assessed at 1.5 years after the last delivery through self-administered questionnaires. The association between fish intake frequency/preference and prevalence of moderate-to-severe menstrual pain was evaluated through logistic regression analyses. Our results show that, compared with the "< 1 time/week" (38.0%) group, the "1 time/week" (26.9%), "2-3 times/week" (27.8%), and "≥ 4 times/week" (23.9%) groups showed a lower prevalence of moderate-to-severe menstrual pain (p < 0.01). The prevalence of moderate-to-severe menstrual pain was 27.7%, 27.6%, and 34.4% in the "like," "neutral," and "dislike" groups, respectively. Multivariate logistic regression showed that frequent fish intake was associated with a lower prevalence of moderate-to-severe menstrual pain ("1 time/week": odds ratio [OR] = 0.59; 95% confidence interval [CI], 0.41-0.86, "2-3 times/week": OR = 0.64; 95% CI, 0.45-0.90 and "≥ 4 times/week": OR = 0.52; 95% CI, 0.34-0.80; trend p = 0.004). Multivariate logistic regression showed no association between fish preference and moderate-to-severe menstrual pain ("dislike" vs "like": OR = 1.16; 95% CI, 0.78-1.73). There was a significant negative association between fish intake frequency and menstrual pain. It is suggested that fish intake can reduce or prevent menstrual pain.
- Published
- 2022
- Full Text
- View/download PDF
5. Association of subjective health and abnormal cervical cytology in Japanese pregnant women: An adjunct study of the Japan Environment and Children's Study
- Author
-
Satomi Sasaki, Hirohito Metoki, Michihiro Satoh, Takahisa Murakami, Kaou Tanoue, Kosuke Tanaka, Noriyuki Iwama, Zen Watanabe, Satoshi Okamoto, Masatoshi Saito, Junichi Sugawara, Kiyoshi Ito, and Nobuo Yaegashi
- Subjects
Cervical cancer ,Pregnancy ,HPV ,Screening ,Subjective health ,Medicine - Abstract
This study examines the association between abnormal cervical cytology and subjective health in pregnant women, as an adjunct to the Japan Environment and Children's Study, which cross-sectionally analyzed a subset of the prospective cohort. A total of 3024 pregnant women at a childbirth facility whose medical records of cervical cytology in the first trimester of pregnancy were transcribed and who responded to the subjective health questionnaire were included herein. They were classified into excellent, good, fair, and poor groups based on their subjective health. Cervical cytology results obtained from perinatal medical records were classified into normal and abnormal cytology based on the Bethesda classification. Logistic regression analysis adjusted for baseline characteristics, including age, pre-pregnancy body mass index, parity, and other possible confounding factors, was used. Of 3024 pregnant women, 106 (3.5%) had abnormal cytology, with the prevalence being 1.3%, 3.7%, 3.9%, and 4.0%, respectively (p = 0.055) in the poor, fair, good, and excellent groups. The baseline characteristics, namely age, history of gynecological diseases, Kessler 6-item psychological distress scale score, and history of mental illness, were significantly different between groups. Compared to the poor group, the other three groups had a significantly higher abnormal cytology risk after adjusting for confounding factors (Fair: adjusted OR [aOR] = 3.6, 95% CI [1.0–12.1]; Good: aOR = 4.6 [1.3–15.5]; Excellent: aOR = 4.6 [1.2–17.8]). This study encourages young women to undergo cervical cancer screening because they are at risk for cervical cancer even if they think that they are healthy, and preventive activities like regular screening are essential.
- Published
- 2021
- Full Text
- View/download PDF
6. Blood Pressure and Chronic Kidney Disease Stratified by Gender and the Use of Antihypertensive Drugs
- Author
-
Michihiro Satoh, Takuo Hirose, Shingo Nakayama, Takahisa Murakami, Kyosuke Takabatake, Kei Asayama, Yutaka Imai, Takayoshi Ohkubo, Takefumi Mori, and Hirohito Metoki
- Subjects
blood pressure ,chronic kidney disease ,cohort study ,database ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The present study assessed the association between blood pressure (BP) and the risk of chronic kidney disease (CKD) according to gender and the use of antihypertensive drugs using data from a large‐scale health checkup. Methods and Results We conducted a retrospective cohort study using the JMDC database, which contains annual health checkup data of Japanese employees and their dependents aged
- Published
- 2020
- Full Text
- View/download PDF
7. Association between tooth loss and cognitive impairment in community-dwelling older Japanese adults: a 4-year prospective cohort study from the Ohasama study
- Author
-
Sho Saito, Takashi Ohi, Takahisa Murakami, Takamasa Komiyama, Yoshitada Miyoshi, Kosei Endo, Michihiro Satoh, Kei Asayama, Ryusuke Inoue, Masahiro Kikuya, Hirohito Metoki, Yutaka Imai, Takayoshi Ohkubo, and Yoshinori Hattori
- Subjects
Cognitive impairment ,Cohort study ,Community-dwelling ,Elderly ,Tooth loss ,Dentistry ,RK1-715 - Abstract
Abstract Background Numerous prospective studies have investigated the association between the number of remaining teeth and dementia or cognitive decline. However, no agreement has emerged on the association between tooth loss and cognitive impairment, possibly due to past studies differing in target groups and methodologies. We aimed to investigate the association between tooth loss, as evaluated through clinical oral examinations, and the development of cognitive impairment in community-dwelling older adults while considering baseline cognitive function. Methods This 4-year prospective cohort study followed 140 older adults (69.3% female) without cognitive impairment aged ≥65 years (mean age: 70.9 ± 4.3 years) living in the town of Ohasama, Iwate Prefecture, Japan. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) in baseline and follow-up surveys. Based on a baseline oral examination, the participants were divided into those with 0–9 teeth and those with ≥10 teeth. To investigate the association between tooth loss and cognitive impairment, we applied a multiple logistic regression analysis adjusted for age, sex, hypertension, diabetes, cerebrovascular/cardiovascular disease, hypercholesterolemia, depressive symptoms, body mass index, smoking status, drinking status, duration of education, and baseline MMSE score. Results In the 4 years after the baseline survey, 27 participants (19.3%) developed cognitive impairment (i.e., MMSE scores of ≤24). Multiple logistic regression analysis indicated that participants with 0–9 teeth were more likely to develop cognitive impairment than those with ≥10 teeth were (odds ratio: 3.31; 95% confidence interval: 1.07–10.2). Age, male gender, and baseline MMSE scores were also significantly associated with cognitive impairment. Conclusions Tooth loss was independently associated with the development of cognitive impairment within 4 years among community-dwelling older adults. This finding corroborates the hypothesis that tooth loss may be a predictor or risk factor for cognitive decline.
- Published
- 2018
- Full Text
- View/download PDF
8. Nocturnal blood pressure decline based on different time intervals and long-term cardiovascular risk: the Ohasama Study
- Author
-
Michihiro Satoh, Kei Asayama, Masahiro Kikuya, Ryusuke Inoue, Megumi Tsubota-Utsugi, Taku Obara, Keiko Murakami, Ayako Matsuda, Takahisa Murakami, Kyoko Nomura, Hirohito Metoki, Yutaka Imai, and Takayoshi Ohkubo
- Subjects
ambulatory blood pressure ,cardiovascular disease ,epidemiology ,nocturnal blood pressure decline ,non-dipper ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
A diminished nocturnal decline in blood pressure (BP) represents a risk factor for cardiovascular disease. To define daytime and nighttime ambulatory BP, clock time-dependent methods are used when information on diary-based sleeping time is unavailable. We aimed to compare fixed-clock intervals with diary records to identify nocturnal BP declines as a predictor of long-term cardiovascular risk among the general population. Data were obtained from 1714 participants with no history of cardiovascular disease in Ohasama, Japan (mean age, 60.6 years; 64.9% women). We defined extreme dippers, dippers, non-dippers, and risers as nocturnal systolic BP decline ≥20%, 10–19%. 0–9%, and
- Published
- 2018
- Full Text
- View/download PDF
9. Age‐Related Trends in Home Blood Pressure, Home Pulse Rate, and Day‐to‐Day Blood Pressure and Pulse Rate Variability Based on Longitudinal Cohort Data: The Ohasama Study
- Author
-
Michihiro Satoh, Hirohito Metoki, Kei Asayama, Takahisa Murakami, Ryusuke Inoue, Megumi Tsubota‐Utsugi, Ayako Matsuda, Takuo Hirose, Azusa Hara, Taku Obara, Masahiro Kikuya, Kyoko Nomura, Atsushi Hozawa, Yutaka Imai, and Takayoshi Ohkubo
- Subjects
blood pressure ,blood pressure measurement/monitoring ,epidemiology ,heart rate/heart rate variability ,home blood pressure ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Home blood pressure is a more accurate prognosticator than office blood pressure and allows the observation of day‐to‐day blood pressure variability. Information on blood pressure change during the life course links the prediction of blood pressure elevation with age. We prospectively assessed age‐related trends in home blood pressure, home pulse rate, and their day‐to‐day variability evaluated as a coefficient of variation. Methods and Results We examined 1665 participants (men, 36.0%; mean age, 56.2 years) from the general population of Ohasama, Japan. A repeated‐measures mixed linear model was used to estimate the age‐related trends. In a mean of 15.9 years, we observed 5438 points of measurements including those at baseline. The home systolic blood pressure linearly increased with age and was higher in men than in women aged 40 years. However, an U‐shaped age‐related trend in day‐to‐day diastolic blood pressure variability with the nadir point at 65 to 69 years of age was observed. No significant sex differences in the day‐to‐day blood pressure variability were observed (P≥0.22). The average and day‐to‐day variability of home pulse rate decreased with age but were lower and higher, respectively, in men than in women. Conclusions The current descriptive data are needed to predict future home blood pressure and pulse rate. The data also provide information on the mechanism of day‐to‐day blood pressure and pulse rate variability.
- Published
- 2019
- Full Text
- View/download PDF
10. Proposal of reference value for day-to-day blood pressure variability based on two outcomes: the Ohasama study.
- Author
-
Michihiro Satoh, Hirohito Metoki, Masahiro Kikuya, Takahisa Murakami, Yukako Tatsumi, Megumi Tsubota-Utsugi, Takuo Hirose, Azusa Hara, Kyoko Nomura, Kei Asayama, Atsushi Hozawa, Yutaka Imai, and Takayoshi Ohkubo
- Published
- 2024
- Full Text
- View/download PDF
11. Association Between Ambulatory Blood Pressure and Risk of Home Hypertension in a Normotensive Population: The Ohasama Study
- Author
-
Shingo Nakayama, Michihiro Satoh, Hirohito Metoki, Takahisa Murakami, Yukako Tatsumi, Kei Asayama, Azusa Hara, Takuo Hirose, Megumi Tsubota-Utsugi, Masahiro Kikuya, Takefumi Mori, Atsushi Hozawa, Yutaka Imai, and Takayoshi Ohkubo
- Subjects
Internal Medicine - Abstract
BackgroundWe investigated the association between ambulatory blood pressure (BP) and the risk of home hypertension in a normotensive population and whether considering ambulatory BP improves the 10-year prediction model for home hypertension risk, which was developed in the previous Ohasama Study.MethodsIn this prospective study, we followed up with 410 participants (83.2% women; age, 53.6 years) without a home and ambulatory hypertension in the general population of Ohasama, Japan. The Cox model was used to assess the hazard ratios (HRs) for home hypertension (home BP ≥ 135/≥85 mmHg or the initiation of antihypertensive treatment) and model improvement.ResultsDuring a mean 14.2-year follow-up, 225 home hypertension incidences occurred. The HR (95% confidence interval) for home hypertension incidence per 1-SD higher (=6.76 mmHg) 24-hour systolic BP (SBP) was 1.59 (1.33 to 1.90), after adjustments for possible confounding factors, including baseline home SBP. Harrell’s C-statistics increased from 0.72 to 0.73 (P = 0.11) when 24-hour SBP was added to the basic 10-year home hypertension prediction model, which includes sex, age, body mass index, smoking status, office SBP, and baseline home SBP. Continuous net reclassification improvement (0.53, P ConclusionsA total of 24-hour SBP could be an independent predictor of future home hypertension. Home BP and 24-hour BP can longitudinally influence each other in the long term.
