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Non-high-density lipoprotein cholesterol and the development of coronary heart disease and stroke subtypes in a general Japanese population: the Hisayama Study.
Atherosclerosis 2014; 233(2):343-8A

Abstract

BACKGROUND AND PURPOSE

It has not been fully determined whether non-high-density lipoprotein cholesterol (non-HDLC) levels are involved in vascular events, especially stroke, in general Asian populations. We evaluated the association between non-HDLC levels and the risk of type-specific cardiovascular disease in a prospective cohort study in Japan.

METHODS

A total of 2452 community-dwelling Japanese subjects aged≥40 years were followed prospectively for 24 years.

RESULTS

The age- and sex-adjusted incidence of coronary heart diseases (CHD) significantly increased with elevating non-HDLC levels (P for trend<0.001), but no such association was observed for ischemic and hemorrhagic strokes. With regard to ischemic stroke subtypes, the age- and sex-adjusted incidence of lacunar infarction significantly increased with elevating non-HDLC levels (P for trend<0.01), and such tendency was seen for atherothrombotic infarction (P for trend=0.098), while a significant inverse association was observed for cardioembolic infarction (P for trend=0.007). After adjustment for confounders, namely, age, sex, diabetes, body mass index, systolic blood pressure, electrocardiogram abnormalities, current drinking, current smoking, and regular exercise, the associations remained significant for CHD [adjusted hazard ratio (HR) for a 1 standard deviation of non-HDLC concentrations=1.17, 95% confidence interval (CI)=1.02 to 1.35], atherothrombotic infarction (adjusted HR=1.39, 95% CI=1.09 to 1.79), and cardioembolic infarction (adjusted HR=0.64, 95% CI=0.47 to 0.85).

CONCLUSIONS

Our findings suggest that elevated non-HDLC levels are a significant risk factor for the development of atherothrombotic infarction as well as CHD but reduce the risk of cardioembolic infarction in the general Japanese population.

Authors+Show Affiliations

Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Electronic address: kiyohara@envmed.med.kyushu-u.ac.jp.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24530960

Citation

Imamura, Tsuyoshi, et al. "Non-high-density Lipoprotein Cholesterol and the Development of Coronary Heart Disease and Stroke Subtypes in a General Japanese Population: the Hisayama Study." Atherosclerosis, vol. 233, no. 2, 2014, pp. 343-8.
Imamura T, Doi Y, Ninomiya T, et al. Non-high-density lipoprotein cholesterol and the development of coronary heart disease and stroke subtypes in a general Japanese population: the Hisayama Study. Atherosclerosis. 2014;233(2):343-8.
Imamura, T., Doi, Y., Ninomiya, T., Hata, J., Nagata, M., Ikeda, F., ... Kiyohara, Y. (2014). Non-high-density lipoprotein cholesterol and the development of coronary heart disease and stroke subtypes in a general Japanese population: the Hisayama Study. Atherosclerosis, 233(2), pp. 343-8. doi:10.1016/j.atherosclerosis.2014.01.005.
Imamura T, et al. Non-high-density Lipoprotein Cholesterol and the Development of Coronary Heart Disease and Stroke Subtypes in a General Japanese Population: the Hisayama Study. Atherosclerosis. 2014;233(2):343-8. PubMed PMID: 24530960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-high-density lipoprotein cholesterol and the development of coronary heart disease and stroke subtypes in a general Japanese population: the Hisayama Study. AU - Imamura,Tsuyoshi, AU - Doi,Yasufumi, AU - Ninomiya,Toshiharu, AU - Hata,Jun, AU - Nagata,Masaharu, AU - Ikeda,Fumie, AU - Mukai,Naoko, AU - Hirakawa,Yoichiro, AU - Yoshida,Daigo, AU - Fukuhara,Masayo, AU - Kitazono,Takanari, AU - Kiyohara,Yutaka, Y1 - 2014/01/21/ PY - 2013/08/02/received PY - 2014/01/05/revised PY - 2014/01/06/accepted PY - 2014/2/18/entrez PY - 2014/2/18/pubmed PY - 2014/12/17/medline KW - Cardiovascular disease KW - Cholesterol KW - Epidemiology KW - Lipoproteins KW - Risk factors SP - 343 EP - 8 JF - Atherosclerosis JO - Atherosclerosis VL - 233 IS - 2 N2 - BACKGROUND AND PURPOSE: It has not been fully determined whether non-high-density lipoprotein cholesterol (non-HDLC) levels are involved in vascular events, especially stroke, in general Asian populations. We evaluated the association between non-HDLC levels and the risk of type-specific cardiovascular disease in a prospective cohort study in Japan. METHODS: A total of 2452 community-dwelling Japanese subjects aged≥40 years were followed prospectively for 24 years. RESULTS: The age- and sex-adjusted incidence of coronary heart diseases (CHD) significantly increased with elevating non-HDLC levels (P for trend<0.001), but no such association was observed for ischemic and hemorrhagic strokes. With regard to ischemic stroke subtypes, the age- and sex-adjusted incidence of lacunar infarction significantly increased with elevating non-HDLC levels (P for trend<0.01), and such tendency was seen for atherothrombotic infarction (P for trend=0.098), while a significant inverse association was observed for cardioembolic infarction (P for trend=0.007). After adjustment for confounders, namely, age, sex, diabetes, body mass index, systolic blood pressure, electrocardiogram abnormalities, current drinking, current smoking, and regular exercise, the associations remained significant for CHD [adjusted hazard ratio (HR) for a 1 standard deviation of non-HDLC concentrations=1.17, 95% confidence interval (CI)=1.02 to 1.35], atherothrombotic infarction (adjusted HR=1.39, 95% CI=1.09 to 1.79), and cardioembolic infarction (adjusted HR=0.64, 95% CI=0.47 to 0.85). CONCLUSIONS: Our findings suggest that elevated non-HDLC levels are a significant risk factor for the development of atherothrombotic infarction as well as CHD but reduce the risk of cardioembolic infarction in the general Japanese population. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/24530960/Non_high_density_lipoprotein_cholesterol_and_the_development_of_coronary_heart_disease_and_stroke_subtypes_in_a_general_Japanese_population:_the_Hisayama_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(14)00022-7 DB - PRIME DP - Unbound Medicine ER -