Serum Triglycerides and Risk of Coronary Heart Disease among Japanese Men and Women
Abstract
To examine the relation of triglycerides with coronary heart disease among populations with low mean total cholesterol, the authors conducted a 15.5-year prospective study ending in 1997 of 11,068 Japanese aged 40–69 years (4,452 men and 6,616 women with mean total cholesterol = 4.73 mmol/liter and 5.03 mmol/liter, respectively), initially free of coronary heart disease or stroke. There were 236 coronary heart disease events comprising 133 myocardial infarctions, 68 angina pectoris events, and 44 sudden cardiac deaths. The coronary heart disease incidence was greater in a dose-response manner across increasing quartiles of nonfasting triglycerides for both sexes. The multivariate relative risk of coronary heart disease adjusting for coronary risk factors and time since last meal associated with a 1-mmol/liter increase in triglycerides was 1.29 (95% confidence interval (CI): 1.09, 1.53; p = 0.004) for men and 1.42 (95% CI: 1.15, 1.75; p = 0.001) for women. The trend was similar for myocardial infarction, angina pectoris, and sudden cardiac death. The relation of triglycerides with coronary heart disease was not influenced materially by total cholesterol levels or, in a subsample analysis (51% of total sample), by high density lipoprotein cholesterol levels. Nonfasting serum triglycerides predict the incidence of coronary heart disease among Japanese men and women who possess low mean values of total cholesterol. Further adjustment for high density lipoprotein cholesterol suggests an independent role of triglycerides on the coronary heart disease risk.
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The association between TG and CAD was observed even with normal HDL-C.
“Despite a normal range of HDL-C, the association between TG and CAD was still observed in several of these studies86–89).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [87]
High TG is associated with CAD risk in Europe, the US, Asia, Oceania, and Japan.
“There have been numerous reports on the association between a high TG level and the risk for CAD not just in Europe and the US86), but also in Asia, Oceania87) and even in Japan46, 78, 88–91).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [87]
In a meta-analysis of epidemiological surveys conducted in the Asia-Pacific region, the group of patients with the highest TG levels had a 50% higher risk of ischemic stroke compared to the group with the lowest TG levels.
“However, the results of a meta-analysis of epidemiological surveys conducted in the Asia-Pacific region, in which the fasting TG level was divided into four groups, reported that the group of patients with the highest TG levels had a 50% higher risk of ischemic stroke compared to the group with the lowest TG levels87).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [87]
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- Authors
- Iso, H., Naito, Y., Sato, S., Kitamura, A., Okamura, T., Sankai, T., Shimamoto, T., Iida, M., & Komachi, Y.
- Affiliations
- University of Tsukuba (JP)
- Osaka Prefectural Hospital Organization (JP)
- Osaka Prefectural Institute of Public Health (JP)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-03-01
- Volume
- 153
- Issue
- 5
- Pages
- 490-499
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2086549084
- Cited by
- 325
- References
- 50
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 7 · 2023: 14 · 2022: 13 · 2021: 14 · 2020: 18 · 2019: 6 · 2018: 22 · 2017: 19 · 2016: 12 · 2015: 11 · 2014: 17 · 2013: 20 · 2012: 12
- FWCI
- 7.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- serum triglycerides, coronary artery disease, myocardial infarction, angina pectoris, sudden cardiac death, HDL cholesterol, sex differences, Japanese adults, dose-response relationship, cardiovascular risk factors
- MeSH terms
- Adult, Aged, Cholesterol, Coronary Disease, Female, Humans, Japan, Cholesterol, HDL, Male, Middle Aged, Prospective Studies, Risk Factors, Sex Factors, Triglycerides, Asian People
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