- Published
- 2022
12. Hypertensive disorders of pregnancy: definition, management, and out-of-office blood pressure measurement
- Author
-
Hirohito Metoki, Noriyuki Iwama, Hirotaka Hamada, Michihiro Satoh, Takahisa Murakami, Mami Ishikuro, and Taku Obara
- Subjects
Pregnancy ,Physiology ,Masked Hypertension ,Hypertension ,Internal Medicine ,Humans ,Blood Pressure ,Blood Pressure Determination ,Female ,Hypertension, Pregnancy-Induced ,Blood Pressure Monitoring, Ambulatory ,Cardiology and Cardiovascular Medicine ,White Coat Hypertension - Abstract
Hypertensive disorders of pregnancy increase the risk of adverse maternal and fetal outcomes. In 2018, the Japanese classification of hypertensive disorders of pregnancy was standardized with those of other countries, and a hypertensive disorder of pregnancy was considered to be present if hypertension existed during pregnancy and up to 12 weeks after delivery. Strategies for the prevention of hypertensive disorders of pregnancy have become much clearer, but further research is needed on appropriate subjects and methods of administration, and these have not been clarified in Japan. Although guidelines for the use of antihypertensive drugs are also being studied and standardized with those of other countries, the use of calcium antagonists before 20 weeks of gestation is still contraindicated in Japan because of the safety concerns that were raised regarding possible fetal anomalies associated with their use at the time of their market launch. Chronic hypertension is now included in the definition of hypertensive disorders of pregnancy, and blood pressure measurement is a fundamental component of the diagnosis of hypertensive disorders of pregnancy. Out-of-office blood pressure measurements, including ambulatory and home blood pressure measurements, are important for pregnant and nonpregnant women. Although conditions such as white-coat hypertension and masked hypertension have been reported, determining their occurrence in pregnancy is complicated by the gestational week. This narrative review focused on recent reports on hypertensive disorders of pregnancy, including those related to blood pressure measurement and classification.
- Published
- 2022
13. Cross-classification by systolic and diastolic blood pressure levels and chronic kidney disease, proteinuria, or kidney function decline
- Author
-
Tsukasa Suenaga, Michihiro Satoh, Takahisa Murakami, Takuo Hirose, Taku Obara, Shingo Nakayama, Hideaki Hashimoto, Maya Toyama, Tomoko Muroya, Atsuhiro Kanno, Takefumi Mori, Takayoshi Ohkubo, Yutaka Imai, and Hirohito Metoki
- Subjects
Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
14. Oral health‐related quality of life is associated with the prevalence and development of depressive symptoms in older Japanese individuals: The Ohasama Study
- Author
-
Hirohito Metoki, Masahiro Kikuya, Michihiro Satoh, Atsushi Hozawa, Takahisa Murakami, Yutaka Imai, Takako Hiratsuka, Makoto Watanabe, Kei Asayama, Yoshitada Miyoshi, Takayoshi Ohkubo, Takashi Ohi, Kosei Endo, Ryusuke Inoue, Takamasa Komiyama, and Yoshinori Hattori
- Subjects
Oral Health ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Quality of life ,Prevalence ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,General Dentistry ,Depression (differential diagnoses) ,Aged ,Depression ,business.industry ,030206 dentistry ,Odds ratio ,medicine.disease ,Comorbidity ,humanities ,Cross-Sectional Studies ,Quality of Life ,Geriatrics and Gerontology ,business ,Body mass index ,Clinical psychology ,Cohort study - Abstract
Objective This prospective study investigated the cross-sectional association between impaired oral health-related quality of life (OHRQoL) and the prevalence of depressive symptoms, and the longitudinal association between impaired OHRQoL and development of depressive symptoms among older adults. Background Previous studies have shown a relationship between poor oral health and depression among older adults; however, findings are inconsistent. Materials and methods Participants were 669 community-dwelling older Japanese individuals aged≥55 years (mean: 67.8 ± 7.2 years). Data of 296 participants were used for longitudinal analyses. OHRQoL was evaluated using the Oral Impacts on Daily Performances scale. Impaired OHRQoL was defined as the presence of at least one impact on the scale. Depressive symptoms were assessed using the Japanese version of the Zung self-rating depression scale with a cut-off score of 40. Results The cross-sectional logistic regression model demonstrated that impaired OHRQoL was significantly associated with depressive symptoms (odds ratio [OR], 5.17; 95% confidence interval [CI], 2.99-8.95) independent of age, sex, body mass index, hypertension, cerebrovascular/cardiovascular disease, smoking, drinking alcohol, education, cognitive function, objective oral health (dentition status) and oral health behaviour (dental visit within 1 year). Similarly, impaired OHRQoL predicted the development of depressive symptoms within 4 years in a fully adjusted longitudinal model (OR, 6.00; 95% CI, 1.38-26.09). Conclusion Impaired OHRQoL was identified as a potential comorbidity of depressive symptoms and a predictor for depressive disorder later in life. OHRQoL may be a useful clinical outcome for elder patients with regard to their mental and oral health.
- Published
- 2021
15. Actual impact of angiotensin II receptor blocker or calcium channel blocker monotherapy on renal function in real-world patients
- Author
-
Michihiro Satoh, Takuo Hirose, Hironori Satoh, Shingo Nakayama, Taku Obara, Takahisa Murakami, Tomoko Muroya, Kei Asayama, Masahiro Kikuya, Takefumi Mori, Yutaka Imai, Takayoshi Ohkubo, and Hirohito Metoki
- Subjects
Male ,Physiology ,Angiotensin-Converting Enzyme Inhibitors ,Middle Aged ,Calcium Channel Blockers ,Kidney ,Angiotensin Receptor Antagonists ,Proteinuria ,Hypertension ,Internal Medicine ,Humans ,Female ,Cardiology and Cardiovascular Medicine ,Antihypertensive Agents ,Retrospective Studies - Abstract
This observational retrospective cohort study investigates the effect of antihypertensive therapy with angiotensin II receptor blockers (ARBs) or dihydropyridine calcium channel blockers (dCCBs) monotherapy on renal function using longitudinal real-world health data of a drug-naive, hypertensive population without kidney disease.Using propensity score matching, we selected untreated hypertensive participants ( n = 10 151) and dCCB ( n = 5078) or ARB ( n = 5073) new-users based on annual health check-ups and claims between 2008 and 2020. Participants were divided by the first prescribed drug.The mean age was 51 years, 79% were men and the mean estimated glomerular filtration rate (eGFR) was 78 ml/min per 1.73 m 2 . Blood pressure rapidly decreased by approximately 10% in both treatment groups. At the 1-year visit, eGFR levels decreased in the ARB group by nearly 2% but increased in the dCCB group by less than 1%. However, no significant difference was apparent in the annual eGFR change after the 1-year visit. The risk for composite kidney outcome (new-onset proteinuria or eGFR decline ≥30%) was lowest in the ARB group owing to their robust effect on preventing proteinuria: hazard ratio (95% confidence interval) for proteinuria was 0.91 (0.78-1.05) for the dCCB group and 0.54 (0.44-0.65) for the ARB group, compared with that for the untreated group after ending follow-up at the last visit before changing antihypertensive treatment.From the present findings based on the real-world data, ARBs can be recommended for kidney protection even in a primary care setting. Meanwhile, dCCB treatment initially increases eGFR with no adverse effects on proteinuria.
- Published
- 2022
16. Association of home and office systolic and diastolic hypertension with glucose metabolism in a general population: the Ohasama study
- Author
-
Yukako Tatsumi, Michihiro Satoh, Kei Asayama, Takahisa Murakami, Takuo Hirose, Azusa Hara, Megumi Tsubota-Utsugi, Ryusuke Inoue, Masahiro Kikuya, Kyoko Nomura, Hirohito Metoki, Atsushi Hozawa, Hideki Katagiri, Yutaka Imai, and Takayoshi Ohkubo
- Subjects
Blood Glucose ,Glucose ,Physiology ,Systole ,Hypertension ,Internal Medicine ,Humans ,Insulin Resistance ,Middle Aged ,Cardiology and Cardiovascular Medicine - Abstract
This study was performed to investigate the association of hypertension subtypes with glucose metabolism among the Japanese general population.The study involved 646 residents (mean age: 62.4 years) without treatment for hypertension or a history of diabetes from Ohasama, a rural Japanese community, who underwent an oral glucose tolerance test. Hypertension subtypes [normotension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH)] were defined on the basis of home and office SBP and DBP (HBP and OBP, respectively). The estimated means of blood glucose related indices among the groups were compared by analysis of covariance adjusted for possible confounding factors.Blood glucose related indices were not different among the morning HBP-defined hypertension subtypes. Participants with evening HBP-defined ISH had a significantly higher estimated mean BG at 120 min, higher homeostasis model assessment-insulin resistance (HOMA-IR) and lower Matsuda-DeFronzo index than participants with NT (all P 0.021). Participants with OBP-defined SDH had a significantly higher estimated mean fasting blood glucose; blood glucose at 30, 60 and 120 min; and HOMA-IR and a lower Matsuda-DeFronzo index than participants with NT (all P 0.0025).The blood glucose related indices were different among hypertension subtypes. Participants with evening HBP-defined ISH and OBP-defined SDH had higher blood glucose levels and insulin resistance than participants with correspondingly defined normotension, while those with morning HBP did not. These findings suggest the importance of measuring evening HBP and office blood pressure for early detection of coexisting hypertension and diabetes.
