Population Attributable Fraction of Smoking and Metabolic Syndrome on Cardiovascular Disease Mortality in Japan: A 15-Year Follow Up of NIPPON DATA90

Naoyuki Takashima, Katsuyuki Miura, Atsushi Hozawa, Aya Kadota, Tomonori Okamura, Yasuyuki Nakamura, Takehito Hayakawa, Nagako Okuda, Akira Fujiyoshi, Shin Ya Nagasawa, Takashi Kadowaki, Yoshitaka Murakami, Yoshikuni Kita, Akira Okayama, Hirotsugu Ueshima

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Abstract

Background. Smoking and metabolic syndrome are known to be related to cardiovascular diseases (CVD) risk. In Asian countries, prevalence of obesity has increased and smoking rate in men is still high. We investigated the attribution of the combination of smoking and metabolic syndrome (or obesity) to excess CVD deaths in Japan. Methods. A cohort of nationwide representative Japanese samples, a total of 6650 men and women aged 30-70 at baseline without history of CVD was followed for 15 years. Multivariate-adjusted hazard ratio for CVD death according to the combination of smoking status and metabolic syndrome (or obesity) was calculated using Cox proportional hazard model. Population attributable fraction (PAF) of CVD deaths was calculated using the hazard ratios. Results. During the follow-up period, 87 men and 61 women died due to CVD. The PAF component of CVD deaths in non-obese smokers was 36.8% in men and 11.3% in women, which were higher than those in obese smokers (9.1% in men and 5.2% in women). The PAF component of CVD deaths in smokers without metabolic syndrome was 40.9% in men and 11.9% in women, which were also higher than those in smokers with metabolic syndrome (7.1% in men and 3.9% in women). Conclusion. Our results indicated that a large proportion of excess CVD deaths was observed in smokers without metabolic syndrome or obesity, especially in men. These findings suggest that intervention targeting on smokers, irrespective of the presence of metabolic syndrome, is still important for the prevention of CVD in Asian countries.

Original languageEnglish
Article number306
JournalBMC Public Health
Volume10
DOIs
Publication statusPublished - 2010
Externally publishedYes

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Japan
Cardiovascular Diseases
Smoking
Mortality
Population
Obesity
Proportional Hazards Models

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Population Attributable Fraction of Smoking and Metabolic Syndrome on Cardiovascular Disease Mortality in Japan : A 15-Year Follow Up of NIPPON DATA90. / Takashima, Naoyuki; Miura, Katsuyuki; Hozawa, Atsushi; Kadota, Aya; Okamura, Tomonori; Nakamura, Yasuyuki; Hayakawa, Takehito; Okuda, Nagako; Fujiyoshi, Akira; Nagasawa, Shin Ya; Kadowaki, Takashi; Murakami, Yoshitaka; Kita, Yoshikuni; Okayama, Akira; Ueshima, Hirotsugu.

In: BMC Public Health, Vol. 10, 306, 2010.

Research output: Contribution to journalArticle

Takashima, N, Miura, K, Hozawa, A, Kadota, A, Okamura, T, Nakamura, Y, Hayakawa, T, Okuda, N, Fujiyoshi, A, Nagasawa, SY, Kadowaki, T, Murakami, Y, Kita, Y, Okayama, A & Ueshima, H 2010, 'Population Attributable Fraction of Smoking and Metabolic Syndrome on Cardiovascular Disease Mortality in Japan: A 15-Year Follow Up of NIPPON DATA90', BMC Public Health, vol. 10, 306. https://doi.org/10.1186/1471-2458-10-306
Takashima, Naoyuki ; Miura, Katsuyuki ; Hozawa, Atsushi ; Kadota, Aya ; Okamura, Tomonori ; Nakamura, Yasuyuki ; Hayakawa, Takehito ; Okuda, Nagako ; Fujiyoshi, Akira ; Nagasawa, Shin Ya ; Kadowaki, Takashi ; Murakami, Yoshitaka ; Kita, Yoshikuni ; Okayama, Akira ; Ueshima, Hirotsugu. / Population Attributable Fraction of Smoking and Metabolic Syndrome on Cardiovascular Disease Mortality in Japan : A 15-Year Follow Up of NIPPON DATA90. In: BMC Public Health. 2010 ; Vol. 10.
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abstract = "Background. Smoking and metabolic syndrome are known to be related to cardiovascular diseases (CVD) risk. In Asian countries, prevalence of obesity has increased and smoking rate in men is still high. We investigated the attribution of the combination of smoking and metabolic syndrome (or obesity) to excess CVD deaths in Japan. Methods. A cohort of nationwide representative Japanese samples, a total of 6650 men and women aged 30-70 at baseline without history of CVD was followed for 15 years. Multivariate-adjusted hazard ratio for CVD death according to the combination of smoking status and metabolic syndrome (or obesity) was calculated using Cox proportional hazard model. Population attributable fraction (PAF) of CVD deaths was calculated using the hazard ratios. Results. During the follow-up period, 87 men and 61 women died due to CVD. The PAF component of CVD deaths in non-obese smokers was 36.8{\%} in men and 11.3{\%} in women, which were higher than those in obese smokers (9.1{\%} in men and 5.2{\%} in women). The PAF component of CVD deaths in smokers without metabolic syndrome was 40.9{\%} in men and 11.9{\%} in women, which were also higher than those in smokers with metabolic syndrome (7.1{\%} in men and 3.9{\%} in women). Conclusion. Our results indicated that a large proportion of excess CVD deaths was observed in smokers without metabolic syndrome or obesity, especially in men. These findings suggest that intervention targeting on smokers, irrespective of the presence of metabolic syndrome, is still important for the prevention of CVD in Asian countries.",
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T2 - A 15-Year Follow Up of NIPPON DATA90

