Gender difference of association between LDL cholesterol concentrations and mortality from coronary heart disease amongst Japanese: the Ibaraki Prefectural Health Study
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Abstract. Noda H, Iso H, Irie F, Sairenchi T, Ohtaka E, Ohta H (Osaka University, Osaka, Japan; Harvard School of Public Health, Cambridge, MA, USA; Ibaraki Prefectural Office, Ibaraki; Dokkyo Medical University School of Medicine, Tochigi; Ibaraki Health Service Association, Ibaraki; Japan). Gender difference of association between LDL cholesterol concentrations and mortality from coronary heart disease amongst Japanese: the Ibaraki Prefectural Health Study. J Intern Med 2010; 267:576–587. Objective. The aim of this study was to examine whether LDL cholesterol raises the risk of coronary heart disease in a dose–response fashion in a population with low LDL‐cholesterol levels. Design. Population‐based prospective cohort study in Japan. Subjects and main outcome measures. A total of 30 802 men and 60 417 women, aged 40 to 79 years with no history of stroke or coronary heart disease, completed a baseline risk factor survey in 1993. Systematic mortality surveillance was performed through 2003 and 539 coronary heart disease deaths were identified. Results. The mean values for LDL‐cholesterol were 110.5 mg dL−1 (2.86 mmol L−1) for men and 123.9 mg dL−1 (3.20 mmol L−1) for women. Men with LDL‐cholesterol ≥140 mg dL−1 (≥3.62 mmol L−1) had two‐fold higher age‐adjusted risk of mortality from coronary heart disease than did those with LDL‐cholesterol <80 mg dL−1 (<2.06 mmol L−1), whereas no such association for women was found. The multivariable hazard ratio for the highest versus lowest categories of LDL‐cholesterol was 2.06 (95 percent confidence interval: 1.34 to 3.17) for men and 1.16 (0.64 to 2.12) for women. Conclusion. Higher concentrations of LDL‐cholesterol were associated with an increased risk of mortality from coronary heart disease for men, but not for women, in a low cholesterol population.
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For CAD deaths, a significant increase in risk was seen only in men.
“As for deaths from CAD, gender differences were observed in regard to risk, and a significant increase was seen only in men38).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [38]
The increase in hazard ratio for CAD incidence and mortality following LDL-C elevation has been validated in Japanese cohort studies.
“the increase in hazard ratio for the CAD incidence and mortality following an elevation in LDL-C has been validated in cohort studies involving the Japanese36–40).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [38]
Epidemiology studies have not found a significant correlation of serum cholesterol level and the incidence of noncardiogenic cerebral infarction.
“Epidemiology studies, however, have not found a significant correlation of serum cholesterol level and the incidence of noncardiogenic cerebral infarction38, 57, 64, 337).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [38]
Epidemiological studies conducted in Japan have indicated that there is no significant relationship between the serum cholesterol levels (TC, LDL-C, and non-HDL-C) and the incidence rate of noncardiogenic cerebral infarction.
“However, the results of epidemiological studies conducted in Japan have indicated that there is no significant relationship between the serum cholesterol levels (TC, LDL-C, and non-HDL-C) and the incidence rate of noncardiogenic cerebral infarction36, 38, 40, 57, 64, 78, 337).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [38]
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- Authors
- Noda, H., Iso, H., Irie, F., Sairenchi, T., Ohtaka, E., & Ohta, H.
- Affiliations
- Harvard University (US)
- The University of Osaka (JP)
- Ibaraki Prefectural Government (JP)
- Dokkyo Medical University (JP)
- Corresponding author
- Iso, H.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 2010-05-04
- Volume
- 267
- Issue
- 6
- Pages
- 576-587
- ISSN
- 0954-6820 (ISSN-L)
- 1365-2796
- OpenAlex
- W1522009756
- Cited by
- 48
- References
- 35
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 14 · 2022: 4 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 1 · 2014: 1 · 2013: 7 · 2012: 2
- FWCI
- 2.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- LDL cholesterol, coronary heart disease mortality, sex differences, dose-response relationship, cardiovascular risk, Japanese population
- MeSH terms
- Adult, Aged, Coronary Disease, Female, Humans, Japan, Cholesterol, LDL, Male, Middle Aged, Risk Factors, Sex Factors, Cohort Studies, Proportional Hazards Models
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