Risk of Hypercholesterolemia for Cardiovascular Disease and the Population Attributable Fraction in a 24-year Japanese Cohort Study
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Japanese cohort studies reported an increase in CAD incidence and mortality following TC elevation.
“a number of cohort studies conducted in Japan have reported an increase in the incidence and mortality rates of CAD following an elevation in TC level48–54).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [54]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Use and misuse of population attributable fractions
Rockhill, B., Newman, B., & Weinberg, C. (1998) · American Journal of Public Health · doi:10.2105/ajph.88.1.15 · Cited by 1,683 · see citing works
Tunstall-Pedoe, H., Kuulasmaa, K., Mähönen, M., Tolonen, H., & Ruokokoski, E. (1999) · The Lancet · doi:10.1016/s0140-6736(99)04021-0 · Cited by 1,444 · see citing works
Cardiovascular Disease and Risk Factors in Asia
Ueshima, H., Sekikawa, A. M., Miura, K., Turin, T. C., Takashima, N., Kita, Y., Watanabe, M., Kadota, A., Okuda, N., Kadowaki, T., et al. (2008) · Circulation · doi:10.1161/circulationaha.108.790048 · Cited by 923 · see citing works
Self-citationKinoshita, M., Yokote, K., Arai, H., Iida, M., Ishigaki, Y., Ishibashi, S., Umemoto, S., Egusa, G., Ohmura, H., Okamura, T., et al. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.gl2017 · Cited by 813 · see citing works
Self-citationTeramoto, T., Sasaki, J., Ishibashi, S., Birou, S., Daida, H., Dohi, S., Egusa, G., Hiro, T., Hirobe, K., Iida, M., et al. (2013) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.15792 · Cited by 468 · see citing works
Self-citationCholesterol, coronary heart disease, and stroke in the Asia Pacific region.
Asia Pacific Cohort Studies Collaboration (2003) · International Journal of Epidemiology · doi:10.1093/ije/dyg106 · Cited by 382 · see citing works
Trend of Westernization of Etiology and Clinical Characteristics of Heart Failure Patients in Japan
Shiba, N., Nochioka, K., Miura, M., Kohno, H., Shimokawa, H., & on behalf of the CHART-2 Investigators (2011) · Circulation Journal · doi:10.1253/circj.cj-11-0135 · Cited by 267 · see citing works
Imamura, T., Doi, Y., Arima, H., Yonemoto, K., Hata, J., Kubo, M., Tanizaki, Y., Ibayashi, S., Iida, M., & Kiyohara, Y. (2009) · Stroke · doi:10.1161/strokeaha.108.529537 · Cited by 235 · see citing works
Cigarette Smoking as a Risk Factor for Stroke Death in Japan: NIPPON DATA80
Ueshima, H., Reza Choudhury, S., Okayama, A., Hayakawa, T., Kita, Y., Kadowaki, T., Okamura, T., Minowa, M., & Iimura, O. (2004) · Stroke · doi:10.1161/01.str.0000131747.84423.74 · Cited by 189 · see citing works
Self-citationOkamura, T., Tanaka, H., Miyamatsu, N., Hayakawa, T., Kadowaki, T., Kita, Y., Nakamura, Y., Okayama, A., & Ueshima, H. (2007) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2006.01.024 · Cited by 172 · see citing works
Self-citationLifestyle and Cardiovascular Disease in Japan
Iso, H. (2011) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.6866 · Cited by 155 · see citing works
What cause of mortality can we predict by cholesterol screening in the Japanese general population?