- Published
- 2022
17. Regular dental visits, periodontitis, tooth loss, and atherosclerosis: The Ohasama study
- Author
-
Sho Yamada, Takamasa Komiyama, Takashi Ohi, Takahisa Murakami, Yoshitada Miyoshi, Kosei Endo, Takako Hiratsuka, Azusa Hara, Michihiro Satoh, Yukako Tatsumi, Ryusuke Inoue, Kei Asayama, Masahiro Kikuya, Atsushi Hozawa, Hirohito Metoki, Yutaka Imai, Takayoshi Ohkubo, and Yoshinori Hattori
- Subjects
alveolar bone loss ,BLOOD-PRESSURE ,Carotid Intima-Media Thickness ,INTIMA-MEDIA THICKNESS ,regular dental visit ,Tooth Loss ,tooth loss ,Dentistry, Oral Surgery & Medicine ,Humans ,CORONARY-HEART-DISEASE ,ORAL-HEALTH ,HOME ,Periodontitis ,periodontitis ,POPULATION ,RISK ,Science & Technology ,ASSOCIATION ,Atherosclerosis ,stomatognathic diseases ,Cross-Sectional Studies ,CAROTID ATHEROSCLEROSIS ,Periodontics ,epidemiology ,atherosclerosis ,Life Sciences & Biomedicine ,STROKE - Abstract
OBJECTIVE: We aimed to explore the association between regular dental visits and atherosclerosis and between periodontitis, number of remaining teeth, and atherosclerosis among community dwellers in Japan. BACKGROUND: Few studies have examined the association between regular dental visits, periodontitis, tooth loss, and atherosclerosis in community dwellers in Japan. METHODS: The participants of this cross-sectional study included community dwellers aged ≥55 years and residing in Ohasama. Exposure variables were regular dental visits; periodontitis, defined as radiographic alveolar bone loss (BL); the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) classification; and number of remaining teeth. The primary outcome was atherosclerosis, defined as maximum carotid intima-media thickness ≥1.1 mm or confirmation of atheromatous plaque. RESULTS: Of 602 participants, 117 had atherosclerosis. In the multivariate model, compared to those with regular dental visits, the odds ratio (OR) (95% confidence intervals [CIs]) of atherosclerosis among those with the absence of regular dental visits was 2.16 (1.03-4.49). Regarding BL-max, compared with those in the first quartile, ORs (95% CIs) of those in the second, third, and fourth quartiles were 1.15 (0.65-2.30), 0.65 (0.32-1.35), and 1.57 (0.81-3.01), respectively. Regarding CDC/AAP classification, compared to those with no or mild periodontitis, ORs (95% CIs) for those with moderate and severe periodontitis were 2.48 (0.61-10.1) and 4.26 (1.01-17.5), respectively. Regarding the number of remaining teeth, compared to those with ≥20 teeth, ORs (95%CIs) for those with 10-19 and 1-9 teeth were 1.77 (1.004-3.12) and 0.96 (0.52-1.80), respectively. CONCLUSION: The absence of regular dental visits and presence of periodontitis are associated with atherosclerosis among community dwellers in Japan. ispartof: JOURNAL OF PERIODONTAL RESEARCH vol:57 issue:3 pages:615-622 ispartof: location:United States status: published
- Published
- 2022
18. Lifetime risk of stroke stratified by chronic kidney disease and hypertension in the general Asian population: the Ohasama study
- Author
-
Atsuhiro Kanno, Hirohito Metoki, Takefumi Mori, Takayoshi Ohkubo, Michihiro Satoh, Takahisa Murakami, Atsushi Hozawa, Shingo Nakayama, Yutaka Imai, Azusa Hara, Megumi Tsubota-Utsugi, Kei Asayama, Masahiro Kikuya, Ryusuke Inoue, and Takuo Hirose
- Subjects
medicine.medical_specialty ,Physiology ,Population ,Renal function ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Epidemiology ,Internal Medicine ,Medicine ,030212 general & internal medicine ,education ,Stroke ,education.field_of_study ,Proteinuria ,business.industry ,Absolute risk reduction ,medicine.disease ,female genital diseases and pregnancy complications ,Blood pressure ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Kidney disease - Abstract
Lifetime risk (LTR) evaluates the absolute risk of developing a disease during the remainder of one’s life. It can be a useful tool, enabling the general public to easily understand their risk of stroke. No study has been performed to determine the LTR of cardiovascular disease in patients with chronic kidney disease (CKD) with or without hypertension; therefore, we performed this study in an Asian population. We followed 1525 participants (66.0% women; age 63.1 years) in the general population of Ohasama, Japan. We defined CKD as an estimated glomerular filtration rate (eGFR)
- Published
- 2021
19. Association between urinary sodium-to-potassium ratio and home blood pressure and ambulatory blood pressure: the Ohasama study
- Author
-
Tomoko Muroya, Michihiro Satoh, Takahisa Murakami, Shingo Nakayama, Kei Asayama, Takuo Hirose, Yukako Tatsumi, Ryusuke Inoue, Megumi Tsubota-Utsugi, Azusa Hara, Mana Kogure, Naoki Nakaya, Kyoko Nomura, Masahiro Kikuya, Hirohito Metoki, Yutaka Imai, Atsushi Hozawa, and Takayoshi Ohkubo
- Subjects
Male ,Cross-Sectional Studies ,Physiology ,Sodium ,Internal Medicine ,Potassium ,Humans ,Blood Pressure ,Blood Pressure Monitoring, Ambulatory ,Middle Aged ,Cardiology and Cardiovascular Medicine - Abstract
No studies have demonstrated the association between urinary sodium-to-potassium (Na/K) ratio and all out-of-office blood pressure (BP) [home morning and evening BP (self-measured at home), and 24-h, daytime, and night-time ambulatory BP] in the same cohort. We aimed to assess, which type of out-of-office BP is more strongly associated with urinary Na/K ratio in the general population.This cross-sectional study was conducted in the general population of Ohasama, Japan. Home and ambulatory BP levels were measured, and 24-h urine samples were obtained from 875 participants (men, 25.5%; mean age, 60.1 years). The urinary Na/K ratio in the 24-h urine samples was calculated.The median (interquartile range) urinary Na/K ratio was 4.19 (3.36-5.26). Significant positive trends of home morning, home evening, 24-h, and daytime SBP were observed across quartiles of urinary Na/K ratio (trend P 0.041; adjusted mean values between Q1 and Q4 of urinary Na/K ratio: 121.0-125.5 mmHg for home morning, 120.1-123.8mmhg for home evening, 121.6-123.4mmHg for 24-h, 127.5-129.5 mmHg for daytime). Urinary Na/K ratio was not significantly associated with office or night-time SBP and nocturnal BP fall (trend P 0.13). In the model with both home morning or evening SBP and daytime SBP, only home SBP was significantly associated with urinary Na/K ratio (P 0.048 for home SBP).These findings suggest that urinary Na/K ratio might be more strongly associated with home BP than with 24-h and daytime BP but was not associated with night-time BP.
- Published
- 2022
20. Characteristics of Industry-Sponsored Drug Clinical Trials Registered in Japan Pharmaceutical Information Center Clinical Trials Information 2010–2018
- Author
-
Mamoru Narukawa, Katsue Suzuki, Midori Matsuyama, Takahisa Murakami, and Eriko Kobayashi
- Subjects
Drug ,medicine.medical_specialty ,Blinding ,Adolescent ,media_common.quotation_subject ,Pharmacy ,Information Centers ,030226 pharmacology & pharmacy ,01 natural sciences ,Double blind ,010104 statistics & probability ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Japan ,Neoplasms ,Internal medicine ,Humans ,Industry ,Medicine ,Pharmacology (medical) ,0101 mathematics ,Child ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,media_common ,business.industry ,Public Health, Environmental and Occupational Health ,Information center ,Mental health ,Clinical trial ,Pharmaceutical Preparations ,business - Abstract
To examine the trends and characteristics of industry-sponsored drug clinical trials registered in the JapicCTI (Japan Pharmaceutical Information Center Clinical Trials Information) in 2010–2018. A data set of 3116 clinical trials registered from Jan. 2010 to Dec. 2018 were analyzed. Fundamental characteristics of the clinical trials were analyzed by 3-year time periods. The analysis was also focused on 3 therapeutic areas: cardiovascular, mental health, and oncology. Of all the trials (2010–2018), 74.7% were conducted in Japan only; the rate decreased from 82.8 to 65.3% over the 3 time periods. Most trials were phase 3 trials, which comprised 44.1% of the trials. Small trials (anticipated number of 1000 or fewer participants) made up 94.0% of the trials. Oncology trials (29.5%) were the most common type and involved more phase 1 trials than mental health and cardiovascular trials (33.6% vs 14.5% and 11.5%, respectively). Oncology trials composed the smallest proportion of trials conducted in “Japan only” at 57.3% vs 81.0% and 83.1% for mental health and cardiovascular trials, respectively (p
- Published
- 2020
21. Epidemiological studies regarding hypertensive disorders of pregnancy: A review
- Author
-
Kosuke Tanaka, Mami Ishikuro, Noriyuki Iwama, Michihiro Satoh, Hirohito Metoki, and Takahisa Murakami
- Subjects
Pediatrics ,medicine.medical_specialty ,Psychological intervention ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Pre-Eclampsia ,Pregnancy ,Epidemiology ,Birth Weight ,Humans ,Medicine ,Child ,030219 obstetrics & reproductive medicine ,business.industry ,Confounding ,Obstetrics and Gynecology ,Hypertension, Pregnancy-Induced ,medicine.disease ,Blood pressure ,030220 oncology & carcinogenesis ,Cohort ,Gestation ,Female ,Observational study ,business - Abstract
A hypertensive disorder of pregnancy (HDP) is defined as hypertension emerging after 20 weeks of gestation and resolving up to 12 weeks post-partum, and occurs in about 5% of all pregnancies. Complications associated with HDP have poor prognoses, and maternal deaths attributable to HDP are predicted to exceed 70 000 per year worldwide. Understanding the pathogenesis and risk factors of hypertensive disorders of pregnancy is important, and they are often investigated in observational studies. Given that therapeutic interventions cannot be controlled in observed studies, it is necessary to interpret which factors correspond to exposure and which factors correspond to confounding and intermediate factors in each study. From the Babies and their parents' longitudinal observation in the Suzuki Memorial Hospital on Intrauterine period study, blood pressure in early pregnancy was not only predictive of a child's birthweight, but the trajectory was also associated with the birthweight. From the larger-scale birth cohort studies currently conducted in Japan will provide the novel potential risk factors of hypertensive disorders of pregnancy and preventive strategies of them. In Japan, observational or intervention studies are just beginning to emerge. The continuation of both a distinctive cohort and a large cohort is needed, and the development of good quality intervention trials based on the results of observational studies is important.
- Published
- 2020
22. The association between bilateral maximum occlusal force and all-cause mortality among community-dwelling older adults: The Tsurugaya project
- Author
-
Takahisa Murakami, Makoto Watanabe, Yoshinori Hattori, Yasutake Tomata, Takamasa Komiyama, Yoshitada Miyoshi, Takashi Ohi, Akito Tsuboi, and Ichiro Tsuji
- Subjects
Male ,Multivariate statistics ,0206 medical engineering ,Comorbidity ,02 engineering and technology ,Bite Force ,03 medical and health sciences ,0302 clinical medicine ,Japan ,medicine ,Humans ,Dentistry (miscellaneous) ,Prospective Studies ,Prospective cohort study ,Aged ,business.industry ,Proportional hazards model ,Hazard ratio ,030206 dentistry ,medicine.disease ,020601 biomedical engineering ,Confidence interval ,Blood chemistry ,Female ,Independent Living ,Oral Surgery ,business ,Demography ,Cohort study - Abstract
Purpose This study aimed to investigate the relationship between the bilateral maximum occlusal force (MOF) of full dental arches and all-cause mortality in a group of community-dwelling older males and females in Japan. Methods This 13-year prospective cohort study was conducted among 815 older adults (395 male and 420 female) aged 70 years or over (mean age ± standard deviation: 75.1 ± 4.5 years). Bilateral MOF in the intercuspal position was recorded with horseshoe-shaped pressure-sensitive film. Participants were grouped by gender into tertiles according to MOF. Demographic variables, chronicity, comorbidity, physical status, cognitive and psychological status, social functioning, and blood chemistry data were also assessed. Information regarding all-cause mortality and migration was obtained from the Sendai Municipal Authority. Cox proportional hazard modeling was performed to assess all-cause mortality during the follow-up period. Results In total, 159 male and 109 female participants died over a median 12.9-year follow-up period, and the cumulative mortality significantly increased with lower MOF in both males and females. The multivariate Cox proportional hazard model demonstrated a significant increase in the risk of all-cause mortality associated with lower tertiles of MOF, relative to the upper tertile in males (hazard ratio: 1.62; 95% confidence interval: 1.05–2.51) and females (hazard ratio: 1.94; 95% confidence interval: 1.10–3.56). Conclusions There was a significant and independent association of bilateral MOF with all-cause mortality in community-dwelling elderly males and females in Japan. These findings suggested that maintenance of oral functioning contributes to general health.
- Published
- 2020
23. Examining the trimester-specific effects of low gestational weight gain on birthweight: the BOSHI study
- Author
-
Hiroto Metoki, Mami Ishikuro, Yoshitaka Murakami, Michihiro Satoh, Kazuhiko Hoshi, Takayoshi Ohkubo, Taku Obara, Mari S. Oba, Takahisa Murakami, and Yutaka Imai
- Subjects
Adult ,Male ,medicine.medical_specialty ,Medicine (miscellaneous) ,Marginal structural model ,Gestation period ,Body Mass Index ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Birth Weight ,Humans ,030212 general & internal medicine ,Risk factor ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Infant, Newborn ,Gestational Weight Gain ,Confidence interval ,Parity ,Gestation ,Female ,Pregnancy Trimesters ,medicine.symptom ,business ,Body mass index ,Weight gain ,Cohort study - Abstract
Low gestational weight gain (GWG) is a known risk factor of low birthweight. Although studies have previously examined the associations between GWG and birthweight, the period-specific effects of low GWG in each trimester remain unclear. This study aimed to quantify the trimester-specific direct effects of low GWG in Japanese women on birthweight. Using perinatal data from a cohort study, we analyzed pregnant women delivered at an obstetrics/gynecology hospital between October 2006 and May 2010. We focused on women with a pre-pregnancy body mass index (BMI) below 25 kg/m2. The exposure was low GWG. The gestation period was subdivided into trimesters, and the direct effects of low trimester-specific GWG on birthweight were estimated using marginal structural models. These models were guided by a direct acyclic graph that incorporated potential confounders, including pre-pregnancy BMI, age, smoking during pregnancy, height, and parity. We analyzed 563 women and their families. The mean cumulative GWG by the end of the first, second, and third trimesters was 0.9, 6.2, and 10.7 kg, respectively. Approximately 14.0% of the women gained total weight below the range recommended by Japanese Ministry of Health, Labour and Welfare. The direct effects of low GWG on birthweight were 65.9 g (95% confidence interval: 11.4, 120.5), −195.4 g (−263.4, −127.4), and −188.8 g (−292.0, −85.5) for the first, second, and third trimesters, respectively. Insufficient weight gain in the second and third trimesters had a negative impact on birthweight after adjusting for pre-pregnancy BMI and other covariates.
