Modifiable Risk Factors for Cardiovascular Disease in Korea and Japan

Arafa, Ahmed; Lee, Hyeok-Hee; Eshak, Ehab S.; Shirai, Kokoro; Liu, Keyang; Li, Jiaqi; Anni, Naharin Sultana; Shim, Sun Young; Kim, Hyeon Chang; Iso, Hiroyasu

doi:10.4070/kcj.2021.0121

Cited by 37 publications

(24 citation statements)

References 77 publications

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“…The present study has several limitations. Perhaps most importantly, a cutline between obese and nonobese status of BMI 25.0 kg/m 2 applies to the Asian population 29 and not to the population of other regions. Therefore, extrapolation of the results to a Western population, where a different definition for obesity is used, may be limited.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

Kwon

Lee

Yang

et al. 2022

JAHA

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Background Several studies have shown that obesity is associated with better outcomes in patients with cardiogenic shock (CS). Although this phenomenon, the “obesity paradox,” reportedly manifests differently based on sex in other disease entities, it has not yet been investigated in patients with CS. Methods and Results A total of 1227 patients with CS from the RESCUE (Retrospective and Prospective Observational Study to Investigate Clinical Outcomes and Efficacy of Left Ventricular Assist Device for Korean Patients With Cardiogenic Shock) registry in Korea were analyzed. The study population was classified into obese and nonobese groups according to Asian Pacific criteria (BMI ≥25.0 kg/m 2 for obese). The clinical impact of obesity on in‐hospital mortality according to sex was analyzed using logistic regression analysis and restricted cubic spline curves. The in‐hospital mortality rate was significantly lower in obese men than nonobese men (34.2% versus 24.1%, respectively; P =0.004), while the difference was not significant in women (37.3% versus 35.8%, respectively; P =0.884). As a continuous variable, higher BMI showed a protective effect in men; conversely, BMI was not associated with clinical outcomes in women. Compared with patients with normal weight, obesity was associated with a decreased risk of in‐hospital death in men (multivariable‐adjusted odds ratio [OR], 0.63; CI, 0.43–0.92 [ P =0.016]), but not in women (multivariable‐adjusted OR, 0.94; 95% CI, 0.55–1.61 [ P =0.828]). The interaction P value for the association between BMI and sex was 0.023. Conclusions The obesity paradox exists and apparently occurs in men among patients with CS. The differential effect of BMI on in‐hospital mortality was observed according to sex. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02985008.

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Section: Discussionmentioning

confidence: 99%

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

Kwon

Lee

Yang

et al. 2022

JAHA

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“…The Japanese population is the most aging population worldwide with 27.7% of the population older than 65 years [37]; therefore, it is highly expected that stroke will remain a chief contributor to morbidity and mortality. However, since stroke development is not inevitable and Color version available online can be prevented in most cases [38], identifying risk factors for stroke and populations at high risk of developing strokes is an important step toward implementing suitable risk prevention programs [39]. Thus, we believe that our stroke risk prediction model that successfully predicted stroke risk factors and identified the population at risk of stroke can have several epidemiological and clinical merits that may help in reducing the burden of stroke in Japan.…”

Section: Discussionmentioning

confidence: 99%

Developing a Stroke Risk Prediction Model Using Cardiovascular Risk Factors: The Suita Study

et al. 2021

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Introduction: Stroke remains a major cause of death and disability in Japan and worldwide. Detecting individuals at high risk for stroke to apply preventive approaches is recommended. This study aimed to develop a stroke risk prediction model among urban Japanese using cardiovascular risk factors. Methods: We followed 6,641 participants aged 30–79 years with neither a history of stroke nor coronary heart disease. The Cox proportional hazard model estimated the risk of stroke incidence adjusted for potential confounders at the baseline survey. The model’s performance was assessed using the receiver operating characteristic curve and the Hosmer-Lemeshow statistics. The internal validity of the risk model was tested using derivation and validation samples. Regression coefficients were used for score calculation. Results: During a median follow-up duration of 17.1 years, 372 participants developed stroke. A risk model including older age, current smoking, increased blood pressure, impaired fasting blood glucose and diabetes, chronic kidney disease, and atrial fibrillation predicted stroke incidence with an area under the curve = 0.76 and p value of the goodness of fit = 0.21. This risk model was shown to be internally valid (p value of the goodness of fit in the validation sample = 0.64). On a risk score from 0 to 26, the incidence of stroke for the categories 0–5, 6–7, 8–9, 10–11, 12–13, 14–15, and 16–26 was 1.1%, 2.1%, 5.4%, 8.2%, 9.0%, 13.5%, and 18.6%, respectively. Conclusion: We developed a new stroke risk model for the urban general population in Japan. Further research to determine the clinical practicality of this model is required.

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“…These reductions were associated with concomitant increases in the average and healthy life expectancies to reach, in 2019, 81.5 and 72.6 years in men and 86.9 and 75.5 years in women [ 1 ]. Such a miracle would not have happened without controlling the modifiable risk factors for cancer and CVD [ 2 , 3 ]. To further promote people’s health, the Japanese government initiated the “Health Japan 21” project.…”

Section: Introductionmentioning

confidence: 99%

The Lifelong Health Support 10: a Japanese prescription for a long and healthy life

Arafa

Kokubo

Kashima

et al. 2022

Environ. Health Prev. Med.

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Background Although the age-adjusted incidence and mortality of cancer and cardiovascular disease (CVD) have been decreasing steadily in Japan, both diseases remain major contributors to morbidity and mortality along with the aging society. Herein, we aim to provide a prescription of 10 health tips for long and healthy life named the “Lifelong Health Support 10 (LHS10).” Method The LHS10 was developed by the preventive medicine specialists at the National Cerebral and Cardiovascular Center in Suita, where it has been used for health guidance to prevent CVD, cancer, and cognitive decline in addition to their major risk factors such as hypertension, diabetes, and obesity. It consisted of the lifestyle modification recommendations of the 2014 Japanese Society of Hypertension guidelines and the 2017 Japan Atherosclerosis Society Guidelines for preventing atherosclerotic CVD. Further, it came in line with other international lifestyle modification guidelines. In this narrative review, we summarized the results of several Japanese epidemiological studies investigating the association between the LHS10 items and the risk of cancer, CVD, and other chronic diseases including dementia, diabetes, and chronic kidney disease. Results The LHS10 included avoiding smoking and secondhand smoke exposure, engaging in physical activity, refraining from excessive alcohol drinking, reducing fried foods and sugary soft drinks, cutting salt in food, consuming more vegetables, fruits, fish, soy foods, and fibers, and maintaining proper body weight. All items of the LHS10 were shown to reduce the risk of cancer, CVD, and other chronic diseases. Conclusions The LHS10 can be a helpful tool for health guidance. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00085 .

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Modifiable Risk Factors for Cardiovascular Disease in Korea and Japan

Cited by 37 publications

References 77 publications

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

Developing a Stroke Risk Prediction Model Using Cardiovascular Risk Factors: The Suita Study

The Lifelong Health Support 10: a Japanese prescription for a long and healthy life

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