Risk of Hypercholesterolemia for Cardiovascular Disease and the Population Attributable Fraction in a 24-year Japanese Cohort Study

Daisuke Sugiyama, Tomonori Okamura, Makoto Watanabe, Aya Higashiyama, Nagako Okuda, Yasuyuki Nakamura, Atsushi Hozawa, Yoshikuni Kita, Aya Kadota, Yoshitaka Murakami, Naomi Miyamatsu, Takayoshi Ohkubo, Takehito Hayakawa, Yoshihiro Miyamoto, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima

Research output: Contribution to journalArticle

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Abstract

Aims: The population-attributable fraction (PAF) is an indicator of the disease burden. In Western countries, the PAF of hypercholesterolemia in cardiovascular disease (CVD) is the highest among that for traditional risk factors; however, data for Asian populations are limited. Methods: A 24-year cohort study was conducted among 9,209 randomly selected participants who were not taking statins. We estimated the hazard ratio (HR) after adjusting for covariates and PAF associated with the serum total cholesterol (TC) levels in relation to CVD mortality. Results: The TC level was found to be positively associated with an increased risk of CVD, coronary heart disease (CHD) and cardiac death (CHD plus heart failure), with an HR of 1.08 (95% confidence interval [CI]: 1.00-1.16), 1.33 (95% CI: 1.14-1.55) and 1.21 (95% CI: 1.08-1.35) for a 1-SD increment in the serum TC level, respectively. Similar positive associations between the TC level and both CHD and cardiac death were observed after classifying the patients by age and sex. Furthermore, the highest serum TC level (≥6.72 mmol/L) was positively associated with CVD death, with an HR of 1.76 (95% CI: 1.25-2.47), as well as both CHD death and cardiac death. In contrast, no significant relationships were observed between the serum TC level and stroke. Meanwhile, the PAF for CVD, CHD, and cardiac deaths due to hypercholesterolemia (serum TC level ≥5.69 mmol/L, defined by the Japan Atherosclerosis Society) was 1.7%, 10.6% and 5.6%, respectively. Conclusions: The estimated PAF of CVD death due to hypercholesterolemia is moderately high, but lower than that for other risk factors, such as hypertension.

Original languageEnglish
Pages (from-to)95-107
Number of pages13
JournalJournal of Atherosclerosis and Thrombosis
Volume22
Issue number1
Publication statusPublished - 2015

Fingerprint

Hypercholesterolemia
Cohort Studies
Cardiovascular Diseases
Cholesterol
Coronary Disease
Population
Confidence Intervals
Serum
Hazards
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Atherosclerosis
Japan
Heart Failure
Stroke
Hypertension
Mortality

Keywords

  • Cardiovascular disease
  • Cohort study
  • NIPPON DATA80
  • Population-attributable fraction
  • Total cholesterol

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine
  • Biochemistry, medical

Cite this

Risk of Hypercholesterolemia for Cardiovascular Disease and the Population Attributable Fraction in a 24-year Japanese Cohort Study. / Sugiyama, Daisuke; Okamura, Tomonori; Watanabe, Makoto; Higashiyama, Aya; Okuda, Nagako; Nakamura, Yasuyuki; Hozawa, Atsushi; Kita, Yoshikuni; Kadota, Aya; Murakami, Yoshitaka; Miyamatsu, Naomi; Ohkubo, Takayoshi; Hayakawa, Takehito; Miyamoto, Yoshihiro; Miura, Katsuyuki; Okayama, Akira; Ueshima, Hirotsugu.

In: Journal of Atherosclerosis and Thrombosis, Vol. 22, No. 1, 2015, p. 95-107.

Research output: Contribution to journalArticle

Sugiyama, D, Okamura, T, Watanabe, M, Higashiyama, A, Okuda, N, Nakamura, Y, Hozawa, A, Kita, Y, Kadota, A, Murakami, Y, Miyamatsu, N, Ohkubo, T, Hayakawa, T, Miyamoto, Y, Miura, K, Okayama, A & Ueshima, H 2015, 'Risk of Hypercholesterolemia for Cardiovascular Disease and the Population Attributable Fraction in a 24-year Japanese Cohort Study', Journal of Atherosclerosis and Thrombosis, vol. 22, no. 1, pp. 95-107.
Sugiyama, Daisuke ; Okamura, Tomonori ; Watanabe, Makoto ; Higashiyama, Aya ; Okuda, Nagako ; Nakamura, Yasuyuki ; Hozawa, Atsushi ; Kita, Yoshikuni ; Kadota, Aya ; Murakami, Yoshitaka ; Miyamatsu, Naomi ; Ohkubo, Takayoshi ; Hayakawa, Takehito ; Miyamoto, Yoshihiro ; Miura, Katsuyuki ; Okayama, Akira ; Ueshima, Hirotsugu. / Risk of Hypercholesterolemia for Cardiovascular Disease and the Population Attributable Fraction in a 24-year Japanese Cohort Study. In: Journal of Atherosclerosis and Thrombosis. 2015 ; Vol. 22, No. 1. pp. 95-107.
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abstract = "Aims: The population-attributable fraction (PAF) is an indicator of the disease burden. In Western countries, the PAF of hypercholesterolemia in cardiovascular disease (CVD) is the highest among that for traditional risk factors; however, data for Asian populations are limited. Methods: A 24-year cohort study was conducted among 9,209 randomly selected participants who were not taking statins. We estimated the hazard ratio (HR) after adjusting for covariates and PAF associated with the serum total cholesterol (TC) levels in relation to CVD mortality. Results: The TC level was found to be positively associated with an increased risk of CVD, coronary heart disease (CHD) and cardiac death (CHD plus heart failure), with an HR of 1.08 (95{\%} confidence interval [CI]: 1.00-1.16), 1.33 (95{\%} CI: 1.14-1.55) and 1.21 (95{\%} CI: 1.08-1.35) for a 1-SD increment in the serum TC level, respectively. Similar positive associations between the TC level and both CHD and cardiac death were observed after classifying the patients by age and sex. Furthermore, the highest serum TC level (≥6.72 mmol/L) was positively associated with CVD death, with an HR of 1.76 (95{\%} CI: 1.25-2.47), as well as both CHD death and cardiac death. In contrast, no significant relationships were observed between the serum TC level and stroke. Meanwhile, the PAF for CVD, CHD, and cardiac deaths due to hypercholesterolemia (serum TC level ≥5.69 mmol/L, defined by the Japan Atherosclerosis Society) was 1.7{\%}, 10.6{\%} and 5.6{\%}, respectively. Conclusions: The estimated PAF of CVD death due to hypercholesterolemia is moderately high, but lower than that for other risk factors, such as hypertension.",
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T1 - Risk of Hypercholesterolemia for Cardiovascular Disease and the Population Attributable Fraction in a 24-year Japanese Cohort Study