- Published
- 2020
24. Design and Progress of Oral Health Examinations in the Tohoku Medical Megabank Project
- Author
-
Yuichi Aoki, Fuji Nagami, Masahiro Kikuya, Shinichi Kuriyama, Hiroyuki Matsui, Hirohito Metoki, Shigeo Kure, Takahisa Murakami, Atsushi Hozawa, Keiichi Sasaki, Gen Tamiya, Naoko Minegishi, Hiroaki Tomita, Kichiya Suzuki, Maki Goto, Tomohiro Nakamura, Soichi Ogishima, Toru Tamahara, Tomomi Kiyama, Shihoko Koyama, Akihito Otsuki, Ritsuko Shimizu, Seizo Koshiba, Takako Takai-Igarashi, Nobuo Fuse, Mika Sakurai-Yageta, Masayuki Yamamoto, Eiichi Kodama, Naru Shiraishi, Junichi Sugawara, Kengo Kinoshita, Akito Tsuboi, and Junko Kawashima
- Subjects
Adult ,Male ,medicine.medical_specialty ,Gingival and periodontal pocket ,Oral Health ,Dental Caries ,Oral health ,Oral hygiene ,General Biochemistry, Genetics and Molecular Biology ,Cohort Studies ,Disasters ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Surveys and Questionnaires ,Earthquakes ,medicine ,Humans ,Sampling (medicine) ,030212 general & internal medicine ,Periodontal Diseases ,Aged ,Biological Specimen Banks ,business.industry ,Diagnosis, Oral ,General Medicine ,Middle Aged ,stomatognathic diseases ,Cross-Sectional Studies ,030220 oncology & carcinogenesis ,Family medicine ,Cohort ,Population study ,Female ,Disaster Victims ,business ,Cohort study - Abstract
In order to assess the long-term impact of the Great East Japan Earthquake on the oral health of disaster victims and to evaluate gene-environmental interactions in the development of major oral diseases and oral-systemic associations, the oral part of two large-scale genome cohort studies by the Tohoku Medical Megabank Organization (ToMMo), including the Community-based cohort (CommCohort) study and the Birth and Three-Generation cohort (BirThree) study, have been conducted. The study population comprised 32,185 subjects, including 16,886 participants in the CommCohort study and 15,299 participants in the BirThree cohort study, recruited from 2013 to 2017. The oral studies consist of a questionnaire regarding oral hygiene behavior, clinical examinations by dentists, and oral plaque and saliva sampling for microbiome analyses, which were carried out at seven community support centers in Miyagi prefecture. The median age of all participants was 55.0 years, and 66.1% of participants were women. Almost all participants reported that they brushed their teeth more than once a day. The median number of present teeth was 27.0, and the decayed, missing and filled tooth number was 16.0, with a significant difference according to age and sex. The median periodontal pocket and clinical attachment level was 2.48 mm and 4.00 mm, respectively. Periodontal parameters increased significantly according to age, except for the accumulation of dental calculus. The oral part of these extensive cross-sectional studies provides a unique and important platform for future studies on oral health and diseases that elicit through interactions with systemic diseases, lifestyles, life events and genetic backgrounds, and contributes to researches clarifying the long-term effects of disasters on oral health.
- Published
- 2020
25. Time-series analysis of blood pressure changes after the guideline update in 2019 and the coronavirus disease pandemic in 2020 using Japanese longitudinal data
- Author
-
Michihiro Satoh, Takahisa Murakami, Taku Obara, and Hirohito Metoki
- Subjects
Male ,Japan ,Physiology ,Hypertension ,Internal Medicine ,COVID-19 ,Humans ,Blood Pressure ,Female ,Middle Aged ,Cardiology and Cardiovascular Medicine ,Pandemics ,Retrospective Studies - Abstract
We assessed blood pressure (BP) changes during fiscal years (April to March of the following year) 2015-2020 to clarify the effect of the state of emergency due to the coronavirus disease 2019 (COVID-19) pandemic in 2020. We then considered BP in 2019 separately, as the Japanese hypertension guidelines were updated in 2019. The present retrospective cohort study extracted data from 157,510 Japanese individuals aged75 years (mean age: 50.3 years, men: 67.5%) from the annual health check-up data of the DeSC database. The trends in BP were assessed using a repeated measures linear mixed model. After adjusting for the month of health check-ups to exclude seasonal BP variation, systolic BP linearly increased during fiscal years 2015-2018. From the value estimated by the trend in 2015-2018, systolic BP was lower by ≤1 mmHg in fiscal year 2019 among the treated participants. Meanwhile, systolic/diastolic BP (95% confidence interval) increased by 2.11 (1.97-2.24)/1.05 (0.96-1.14) mmHg for untreated women (n = 43,292), 1.60 (1.51-1.70)/1.17 (1.11-1.24) mmHg for untreated men (n = 88,479), 1.92 (1.60-2.23)/0.46 (0.25-0.67) mmHg for treated women (n = 7855), and 1.00 (0.79-1.21)/0.39 (0.25-0.53) mmHg for treated men (n = 17,884) in fiscal year 2020. These increases remained time-dependent covariates after adjustments for age, body mass index, alcohol consumption, smoking, physical activity, and blood sampling indices. Social change due to the pandemic might have increased BP by approximately 1-2/0.5-1 mmHg. Meanwhile, only a slight decrease in BP was observed immediately after the guideline update in Japan.
- Published
- 2022
26. AW-AD-2: ASSOCIATION BETWEEN AMBULATORY BLOOD PRESSURE AND RISK OF HOME HYPERTENSION IN A NORMOTENSIVE POPULATION
- Author
-
Shingo Nakayama, Michihiro Satoh, Hirohito Metoki, Takahisa Murakami, Yukako Tatsumi, Kei Asayama, Azusa Hara, Takuo Hirose, Megumi Tsubota Utsugi, Masahiro Kikuya, Takefumi Mori, Atsushi Hozawa, Yutaka Imai, and Takayoshi Ohkubo
- Subjects
Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
27. PS-P11-4: ASSOCIATION OF HOME AND OFFICE SYSTOLIC AND DIASTOLIC HYPERTENSION WITH GLUCOSE METABOLISM IN A GENERAL POPULATION
- Author
-
Yukako Tatsumi, Michihiro Satoh, Kei Asayama, Takahisa Murakami, Takuo Hirose, Azusa Hara, Megumi Utsugi Tsubota, Ryusuke Inoue, Masahiro Kikuya, Kyoko Nomura, Hirohito Metoki, Atsushi Hozawa, Hideki Katagiri, Yutaka Imai, and Takayoshi Ohkubo
- Subjects
Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
28. 622Low birthweight prediction is not improved by repeated measures of gestational weight: the BOSHI study
- Author
-
Takahisa Murakami, Hiroto Metoki, Mami Ishikuro, Taku Obara, Yutaka Imai, Mari S. Oba, Yoshitaka Murakami, Michihiro Sato, Kazuhiko Hoshi, Noriyuki Iwama, and Takayoshi Ohkubo
- Subjects
medicine.medical_specialty ,Pregnancy ,Epidemiology ,Obstetrics ,Calibration (statistics) ,business.industry ,Birth weight ,Repeated measures design ,General Medicine ,medicine.disease ,medicine ,Gestation ,medicine.symptom ,business ,Weight gain ,Perinatal period - Abstract
Background Both pre-pregnancy body mass index and total weight gain during pregnancy are known risk factors for perinatal outcomes. However, little is known if repeated measurements of gestational weight gain can be utilized in the prediction of perinatal outcomes. We examined whether repeated measures of gestational weight improve the prediction of low infant birthweight. Methods Using data from the BOSHI study, we developed prediction models with low infant birthweight ( Results Among women who experienced full-term deliveries and had measured weights, the proportion of low infant birthweights was 5%. The c-statistics of Model 1, Model 2, and Model 3 were 0.78, 0.81, and 0.83, respectively. Other assessments were relatively unchanged. The extent of predictive performance improvement depends not only on the exposure-outcome associations but correlations among exposure measurements. Conclusions The inclusion of repeated gestational weight measurements in a model for predicting low infant birthweight only produced a marginal improvement in predictive performance. Key messages The prediction of low infant birthweight is not substantially improved by using repeated measurements of gestational weight.
- Published
- 2021
29. Association of subjective health and abnormal cervical cytology in Japanese pregnant women: An adjunct study of the Japan Environment and Children's Study
- Author
-
Kiyoshi Ito, Michihiro Satoh, Junichi Sugawara, Kosuke Tanaka, Hirohito Metoki, Zen Watanabe, Kaou Tanoue, Takahisa Murakami, Masatoshi Saito, Nobuo Yaegashi, Satoshi Okamoto, Noriyuki Iwama, and Satomi Sasaki
- Subjects
Cervical cancer ,medicine.medical_specialty ,Pregnancy ,HPV ,Subjective health ,business.industry ,Obstetrics ,Medical record ,Confounding ,Public Health, Environmental and Occupational Health ,Health Informatics ,Review Article ,medicine.disease ,Logistic regression ,Screening ,Medicine ,Childbirth ,business ,Prospective cohort study ,Body mass index - Abstract
Highlights • Examined the association between abnormal cervical cytology and subjective health in pregnant women. • This study was an adjunct study of the Japan Environment and Children’s Study (JECS). • High subjective health was associated with high cervical cytology abnormality risk. • Young women may be at risk for cervical cancer even if they are aware of their health. • We should encourage young women who think they are healthy to get screened for cancer., This study examines the association between abnormal cervical cytology and subjective health in pregnant women, as an adjunct to the Japan Environment and Children's Study, which cross-sectionally analyzed a subset of the prospective cohort. A total of 3024 pregnant women at a childbirth facility whose medical records of cervical cytology in the first trimester of pregnancy were transcribed and who responded to the subjective health questionnaire were included herein. They were classified into excellent, good, fair, and poor groups based on their subjective health. Cervical cytology results obtained from perinatal medical records were classified into normal and abnormal cytology based on the Bethesda classification. Logistic regression analysis adjusted for baseline characteristics, including age, pre-pregnancy body mass index, parity, and other possible confounding factors, was used. Of 3024 pregnant women, 106 (3.5%) had abnormal cytology, with the prevalence being 1.3%, 3.7%, 3.9%, and 4.0%, respectively (p = 0.055) in the poor, fair, good, and excellent groups. The baseline characteristics, namely age, history of gynecological diseases, Kessler 6-item psychological distress scale score, and history of mental illness, were significantly different between groups. Compared to the poor group, the other three groups had a significantly higher abnormal cytology risk after adjusting for confounding factors (Fair: adjusted OR [aOR] = 3.6, 95% CI [1.0–12.1]; Good: aOR = 4.6 [1.3–15.5]; Excellent: aOR = 4.6 [1.2–17.8]). This study encourages young women to undergo cervical cancer screening because they are at risk for cervical cancer even if they think that they are healthy, and preventive activities like regular screening are essential.