AU - Takashima, Naoyuki

AU - Miura, Katsuyuki

AU - Hozawa, Atsushi

AU - Kadota, Aya

AU - Okamura, Tomonori

AU - Nakamura, Yasuyuki

AU - Hayakawa, Takehito

AU - Okuda, Nagako

AU - Fujiyoshi, Akira

AU - Nagasawa, Shin Ya

AU - Kadowaki, Takashi

AU - Murakami, Yoshitaka

AU - Kita, Yoshikuni

AU - Okayama, Akira

AU - Ueshima, Hirotsugu

PY - 2010

Y1 - 2010

N2 - Background. Smoking and metabolic syndrome are known to be related to cardiovascular diseases (CVD) risk. In Asian countries, prevalence of obesity has increased and smoking rate in men is still high. We investigated the attribution of the combination of smoking and metabolic syndrome (or obesity) to excess CVD deaths in Japan. Methods. A cohort of nationwide representative Japanese samples, a total of 6650 men and women aged 30-70 at baseline without history of CVD was followed for 15 years. Multivariate-adjusted hazard ratio for CVD death according to the combination of smoking status and metabolic syndrome (or obesity) was calculated using Cox proportional hazard model. Population attributable fraction (PAF) of CVD deaths was calculated using the hazard ratios. Results. During the follow-up period, 87 men and 61 women died due to CVD. The PAF component of CVD deaths in non-obese smokers was 36.8% in men and 11.3% in women, which were higher than those in obese smokers (9.1% in men and 5.2% in women). The PAF component of CVD deaths in smokers without metabolic syndrome was 40.9% in men and 11.9% in women, which were also higher than those in smokers with metabolic syndrome (7.1% in men and 3.9% in women). Conclusion. Our results indicated that a large proportion of excess CVD deaths was observed in smokers without metabolic syndrome or obesity, especially in men. These findings suggest that intervention targeting on smokers, irrespective of the presence of metabolic syndrome, is still important for the prevention of CVD in Asian countries.

AB - Background. Smoking and metabolic syndrome are known to be related to cardiovascular diseases (CVD) risk. In Asian countries, prevalence of obesity has increased and smoking rate in men is still high. We investigated the attribution of the combination of smoking and metabolic syndrome (or obesity) to excess CVD deaths in Japan. Methods. A cohort of nationwide representative Japanese samples, a total of 6650 men and women aged 30-70 at baseline without history of CVD was followed for 15 years. Multivariate-adjusted hazard ratio for CVD death according to the combination of smoking status and metabolic syndrome (or obesity) was calculated using Cox proportional hazard model. Population attributable fraction (PAF) of CVD deaths was calculated using the hazard ratios. Results. During the follow-up period, 87 men and 61 women died due to CVD. The PAF component of CVD deaths in non-obese smokers was 36.8% in men and 11.3% in women, which were higher than those in obese smokers (9.1% in men and 5.2% in women). The PAF component of CVD deaths in smokers without metabolic syndrome was 40.9% in men and 11.9% in women, which were also higher than those in smokers with metabolic syndrome (7.1% in men and 3.9% in women). Conclusion. Our results indicated that a large proportion of excess CVD deaths was observed in smokers without metabolic syndrome or obesity, especially in men. These findings suggest that intervention targeting on smokers, irrespective of the presence of metabolic syndrome, is still important for the prevention of CVD in Asian countries.

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