AU - Sugiyama, Daisuke

AU - Okamura, Tomonori

AU - Watanabe, Makoto

AU - Higashiyama, Aya

AU - Okuda, Nagako

AU - Nakamura, Yasuyuki

AU - Hozawa, Atsushi

AU - Kita, Yoshikuni

AU - Kadota, Aya

AU - Murakami, Yoshitaka

AU - Miyamatsu, Naomi

AU - Ohkubo, Takayoshi

AU - Hayakawa, Takehito

AU - Miyamoto, Yoshihiro

AU - Miura, Katsuyuki

AU - Okayama, Akira

AU - Ueshima, Hirotsugu

PY - 2015

Y1 - 2015

N2 - Aims: The population-attributable fraction (PAF) is an indicator of the disease burden. In Western countries, the PAF of hypercholesterolemia in cardiovascular disease (CVD) is the highest among that for traditional risk factors; however, data for Asian populations are limited. Methods: A 24-year cohort study was conducted among 9,209 randomly selected participants who were not taking statins. We estimated the hazard ratio (HR) after adjusting for covariates and PAF associated with the serum total cholesterol (TC) levels in relation to CVD mortality. Results: The TC level was found to be positively associated with an increased risk of CVD, coronary heart disease (CHD) and cardiac death (CHD plus heart failure), with an HR of 1.08 (95% confidence interval [CI]: 1.00-1.16), 1.33 (95% CI: 1.14-1.55) and 1.21 (95% CI: 1.08-1.35) for a 1-SD increment in the serum TC level, respectively. Similar positive associations between the TC level and both CHD and cardiac death were observed after classifying the patients by age and sex. Furthermore, the highest serum TC level (≥6.72 mmol/L) was positively associated with CVD death, with an HR of 1.76 (95% CI: 1.25-2.47), as well as both CHD death and cardiac death. In contrast, no significant relationships were observed between the serum TC level and stroke. Meanwhile, the PAF for CVD, CHD, and cardiac deaths due to hypercholesterolemia (serum TC level ≥5.69 mmol/L, defined by the Japan Atherosclerosis Society) was 1.7%, 10.6% and 5.6%, respectively. Conclusions: The estimated PAF of CVD death due to hypercholesterolemia is moderately high, but lower than that for other risk factors, such as hypertension.

AB - Aims: The population-attributable fraction (PAF) is an indicator of the disease burden. In Western countries, the PAF of hypercholesterolemia in cardiovascular disease (CVD) is the highest among that for traditional risk factors; however, data for Asian populations are limited. Methods: A 24-year cohort study was conducted among 9,209 randomly selected participants who were not taking statins. We estimated the hazard ratio (HR) after adjusting for covariates and PAF associated with the serum total cholesterol (TC) levels in relation to CVD mortality. Results: The TC level was found to be positively associated with an increased risk of CVD, coronary heart disease (CHD) and cardiac death (CHD plus heart failure), with an HR of 1.08 (95% confidence interval [CI]: 1.00-1.16), 1.33 (95% CI: 1.14-1.55) and 1.21 (95% CI: 1.08-1.35) for a 1-SD increment in the serum TC level, respectively. Similar positive associations between the TC level and both CHD and cardiac death were observed after classifying the patients by age and sex. Furthermore, the highest serum TC level (≥6.72 mmol/L) was positively associated with CVD death, with an HR of 1.76 (95% CI: 1.25-2.47), as well as both CHD death and cardiac death. In contrast, no significant relationships were observed between the serum TC level and stroke. Meanwhile, the PAF for CVD, CHD, and cardiac deaths due to hypercholesterolemia (serum TC level ≥5.69 mmol/L, defined by the Japan Atherosclerosis Society) was 1.7%, 10.6% and 5.6%, respectively. Conclusions: The estimated PAF of CVD death due to hypercholesterolemia is moderately high, but lower than that for other risk factors, such as hypertension.

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KW - Cohort study

KW - NIPPON DATA80

KW - Population-attributable fraction

KW - Total cholesterol

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