- Published
- 2021
30. Prediction Models for the 5- and 10-Year Incidence of Home Morning Hypertension: The Ohasama Study
- Author
-
Atsushi Hozawa, Megumi Tsubota-Utsugi, Yutaka Imai, Hirohito Metoki, Masahiro Kikuya, Takahisa Murakami, Ryusuke Inoue, Kyoko Nomura, Kei Asayama, Takayoshi Ohkubo, Takuo Hirose, Yukako Tatsumi, Michihiro Satoh, and Azusa Hara
- Subjects
Male ,education.field_of_study ,Proportional hazards model ,business.industry ,Incidence (epidemiology) ,Concordance ,Incidence ,Population ,Blood Pressure ,Blood Pressure Monitoring, Ambulatory ,Middle Aged ,Blood pressure ,Japan ,Hypertension ,Internal Medicine ,Medicine ,Humans ,education ,business ,Body mass index ,Antihypertensive Agents ,Demography ,Morning ,Cohort study - Abstract
Background We aimed to develop risk prediction models for new-onset home morning hypertension. Methods We followed up 978 participants without home hypertension in the general population of Ohasama, Japan (men: 30.1%, age: 53.3 years). The participants were divided into derivation (n = 489) and validation (n = 489) cohorts by their residential area. The C-statistics and calibration plots were assessed after the 5- or 10-year follow-up. Results In the derivation cohort, sex, age, body mass index, smoking, office systolic blood pressure (SBP), and home SBP at baseline were selected as significant risk factors for new-onset home hypertension (≥135/85 mm Hg or the initiation of antihypertensive treatment) using the Cox model. In the validation cohort, Harrell’s C-statistic for the 5-/10-year home hypertension was 0.7637 (0.7195–0.8100)/0.7308 (0.6932–0.7677), when we used the full model, which included the significant risk factors in the derivation cohort. The calibration test revealed good concordance between the observed and predicted 5-/10-year home hypertension probabilities (P ≥ 0.19); the regression slope of the observed probability on the predicted probability was 1.10/1.02, and the intercept was −0.04/0.06, respectively. A model without home SBP was also developed; for the 10-year home hypertension risk, the calibration test revealed a good concordance (P = 0.19) but Harrell’s C-statistic was 0.6689 (0.6266–0.7067). Conclusions The full model revealed good ability to predict the 5- and 10-year home morning hypertension risk. Although the model without home SBP is acceptable, the low C-statistic implies that home BP should be measured to predict home morning hypertension precisely.
- Published
- 2021
31. MO491ASSOCIATION BETWEEN SERUM URIC ACID LEVEL AND CHRONIC KIDNEY DISEASE INCIDENCE STRATIFIED BY SEX IN MIDDLE-AGED ADULTS
- Author
-
Takayoshi Ohkubo, Hirohito Metoki, Takahisa Murakami, Takuo Hirose, Tomoko Muroya, Yukako Tatsumi, Michihiro Satoh, Shingo Nakayama, Takefumi Mori, and Atsushi Hozawa
- Subjects
Transplantation ,Kidney ,medicine.medical_specialty ,Proteinuria ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Gastroenterology ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Nephrology ,Internal medicine ,medicine ,Serum uric acid level ,Uric acid ,Hyperuricemia ,medicine.symptom ,business ,Kidney disease - Abstract
Background and Aims While previous studies have reported the association between serum uric acid (SUA) and chronic kidney disease (CKD) incidence, the sex differences in this association remain controversial. Therefore, we examined the association between SUA levels and CKD incidence in middle-aged adults stratified by sex using data from a large-scale health check-up. Method We analyzed information from the JMDC database, which included the annual health check-up data of Japanese employees and their dependents aged Results The mean participant age was 44.1 years, and 29.6% were women. The mean SUA levels were 5.9 mg/dL and 4.1 mg/dL in men and women, respectively. During the mean follow-up period of 4.68 years, 12,589 participants developed CKD. The age-standardized incidence rates for CKD were 17.88/17.80 per 1000 person-years in men/women with SUA concentrations of 4.0–4.9 mg/dL, 209.76 per 1000 person-years in men with SUA ≥11.0 mg/dL, and 73.38 per 1000 person-years in women with SUA ≥ 9.0 mg/dL. The fully adjusted HRs (95% confidence interval [CI], P value) for CKD incidence in the groups with SUA concentrations of Conclusion The results of the present study demonstrated an increased risk of CKD in men with SUA concentrations of
- Published
- 2021
32. Preconception dysmenorrhea as a risk factor for psychological distress in pregnancy: The Japan Environment and Children's Study
- Author
-
Nobuo Yaegashi, Noriyuki Iwama, Hidekazu Nishigori, Hirohito Metoki, Masahito Tachibana, Shinichi Kuriyama, Satoshi Mizuno, Masatoshi Saito, Takahisa Murakami, Takashi Takeda, Taku Obara, Kunihiko Nakai, Michihiro Satoh, Kosuke Tanaka, Kasumi Sakurai, Ikuma Fujiwara, Takahiro Arima, Mami Ishikuro, Kaou Tanoue, Toshie Nishigori, Nozomi Tatsuta, and Zen Watanabe
- Subjects
Adult ,medicine.medical_specialty ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Dysmenorrhea ,Japan ,Pregnancy ,Risk Factors ,Emotional distress ,Odds Ratio ,Prevalence ,medicine ,Humans ,Risk factor ,Obstetrics ,business.industry ,Incidence ,Incidence (epidemiology) ,Psychological distress ,Odds ratio ,medicine.disease ,Confidence interval ,030227 psychiatry ,Pregnancy Complications ,Psychiatry and Mental health ,Clinical Psychology ,Logistic Models ,Female ,Pregnant Women ,business ,Stress, Psychological ,030217 neurology & neurosurgery ,Cohort study - Abstract
Background Dysmenorrhea influences emotional distress as well as physical suffering in young non-pregnant women. The aim of this study was to assess the potential association between preconception dysmenorrhea and the development of psychological distress during pregnancy. Methods This study was a part of the Japan Environment and Children's Study (JECS), a nationwide birth cohort study conducted between 2011 and 2014 in Japan. A total of 87,102 pregnant Japanese women with no psychological distress (Kessler 6-item psychological distress scale [K6] score ≤ 12) in early pregnancy were eligible. Among these, 7626 had mild and 1638 had severe preconception dysmenorrhea. The prevalence and risk of maternal psychological distress (K6 scores ≥ 13) in the second or third trimester were compared among preconception dysmenorrhea severity groups. Results A higher percentage of women with mild (2.6%) or severe preconception dysmenorrhea (3.6%) suffered psychological distress during pregnancy compared to that in women without dysmenorrhea (2.1%). A multilevel logistic regression model, adjusting for baseline characteristics and the K6 score at enrollment, showed that the severity of dysmenorrhea was associated with psychological distress (mild dysmenorrhea: adjusted odds ratio [aOR], 1.154; 95% confidence interval [95% CI], 0.980–1.359; and severe dysmenorrhea: aOR, 1.457; 95% CI, 1.087–1.951). Limitations Information about dysmenorrhea was obtained during early pregnancy. The JECS did not have clear diagnostic criteria for dysmenorrhea. Conclusions Preconception dysmenorrhea is associated with an elevated incidence of psychological distress during pregnancy. Additionally, expectant mothers with a history of severe dysmenorrhea symptoms before pregnancy have a higher risk of developing psychological distress.
- Published
- 2019
33. Development and evaluation of a home nocturnal blood pressure monitoring system using a wrist-cuff device
- Author
-
Toshikazu Haga, Hironori Sato, Ryusuke Inoue, Kei Asayama, Michihiro Satoh, Kanako Saito, Takayoshi Ohkubo, Yutaka Imai, Taku Obara, Hirohito Metoki, Takahisa Murakami, Fujiwara Seisuke, and Masahiro Kikuya
- Subjects
Male ,medicine.medical_specialty ,Blood Pressure ,030204 cardiovascular system & hematology ,Assessment and Diagnosis ,Wrist ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Lead (electronics) ,Aged ,Advanced and Specialized Nursing ,Sleep disorder ,Blood pressure monitors ,business.industry ,Blood Pressure Determination ,Monitoring system ,General Medicine ,Middle Aged ,medicine.disease ,Blood Pressure Monitors ,Nocturnal blood pressure ,Blood pressure ,medicine.anatomical_structure ,Hypertension ,Cuff ,Female ,Sleep ,Cardiology and Cardiovascular Medicine ,business - Abstract
The conventional nocturnal blood pressure monitoring (NBPM) systems can disturb sleep and lead to false measurements. The present study compared the validity and acceptability of a newly developed wrist-cuff system with that of the conventional upper arm-cuff system for NBPM.Home blood pressure (BP) and pulse rate (PR) were measured in hypertensive patients (n=57) every 30 min at night using a wrist-cuff system and at 2 am (fixed time) and 4 h after going to bed (flexible time) using an upper arm-cuff system. The nocturnal BPs with the wrist-cuff system at 2 am and at 4 h after going to bed were selected from the measurements taken every 30 min at night. The same systems were used to measure the morning and evening home BP and PR, after rising and before going to bed. Measurements were taken for two nights separately for each system. BP, PR, sleep quality, and the perception of several stimuli during NBPM were compared between the two systems. Systolic BP/diastolic BP (DBP) in the supine position at 2 am and at 4 h after going to bed were corrected by the mean difference between the wrist-cuff and the arm-cuff systems.Compared with the arm-cuff system, the wrist-cuff system had significantly lower systolic BP (mean±SD: 106.3±13.4 vs. 109.8±10.8 mmHg, P0.05), DBP (59.4±11.0 vs. 64.5±7.8 mmHg, P0.005), and PR (53.8±7.1 vs. 60.5±8.1 bpm, P0.0005) at 2 am and significantly lower DBP (60.2±10.3 vs. 66.0±9.8 mmHg, P0.005) and PR (53.6±7.4 vs. 60.9±8.5 bpm, P0.0005) at 4 h after going to bed. Among the participants, sleep disturbance during NBPM was reported in less than 20% with the wrist-cuff system and in 70% with the arm-cuff system. A significantly higher rate of participants who wore the wrist-cuff system reported that they were not bothered by various stimuli, such as noise, during NBPM.The newly developed wrist-cuff home NBPM system provided information on BP as a function of time, especially at night, with minimal sleep disturbance and with more frequent BP measurements.
- Published
- 2018
34. Detailed association between serum uric acid levels and the incidence of chronic kidney disease stratified by sex in middle-aged adults
- Author
-
Takuo Hirose, Hirohito Metoki, Yukako Tatsumi, Takahisa Murakami, Takayoshi Ohkubo, Michihiro Satoh, Shingo Nakayama, Atsushi Hozawa, Tomoko Muroya, and Takefumi Mori
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Epidemiology ,medicine ,Global health ,Humans ,Renal Insufficiency, Chronic ,Cardiovascular mortality ,Aged ,business.industry ,Incidence (epidemiology) ,Incidence ,Serum uric acid ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,Confidence interval ,Uric Acid ,030104 developmental biology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Kidney disease ,Cohort study ,Glomerular Filtration Rate - Abstract
Chronic kidney disease (CKD) is a global health burden. Previous studies have shown a J- or U-shaped association between serum uric acid (SUA) and cardiovascular mortality. We assessed the risk of CKD incidence in a refined SUA category in middle-aged adults stratified by sex.We analyzed data from 138,511 participants65 years old (29.6% women; mean age 44.1 years) without CKD at baseline acquired from the JMDC database. The Cox model was used to assess the adjusted hazard ratio (HR).During the mean follow-up period of 4.68 years, 12,589 participants developed CKD. The fully adjusted HRs (95% confidence interval [CI], p-value) for CKD incidence in men with SUA4.0, 10.0-10.9 and ≥ 11.0 mg/dL compared to men with SUA 4.0-4.9 mg/dL were 1.13 (1.01-1.26, p = 0.030), 1.98 (1.32-2.97, p = 0.0010), and 3.74 (1.68-8.35, p = 0.0013), respectively. The fully adjusted HRs for CKD incidence in women with SUA4.0, 8.0-8.9, and ≥9.0 mg/dL compared to women with SUA 4.0-4.9 mg/dL were 1.08 (1.01-1.16, p = 0.032), 2.39 (1.07-5.35, p = 0.034), and 3.20 (0.80-12.8, p = 0.10), respectively.Both high and low SUA levels were identified as risk factors for CKD incidence in middle-aged men and women. The association of SUA levels with the increase in the risk of CKD incidence differed by sex, and the range of SUA levels associated with an increase in the risk of CKD incidence varied by sex.
- Published
- 2021
35. The prevalence of psychological distress during pregnancy in Miyagi Prefecture for 3 years after the Great Eas t Japan Earthquake
- Author
-
Hirohito Metoki, Takahisa Murakami, Nozomi Tatsuta, Shinichi Kuriyama, Nobuo Yaegashi, Kunihiko Nakai, Mami Ishikuro, Kasumi Sakurai, Kaou Tanoue, Noriyuki Iwama, Satomi Sasaki, Junichi Sugawara, Michihiro Satoh, Kousuke Tanaka, Masatoshi Saito, Taku Obara, Takahiro Arima, Hidekazu Nishigori, and Zen Watanabe
- Subjects
Adult ,medicine.medical_specialty ,Earthquake ,Adolescent ,Psychological distress ,Negative life events ,Disasters ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Pregnancy ,Earthquakes ,Prevalence ,medicine ,Humans ,030212 general & internal medicine ,Young adult ,Tsunami ,business.industry ,Pregnant women ,lcsh:Public aspects of medicine ,Public health ,Incidence (epidemiology) ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,General Medicine ,Mental illness ,medicine.disease ,Pregnancy Complications ,Distress ,Tsunamis ,Female ,business ,030217 neurology & neurosurgery ,Research Article ,Demography - Abstract
Background To examine changes in psychological distress prevalence among pregnant women in Miyagi Prefecture, which was directly affected by the Great East Japan Earthquake and tsunami, and compare it with the other, less damaged areas of Japan. Methods This study was conducted in conjunction with the Japan Environment and Children`s Study. We examined 76,152 pregnant women including 8270 in Miyagi Regional Center and 67,882 in 13 other regional centers from the all-birth fixed data of the Japan Environment and Children’s Study. We then compared the prevalence and risk of distress in women in Miyagi Regional Center and women in the 13 regional centers for 3 years after the disaster. Results Women in the Miyagi Regional Center suffered more psychological distress than those in the 13 regional centers: OR 1.38 (95% CI, 1.03–1.87) to 1.92 (95% CI, 1.42–2.60). Additionally, women in the inland area had a consistently higher prevalence of psychological distress compared to those from the 13 regional centers: OR 1.67 (95% CI, 1.18–2.38) to 2.19 (95% CI, 1.60–2.99). Conclusions The lack of pre-disaster data in the Japan Environment and Children’s Study made it impossible to compare the incidence of psychological distress before and after the March 2011 Great East Japan Earthquake. However, 3 years after the Great East Japan Earthquake, the prevalence of pregnant women with psychological distress did not improve in Miyagi Regional Center. Further, the prevalence of mental illness in inland areas was consistently higher than that in the 13 regional centers after the disaster.
- Published
- 2021
36. Impact of COVID-19 pandemic on glycemic control among outpatients with type 2 diabetes in Japan: A hospital-based survey from a country without lockdown
- Author
-
Taichi Watanabe, Shojiro Sawada, Takashi Mita, Yasuhiro Tanji, Yasutaka Kobayashi, Hirohito Metoki, Hiroaki Akai, and Takahisa Murakami
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,COVID-19 pandemic ,030209 endocrinology & metabolism ,Type 2 diabetes ,Glycemic Control ,Article ,Cohort Studies ,lockdown ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Japan ,Diabetes mellitus ,Surveys and Questionnaires ,Pandemic ,Outpatients ,Internal Medicine ,Medicine ,Humans ,030212 general & internal medicine ,Pandemics ,Glycemic ,Aged ,business.industry ,SARS-CoV-2 ,Medical record ,COVID-19 ,General Medicine ,medicine.disease ,Diabetes Mellitus, Type 2 ,Emergency medicine ,Female ,type 2 diabetes ,business ,Body mass index ,linear mixed model ,Historical Cohort ,Cohort study - Abstract
Aims Some studies have reported changes in glycemic control of patients with diabetes mellitus under lockdown. However, no previous study examined the impact of the pandemic on glycemic control in patients with diabetes in countries that did not introduce a lockdown such as Japan. This study aimed to assess changes in glycemic control during the pandemic in patients with type 2 diabetes treated at a Japanese clinic. Methods We conducted a historical cohort study, using electronic medical records of patients with type 2 diabetes who visited our clinic between January 2019 and August 2020. Differences in HbA1c values before and after the outbreak of COVID-19 were the primary outcome, examined using the linear mixed model. Results HbA1c values significantly increased from 7.45% to 7.53% after the state of emergency was introduced (n = 1,009). Furthermore, a deterioration in HbA1c values was observed in particular among women, patients aged ≥ 65 years, those with body mass index of ≥ 25 kg/m2, and those that were not using insulin. Conclusions Glycemic control deteriorated in patients with type 2 diabetes during the pandemic even in a country without a national lockdown.
- Published
- 2021
37. Blood Pressure Phenotypes Defined by Ambulatory Blood Pressure Monitoring and Carotid Artery Changes in Community-Dwelling Older Japanese Adults: The Ohasama Study
- Author
-
Yuko Takatsuji, Takuo Hirose, Megumi Tsubota-Utsugi, Kei Asayama, Takayoshi Ohkubo, Masahiro Kikuya, Kaori Asakura, Ryusuke Inoue, Hirohito Metoki, Michihiro Satoh, Takahisa Murakami, Yoriko Shintani, Shinya Uchida, Seiko Miyazaki, Ayami Fujita, Azusa Hara, Kyoko Nomura, Atsushi Hozawa, and Yutaka Imai
- Subjects
Male ,PROGNOSIS ,carotid plaque ,White coat hypertension ,Blood Pressure ,Research & Experimental Medicine ,INTIMA-MEDIA THICKNESS ,MASKED HYPERTENSION ,0302 clinical medicine ,Japan ,Masked Hypertension ,Odds Ratio ,030212 general & internal medicine ,Ultrasonography ,DAMAGE ,RISK ,education.field_of_study ,Confounding ,Carotid ultrasonography ,ASSOCIATION ,General Medicine ,Blood Pressure Monitoring, Ambulatory ,Middle Aged ,WHITE-COAT HYPERTENSION ,Carotid Arteries ,Phenotype ,Medicine, Research & Experimental ,030220 oncology & carcinogenesis ,Cardiology ,Female ,Independent Living ,Life Sciences & Biomedicine ,White Coat Hypertension ,medicine.medical_specialty ,Ambulatory blood pressure ,carotid intima-media thickness ,Population ,Risk Assessment ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Medicine, General & Internal ,General & Internal Medicine ,Internal medicine ,medicine ,Humans ,HOME ,education ,ambulatory blood pressure ,Aged ,Science & Technology ,business.industry ,Odds ratio ,medicine.disease ,United States ,Blood pressure ,Cross-Sectional Studies ,ATHEROSCLEROSIS ,white coat hypertension ,business - Abstract
White coat hypertension is defined as elevated blood pressure in the office, but a normal blood pressure out-of-office, whereas masked hypertension is defined as elevated blood pressure in the office, but normal out-of-office blood pressure. The objective was to investigate the associations between these blood pressure phenotypes and carotid artery changes. Conventional blood pressure, ambulatory blood pressure, and carotid ultrasonography were evaluated in 851 Ohasama residents (31.8% men; mean age 66.3 years). The blood pressure phenotypes were defined by the ordinary thresholds (140/90 mmHg for conventional blood pressure, 135/85 mmHg for daytime blood pressure) and then by the 2017 American College of Cardiology/American Heart Association (ACC/AHA) thresholds for hypertension (130/80 mmHg for both conventional and daytime blood pressure), irrespective of antihypertensive medication treatment status. Blood pressure phenotypes were linearly associated with the mean intima-media thickness of the carotid artery in ascending order for sustained normal blood pressure, white coat hypertension, masked hypertension, and sustained hypertension according to the ordinary thresholds and the 2017 ACC/AHA thresholds (both linear trends P < 0.0001) after adjustments for possible confounding factors. The odds ratios for the presence of carotid plaques showed similar linear trends with the blood pressure phenotypes according to the 2017 ACC/AHA thresholds (linear trend P < 0.0191). In conclusion, there was a close relationship between blood pressure phenotypes and carotid artery changes, suggesting that blood pressure phenotypes as defined by ambulatory blood pressure are potentially useful for risk stratification of carotid artery changes in the Japanese general population. ispartof: TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE vol:252 issue:3 pages:269-279 ispartof: location:Japan status: published
- Published
- 2020
38. Lifetime risk of stroke stratified by chronic kidney disease and hypertension in the general Asian population: the Ohasama study
- Author
-
Shingo, Nakayama, Michihiro, Satoh, Hirohito, Metoki, Takahisa, Murakami, Kei, Asayama, Azusa, Hara, Takuo, Hirose, Atsuhiro, Kanno, Ryusuke, Inoue, Megumi, Tsubota-Utsugi, Masahiro, Kikuya, Takefumi, Mori, Atsushi, Hozawa, Yutaka, Imai, and Takayoshi, Ohkubo
- Subjects
Male ,Stroke ,Japan ,Risk Factors ,Hypertension ,Humans ,Female ,Middle Aged ,Renal Insufficiency, Chronic - Abstract
Lifetime risk (LTR) evaluates the absolute risk of developing a disease during the remainder of one's life. It can be a useful tool, enabling the general public to easily understand their risk of stroke. No study has been performed to determine the LTR of cardiovascular disease in patients with chronic kidney disease (CKD) with or without hypertension; therefore, we performed this study in an Asian population. We followed 1525 participants (66.0% women; age 63.1 years) in the general population of Ohasama, Japan. We defined CKD as an estimated glomerular filtration rate (eGFR)60 mL/min/1.73 m
- Published
- 2020
39. Home blood pressure predicts stroke incidence among older adults with impaired physical function
- Author
-
Michihiro Satoh, Ayako Matsuda, Takayoshi Ohkubo, Hirohito Metoki, Takahisa Murakami, Yutaka Imai, Keiko Murakami, Ryusuke Inoue, Megumi Tsubota-Utsugi, Kei Asayama, Kyoko Nomura, Masahiro Kikuya, and Miki Hosaka
- Subjects
medicine.medical_specialty ,Physiology ,Adverse outcomes ,Blood Pressure ,030204 cardiovascular system & hematology ,Physical function ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Stroke ,Aged ,business.industry ,Incidence ,Incidence (epidemiology) ,Blood Pressure Determination ,Middle Aged ,medicine.disease ,Blood pressure ,Physical therapy ,Observational study ,Functional status ,Independent Living ,Cardiology and Cardiovascular Medicine ,business ,Stroke incidence ,030217 neurology & neurosurgery - Abstract
Several observational studies have found modifying effects of functional status on the association between conventional office blood pressure (BP) and adverse outcomes. We aimed to examine whether the association between higher BP and stroke was attenuated or inverted among older adults with impaired function using self-measured home BP measurements.We followed 501 Japanese community-dwelling adults aged at least 60 years (mean age, 68.6 years) with no history of stroke. Multivariate-adjusted hazard ratios for 1-SD increase in home BP and office BP measurements were calculated by the Cox proportional hazards model. Functional status was assessed by self-reported physical function.During a median follow-up of 11.5 years, first strokes were observed in 47 participants. Higher home SBP, but not office SBP, was significantly associated with increased risk of stroke among both 349 participants with normal physical function and 152 participants with impaired physical function [hazard ratio (95% confidence interval) per 14.4-mmHg increase: 1.74 (1.12-2.69) and 1.77 (1.06-2.94), respectively], with no significant interaction for physical function (P = 0.56). Higher home DBP, but not office DBP, was also significantly associated with increased risk of stroke (P ≤ 0.029) irrespective of physical function (all P 0.05 for interaction). Neither home BP nor office BP was significantly associated with all-cause mortality irrespective of physical function.Higher home BP was associated with increased risk of stroke even among those with impaired physical function. Measurements of home BP would be useful for stroke prevention, even after physical function decline.
- Published
- 2017
40. ASSOCIATIONS OF PARITY AND AGE AT MENARCHE WITH SILENT CEREBROVASCULAR LESIONS OF BRAIN MAGNETIC RESONANCE IMAGING: THE OHASAMA STUDY
- Author
-
Michihro Satoh, Hirohito Metoki, Tomoko Totsune, Yutaka Imai, Takahisa Murakami, Ryusuke Inoue, Kyoko Nomura, Atsushi Hozawa, Takuo Hirose, Masahiro Kikuya, Kei Asayama, Yuuki Kobayashi, Takayoshi Ohkubo, Azusa Hara, Megumi Tsubota-Utsugi, Hiroyuki Watanabe, Wakana Sato, and Yukako Tatsumi
- Subjects
medicine.medical_specialty ,Physiology ,Obstetrics ,business.industry ,Internal Medicine ,Menarche ,medicine ,Brain magnetic resonance imaging ,Cardiology and Cardiovascular Medicine ,Parity (mathematics) ,business - Published
- 2021
41. Risk Factors for Stroke among Young-Old and Old-Old Community-Dwelling Adults in Japan: The Ohasama Study
- Author
-
Keiko Murakami, Ayako Matsuda, Kei Asayama, Michihiro Satoh, Hirohito Metoki, Takahisa Murakami, Ryusuke Inoue, Kyoko Nomura, Yutaka Imai, Megumi Tsubota-Utsugi, Masahiro Kikuya, Miki Hosaka, and Takayoshi Ohkubo
- Subjects
Adult ,Male ,Community-Based Participatory Research ,030204 cardiovascular system & hematology ,Older population ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Japan ,Risk Factors ,Internal Medicine ,medicine ,Humans ,Longitudinal Studies ,Risk factor ,Stroke ,Aged ,Proportional hazards model ,business.industry ,Incidence ,Biochemistry (medical) ,Hazard ratio ,Confounding ,Middle Aged ,medicine.disease ,Confidence interval ,Hypertension ,Original Article ,Old-old ,Young-old ,Female ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Demography - Abstract
Aim: Few studies have addressed stroke risk factors in older populations, particularly among the old-old. We examined differences in traditional risk factors for stroke among the old-old compared with the young-old in community-dwelling Japanese adults. Methods: We followed 2,065 residents aged ≥ 60 years who had no history of stroke. Traditional risk factors for stroke were obtained from a self-administered questionnaire at baseline. We classified participants into two age categories, 60–74 years (n = 1,502) and ≥ 75 years (n = 563), and assessed whether traditional risk factors were differentially associated with stroke incidence according to age category. Hazard ratios were calculated by the Cox proportional hazards model, adjusting for confounding factors and competing risk of death. Results: During a median follow-up of 12.8 and 7.9 years, 163 and 111 participants aged 60–74 and ≥ 75 years, respectively, developed a first stroke. Hypertension was consistently associated with increased risk of stroke, regardless of age category. Diabetes mellitus was associated with increased risk of stroke in those aged 60–74 years (hazard ratio, 1.50; 95% confidence interval, 1.00–2.25), but not in those aged ≥ 75 years (hazard ratio, 0.65; 95% confidence interval, 0.33–1.29), with significant interaction by age (P = 0.035). No traditional risk factor other than hypertension was associated with stroke among those aged ≥ 75 years. Conclusion: Those with hypertension had significantly higher stroke risk among old people, while diabetes mellitus was differentially associated with stroke according to age category. Our findings indicate the importance of different prevention strategies for stroke incidence according to age category.
- Published
- 2017
42. Association Between Tooth Loss, Receipt of Dental Care, and Functional Disability in an Elderly Japanese Population: The Tsurugaya Project
- Author
-
Ichiro Tsuji, Yoshitada Miyoshi, Makoto Watanabe, Yoshinori Hattori, Takahisa Murakami, Yasutake Tomata, Takamasa Komiyama, Takashi Ohi, and Akito Tsuboi
- Subjects
Male ,medicine.medical_specialty ,Oral Health ,Dental Care for Aged ,Disability Evaluation ,Tooth Loss ,03 medical and health sciences ,Insurance, Long-Term Care ,0302 clinical medicine ,Japan ,stomatognathic system ,Risk Factors ,Interquartile range ,Tooth loss ,Humans ,Medicine ,Medical history ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Geriatric Assessment ,Aged ,Geriatrics ,business.industry ,Incidence ,Hazard ratio ,030206 dentistry ,stomatognathic diseases ,Physical therapy ,Female ,Geriatrics and Gerontology ,medicine.symptom ,business ,Body mass index ,Cohort study - Abstract
Objectives To examine whether number of remaining teeth and regular dental care affect incident functional disability in elderly Japanese adults. Design Prospective cohort study. Setting Tsurugaya district, Sendai, Japan. Participants Community-dwelling individuals aged 70 and older (N = 834). Measurements The outcome measurement was incident functional disability, defined as first certification of long-term care insurance in Japan, which is determined on the basis of a strictly established uniform nationwide standard. During a median follow-up of 7.9 years (interquartile range 4.8–7.9 years), information on long-term care insurance was obtained from the Sendai Municipal Authority. Oral health was assessed according to number of remaining teeth and presence or absence of regular dental care. Data were also collected on age, sex, body mass index, medical history, smoking, alcohol consumption, duration of education, depressive symptoms, cognitive impairment, physical functioning, and social support. Results Participants with 10 to 19 teeth (adjusted hazard ratio (aHR) = 1.42, 95% confidence interval (CI) = 1.03–1.94), one to nine teeth (aHR = 1.46, 95% CI = 1.04–2.03), and no teeth (aHR = 1.49, 95% CI = 1.03–2.14) were more likely to develop functional disability than those with 20 or more teeth. There was no significant difference in risk of functional disability between participants with 20 or more teeth and those with zero to 19 teeth who were receiving regular dental care, whereas those with zero to 19 teeth without regular dental care had a significantly greater risk of functional disability than those with 20 or more teeth (HR = 1.46, 95% CI = 1.11–1.92). Conclusion Tooth loss was associated with greater risk of functional disability in community-dwelling elderly Japanese. Regular dental care might moderate the risk of functional disability in elderly individuals with missing teeth.
- Published
- 2016
43. Age‐Related Trends in Home Blood Pressure, Home Pulse Rate, and Day‐to‐Day Blood Pressure and Pulse Rate Variability Based on Longitudinal Cohort Data: The Ohasama Study
- Author
-
Ayako Matsuda, Azusa Hara, Atsushi Hozawa, Taku Obara, Takayoshi Ohkubo, Michihiro Satoh, Masahiro Kikuya, Ryusuke Inoue, Hirohito Metoki, Kei Asayama, Megumi Tsubota-Utsugi, Yutaka Imai, Takahisa Murakami, Takuo Hirose, and Kyoko Nomura
- Subjects
Male ,Aging ,medicine.medical_specialty ,Cardiac & Cardiovascular Systems ,Blood pressure change ,PREDICTION ,Cohort Studies ,home blood pressure ,SELF-MEASUREMENT ,Heart Rate ,Age related ,Internal medicine ,MANAGEMENT ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,Longitudinal cohort ,JAPANESE SOCIETY ,Original Research ,Aged ,GENERAL-POPULATION ,blood pressure measurement/monitoring ,Science & Technology ,HEART-RATE-VARIABILITY ,heart rate/heart rate variability ,business.industry ,CARDIOVASCULAR RISK ,Age Factors ,blood pressure ,Blood Pressure Determination ,ASSOCIATION ,BY-DAY VARIABILITY ,Middle Aged ,HYPERTENSION GUIDELINES ,Pulse rate ,Blood pressure ,Hypertension ,Cardiovascular System & Cardiology ,Cardiology ,epidemiology ,Female ,Day to day ,Cardiology and Cardiovascular Medicine ,business ,Life Sciences & Biomedicine ,Pulse rate variability - Abstract
Background Home blood pressure is a more accurate prognosticator than office blood pressure and allows the observation of day‐to‐day blood pressure variability. Information on blood pressure change during the life course links the prediction of blood pressure elevation with age. We prospectively assessed age‐related trends in home blood pressure, home pulse rate, and their day‐to‐day variability evaluated as a coefficient of variation. Methods and Results We examined 1665 participants (men, 36.0%; mean age, 56.2 years) from the general population of Ohasama, Japan. A repeated‐measures mixed linear model was used to estimate the age‐related trends. In a mean of 15.9 years, we observed 5438 points of measurements including those at baseline. The home systolic blood pressure linearly increased with age and was higher in men than in women aged 40 years. However, an U‐shaped age‐related trend in day‐to‐day diastolic blood pressure variability with the nadir point at 65 to 69 years of age was observed. No significant sex differences in the day‐to‐day blood pressure variability were observed ( P ≥0.22). The average and day‐to‐day variability of home pulse rate decreased with age but were lower and higher, respectively, in men than in women. Conclusions The current descriptive data are needed to predict future home blood pressure and pulse rate. The data also provide information on the mechanism of day‐to‐day blood pressure and pulse rate variability.
- Published
- 2019
44. Maximum Occlusal Force and Incident Functional Disability in Older Adults: The Tsurugaya Project
- Author
-
Takamasa Komiyama, Takahisa Murakami, Akito Tsuboi, Takashi Ohi, Ichiro Tsuji, Yoshinori Hattori, Yasutake Tomata, Makoto Watanabe, and Yoshitada Miyoshi
- Subjects
Male ,medicine.medical_specialty ,Bite Force ,03 medical and health sciences ,Tooth Loss ,0302 clinical medicine ,Japan ,Interquartile range ,Tooth loss ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,General Dentistry ,Aged ,business.industry ,Hazard ratio ,030206 dentistry ,Masticatory force ,Quartile ,Physical therapy ,Female ,Geriatric dentistry ,Independent Living ,medicine.symptom ,business ,Cohort study - Abstract
The purpose of the current study was to investigate the association between maximum occlusal force, which is an objective predictor of masticatory performance, and incident functional disability in an elderly Japanese population. A prospective cohort study was conducted targeting 815 (51.7% female) community-dwelling older adults aged ≥70 y residing in the Tsurugaya district, Sendai, Japan. The outcome measurement was incident functional disability, defined as a first certification of long-term care insurance in Japan, which is determined on the basis of a strictly established, uniform, nationwide standard. During a median follow-up of 7.9 y (interquartile range, 4.8-7.9 y), information on long-term care insurance was obtained from the Sendai Municipal Authority. Bilateral maximum occlusal forces of the participants were measured using a horseshoe-shaped pressure-indicating film, and the participants were categorized into quartiles based on occlusal force. Adjusted hazard ratios for functional disability were estimated with Cox proportional hazard models, adjusted for age, sex, body mass index, medical history, smoking status, alcohol consumption, duration of education, depressive symptoms, cognitive impairment, physical functioning, marital status, history of falls, and number of remaining teeth. The multiple-adjusted hazard ratios and 95% confidence intervals (CIs) for incident functional disability compared to the greatest occlusal force quartile were 1.53 (95% CI, 1.02-2.33), 1.64 (95% CI, 1.06-2.55), and 1.64 (95% CI, 1.01-2.68) for the third, second, and first quartiles, respectively ( P for trend = 0.011). A lower maximum occlusal force was significantly associated with an increased risk of functional disability independently of possible confounders, including the number of remaining teeth. Occlusal force may be a useful indicator of the relationship between oral function and geriatric health. Knowledge Transfer Statement:This prospective cohort study demonstrated that lower maximum occlusal force was associated with an increased risk of functional disability in older adults, even after adjustment for possible confounding factors, including the number of remaining teeth. This strengthens the rationale regarding the association between oral function and geriatric health. Particularly in older adults, occlusal force is reduced by several factors other than tooth loss, such as the absence of a dental prostheses, sarcopenia in the masticatory muscle, poor periodontal condition, and orofacial pain. Our findings suggest that maximum occlusal force may be a useful biomarker associated with diverse parameters aside from the number of remaining teeth.
- Published
- 2019
45. ASSOCIATION OF PARITY AND GRAVIDITY WITH CAROTID INTIMA-MEDIA THICKNESS: THE OHASAMA STUDY
- Author
-
Takayoshi Ohkubo, Hiroyuki Watanabe, Wakana Sato, Yutaka Imai, Kyoko Nomura, Yukako Tatsumi, Azusa Hara, Megumi Tsubota-Utsugi, Michihiro Satoh, Masahiro Kikuya, Atsushi Hozawa, Hirohito Metoki, Takahisa Murakami, Kei Asayama, Yuuki Kobayashi, Takuo Hirose, and Ryusuke Inoue
- Subjects
medicine.medical_specialty ,Intima-media thickness ,Physiology ,business.industry ,Obstetrics ,Internal Medicine ,Medicine ,Cardiology and Cardiovascular Medicine ,Parity (mathematics) ,business - Published
- 2021
46. BLOOD PRESSURE AND CHRONIC KIDNEY DISEASE INCIDENCE STRATIFIED BY SEX AND THE USE OF ANTIHYPERTENSIVE DRUGS
- Author
-
Kyosuke Takabatake, Takefumi Mori, Michihiro Satoh, Takuo Hirose, Takayoshi Ohkubo, Kei Asayama, Shingo Nakayama, Yutaka Imai, Hirohito Metoki, and Takahisa Murakami
- Subjects
medicine.medical_specialty ,Blood pressure ,Physiology ,business.industry ,Incidence (epidemiology) ,Internal medicine ,Internal Medicine ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Kidney disease - Published
- 2021
47. Reference values and associated factors for Japanese newborns’ blood pressure and pulse rate
- Author
-
Masakuni Suzuki, Nariyasu Mano, Kazuhiko Hoshi, Ryusuke Inoue, Katsuyo Yagihashi, Michihiro Satoh, Hideko Tada, Hirohito Metoki, Kei Asayama, Takahisa Murakami, Yutaka Imai, Miki Hosaka, and Takayoshi Ohkubo
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Percentile ,Term Birth ,Physiology ,Birth weight ,Blood Pressure ,Gestational Age ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Japan ,Heart Rate ,Reference Values ,030225 pediatrics ,Heart rate ,Internal Medicine ,Birth Weight ,Humans ,Medicine ,Longitudinal Studies ,Slow-wave sleep ,business.industry ,Infant, Newborn ,Gestational age ,Hospitals ,Blood pressure ,Apgar Score ,Female ,Apgar score ,Sleep ,Cardiology and Cardiovascular Medicine ,business ,Maternal Age - Abstract
Objective: Currently, normative means and ranges of blood pressure (BP) and pulse rates in Japanese newborns are not available. The objective of the present study was to estimate BP, pulse rate, and their distribution among Japanese newborns. Methods: Using oscillometric devices, arm or calf BP and pulse rate levels were obtained from 3148 infants born between 2007 and 2014, consecutively at Suzuki Memorial Hospital, Iwanuma, Japan. Of those, data from 2628 full-term, singleton newborns with BP measured on day 3 after birth were analyzed. Results: Arm SBP/DBP and pulse rate in the reference group (n = 2628) were 70.5 ± 7.4/44.3 ± 6.7 mmHg and 117.3 ± 16.6 bpm, respectively. The 5–95th percentiles were 58–83 mmHg for SBP, 35–57 mmHg for DBP, and 91–145 bpm for pulse rate. Similar values were obtained from calf measurements. In multiple regression analysis, birth weight and spontaneous cephalic delivery were positively and light/deep sleep was inversely associated with higher arm SBP/DBP (P ≤ 0.04), whereas sex, Apgar score, gestational age, and mother's age did not significantly affect BP levels (P ≥ 0.06). Male sex, gestational age, spontaneous cephalic delivery, and light/deep sleep were inversely associated with higher pulse rate (P ≤ 0.02). Conclusion: The present study is the first to show the distributions of Asian newborns’ BP levels and pulse rate. The assessment of newborns’ BP levels and pulse rate should consider birth weight, gestational age after birth, and actual condition at BP measurement.
- Published
- 2016
48. The velocity of antihypertensive effects of seven angiotensin II receptor blockers determined by home blood pressure measurements
- Author
-
Nariyasu Mano, Ryusuke Inoue, Hirohito Metoki, Taku Obara, Takahisa Murakami, Masahiro Kikuya, Kei Asayama, Miki Hosaka, Michihiro Satoh, Toshikazu Haga, Takayoshi Ohkubo, and Yutaka Imai
- Subjects
Male ,Time Factors ,Physiology ,Tetrazoles ,Blood Pressure ,030204 cardiovascular system & hematology ,Pharmacology ,Benzoates ,Losartan ,Angiotensin Receptor Antagonists ,03 medical and health sciences ,0302 clinical medicine ,Irbesartan ,Internal Medicine ,medicine ,Humans ,Telmisartan ,030212 general & internal medicine ,Antihypertensive Agents ,Aged ,Oxadiazoles ,business.industry ,Biphenyl Compounds ,Imidazoles ,Blood Pressure Determination ,Middle Aged ,Self Care ,Biphenyl compound ,Blood pressure ,Valsartan ,Hypertension ,Benzimidazoles ,Female ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
We aimed to examine the blood pressure (BP)-lowering effect and the time to attain the maximal antihypertensive effect (stabilization time) of several angiotensin II receptor blockers (ARBs) based on home BP measurements.We surveyed consecutive newly diagnosed, untreated patients with hypertension who started the treatment with a mid-level dose of one of seven ARBs (losartan 50 mg, telmisartan 40 mg, candesartan 8 mg, olmesartan 20 mg, valsartan 80 mg, irbesartan 100 mg, or azilsartan 20 mg). All study participants measured home BP in the morning for at least 1 week during an untreated period and 4 weeks during the treatment period.Age, the proportion of men, and baseline home BP levels did not differ significantly between groups (total n = 232; age, 62.2 years; 50.9% men; home SBP/DBP, 151.6/90.0 mmHg). Significant differences in the BP-lowering effect and the stabilization time between ARBs were observed (P ≤ 0.02). The extent of BP-lowering effects of azilsartan 20 mg was significantly greater than that of valsartan 80 mg or irbesartan 100 mg (15.3 vs. 7.9 or 8.2 mmHg, respectively P ≤ 0.03). The stabilization time of losartan for home SBP was significantly longer than that of valsartan, irbesartan, or azilsartan (22.8 vs. 7.1, 4.7, or 7.1 days, respectively, P ≤ 0.01).The maximum effect and the stabilization time differed among ARBs used at the mid-level dose in Japan. An ARB should be chosen based on its desired characteristics.
- Published
- 2016
49. Impaired Higher-Level Functional Capacity as a Predictor of Stroke in Community-Dwelling Older Adults
- Author
-
Hirohito Metoki, Masahiro Kikuya, Aya Ishiguro, Takahisa Murakami, Atsuhiro Kanno, Ayako Matsuda, Daisaku Yasui, Megumi Tsubota-Utsugi, Keiko Murakami, Yutaka Imai, Michihiro Satoh, Ryusuke Inoue, Kei Asayama, and Takayoshi Ohkubo
- Subjects
Male ,Gerontology ,Activities of daily living ,030204 cardiovascular system & hematology ,Risk Assessment ,Body Mass Index ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Japan ,Activities of Daily Living ,Humans ,Medicine ,Longitudinal Studies ,Prospective Studies ,Social Behavior ,Prospective cohort study ,Exercise ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,Advanced and Specialized Nursing ,business.industry ,Proportional hazards model ,Hazard ratio ,Middle Aged ,Confidence interval ,Stroke ,Female ,Independent Living ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business ,Body mass index ,030217 neurology & neurosurgery ,Independent living - Abstract
Background and Purpose— Functional capacity is a predictor, as well as a consequence, of stroke. However, little research has been done to examine whether higher-level functional capacity above basic activities of daily living is a predictor of stroke. Methods— We followed 1493 Japanese community-dwelling adults aged ≥60 years (mean age, 70.1 years) who were independent in basic activities of daily living and had no history of stroke. Baseline data were collected using a self-administered questionnaire. Higher-level functional capacity was measured using the total score and 3 subscales (instrumental activities of daily living, intellectual activity, and social role) derived from the Tokyo Metropolitan Institute of Gerontology Index of Competence. Adjusted hazard ratios and 95% confidence intervals were calculated by the Cox proportional hazards model. Results— During a mean follow-up of 10.4 years, 191 participants developed a first stroke. Impaired higher-level functional capacity based on total score of the Tokyo Metropolitan Institute of Gerontology Index of Competence was significantly associated with stroke (hazard ratio, 1.64; 95% confidence interval, 1.15–2.33). Among the 3 subscales, only intellectual activity was significantly associated with stroke (hazard ratio, 1.64; 95% confidence interval, 1.21–2.22). Social role was significantly associated with stroke only among those aged ≥75 years (hazard ratio, 1.78; 95% confidence interval, 1.07–2.98). Conclusions— Impaired higher-level functional capacity, especially in the domain of intellectual activity, was a predictor of stroke, even among community-dwelling older adults with independent basic activities of daily living at baseline. Monitoring of higher-level functional capacity might be useful to detect those at higher risk of developing stroke in the future.
- Published
- 2016
50. Long-Term Stroke Risk Due to Partial White-Coat or Masked Hypertension Based on Home and Ambulatory Blood Pressure Measurements
- Author
-
Megumi Tsubota-Utsugi, Nariyasu Mano, Taku Obara, Ryusuke Inoue, Keiko Murakami, Masahiro Kikuya, Miki Hosaka, Michihiro Satoh, Hirohito Metoki, Daisaku Yasui, Kei Asayama, Aya Ishiguro, Takahisa Murakami, Takayoshi Ohkubo, Ayako Matsuda, and Yutaka Imai
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Ambulatory blood pressure ,Population ,Blood Pressure ,White coat hypertension ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Internal medicine ,Internal Medicine ,Humans ,Medicine ,030212 general & internal medicine ,Intensive care medicine ,education ,Stroke ,Aged ,Retrospective Studies ,education.field_of_study ,business.industry ,Incidence ,Hazard ratio ,Blood Pressure Monitoring, Ambulatory ,Middle Aged ,medicine.disease ,Masked Hypertension ,Blood pressure ,Ambulatory ,Cardiology ,Female ,business ,White Coat Hypertension ,Follow-Up Studies ,Forecasting - Abstract
The prognostic significance of white-coat hypertension (WCHT) is controversial, and different findings on self-measured home measurements and 24-h ambulatory monitoring make identifying WCHT difficult. We examined whether individuals with partially or completely defined WCHT, as well as masked hypertension, as determined by different out-of-office blood pressure measurements, have a distinct long-term stroke risk. We followed 1464 participants (31.8% men; mean age, 60.6±10.8 years) in the general population of Ohasama, Japan, for a median of 17.1 years. A first stroke occurred in 212 subjects. Using sustained normal blood pressure (events/n=61/776) as a reference, adjusted hazard ratios for stroke (95% confidence intervals; events/n) were 1.38 (0.82–2.32; 19/137) for complete WCHT (isolated office hypertension), 2.16 (1.36–3.43; 29/117) for partial WCHT (either home or ambulatory normotension with office hypertension), 2.05 (1.24–3.41; 23/100) for complete masked hypertension (both home and ambulatory hypertension with office normotension), 2.08 (1.37–3.16; 38/180) for partial masked hypertension (either home or ambulatory hypertension with office normotension), and 2.46 (1.61–3.77; 42/154) for sustained hypertension. When partial WCHT and partial masked hypertension groups were further divided into participants only with home hypertension and those only with ambulatory hypertension, all subgroups had a significantly higher stroke risk (adjusted hazard ratio ≥1.84, P ≤0.04). In conclusion, impacts of partial WCHT as well as partial masked hypertension for long-term stroke risk were comparable to those of complete masked hypertension or sustained hypertension. We need both home and 24-h ambulatory blood pressure measurements to evaluate stroke risk accurately.
- Published
- 2016
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.