Okamura, T., Kadowaki, T., Hayakawa, T., Kita, Y., Okayama, A., & Ueshima, H. (2003) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2003.01080.x · Cited by 128 · see citing works
Self-citationEmberson, J. (2003) · European Heart Journal · doi:10.1016/s0195-668x(03)00471-8 · Cited by 128 · see citing works
Ikeda, A., Iso, H., Yamagishi, K., Inoue, M., & Tsugane, S. (2009) · American Journal of Hypertension · doi:10.1038/ajh.2008.356 · Cited by 121 · see citing works
Okamura, T., Hayakawa, T., Kadowaki, T., Kita, Y., Okayama, A., Elliott, P., & Ueshima, H. (2004) · American Heart Journal · doi:10.1016/j.ahj.2003.12.020 · Cited by 119 · see citing works
Self-citationKitamura, A., Iso, H., Iida, M., Naito, Y., Sato, S., Jacobs, D. R., Nakamura, M., Shimamoto, T., & Komachi, Y. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(01)01053-1 · Cited by 107 · see citing works
Nago, N., Ishikawa, S., Goto, T., et al. (2010) · Journal of Epidemiology · doi:10.2188/jea.je20100065 · Cited by 106 · see citing works
Tanabe, N., Iso, H., Okada, K., Nakamura, Y., Harada, A., Ohashi, Y., Ando, T., Ueshima, H., & The Japan Arteriosclerosis Longitudinal Study Group (2010) · Circulation Journal · doi:10.1253/circj.cj-09-0861 · Cited by 99 · see citing works
Self-citationCui, R., Iso, H., Toyoshima, H., Date, C., Yamamoto, A., Kikuchi, S., Kondo, T., Watanabe, Y., Koizumi, A., Inaba, Y., et al. (2007) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2006.08.022 · Cited by 96 · see citing works
Nakamura, Y., Ueshima, H., Okamura, T., Kadowaki, T., Hayakawa, T., Kita, Y., Tamaki, S., & Okayama, A. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2004.12.016 · Cited by 95 · see citing works
Self-citationLong-term risk of BP values above normal for cardiovascular mortality
Takashima, N., Ohkubo, T., Miura, K., Okamura, T., Murakami, Y., Fujiyoshi, A., Nagasawa, S., Kadota, A., Kita, Y., Miyagawa, N., et al. (2012) · Journal of Hypertension · doi:10.1097/hjh.0b013e328359a9f7 · Cited by 82 · see citing works
Self-citationCui, R., Iso, H., Yamagishi, K., Saito, I., Kokubo, Y., Inoue, M., & Tsugane, S. (2012) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2012.01.013 · Cited by 75 · see citing works
Kadowaki, S., Okamura, T., Hozawa, A., Kadowaki, T., Kadota, A., Murakami, Y., Nakamura, K., Saitoh, S., Nakamura, Y., Hayakawa, T., et al. (2008) · Diabetologia · doi:10.1007/s00125-007-0915-6 · Cited by 69 · see citing works
Self-citationNakamura, K., Nakagawa, H., Sakurai, M., Murakami, Y., Irie, F., Fujiyoshi, A., Okamura, T., Miura, K., & Ueshima, H. (2012) · Cerebrovascular Diseases · doi:10.1159/000336764 · Cited by 66 · see citing works
Self-citationNakamura, K., Barzi, F., Huxley, R., Lam, T.-H., Suh, I., Woo, J., Kim, H. C., Feigin, V. L., Gu, D., & Woodward, M. (2009) · Heart · doi:10.1136/hrt.2008.147066 · Cited by 56 · see citing works
The Role of Conventional Risk Factors in Explaining Social Inequalities in Coronary Heart Disease
Singh‐Manoux, A., Nabi, H., Shipley, M. J., Guéguen, A., Sabia, S., Dugravot, A., Marmot, M. G., & Mika Kivimaki, B. (2008) · Epidemiology · doi:10.1097/ede.0b013e3181761cdc · Cited by 50 · see citing works
Hozawa, A., Okamura, T., Murakami, Y., Kadowaki, T., Nakamura, K., Hayakawa, T., Kita, Y., Nakamura, Y., Abbott, R. D., Okayama, A., et al. (2007) · Hypertension Research · doi:10.1291/hypres.30.1169 · Cited by 39 · see citing works
Self-citationOkamura, T., Hayakawa, T., Kadowaki, T., Kita, Y., Okayama, A., Elliott, P., & Ueshima, H. (2004) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2004.02.019 · Cited by 35 · see citing works
Self-citationWhy should population attributable fractions be periodically recalculated?
Grau, M., Subirana, I., Elosúa, R., Fitó, M., Covas, M., Sala, J., Masiá, R., Ramos, R., Solanas, P., Cordón, F., et al. (2010) · Preventive Medicine · doi:10.1016/j.ypmed.2010.03.012 · Cited by 28 · see citing works
Woodward, M., Martiniuk, A. L. C., Lee, C., et al. (2008) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e3282fdc967 · Cited by 24 · see citing works
Miyamatsu, N., Kadowaki, T., Okamura, T., Hayakawa, T., Kita, Y., Okayama, A., Nakamura, Y., Oki, I., & Ueshima, H. (2005) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1001817 · Cited by 23 · see citing works
Self-citationHozawa, A., Okamura, T., Kadowaki, T., Murakami, Y., Nakamura, K., HAYAKAWA, T., Kita, Y., Nakamura, Y., & Okayama, A. (2007) · International Journal of Epidemiology · doi:10.1093/ije/dym169 · Cited by 10 · see citing works
Self-citationNakamura, M., Sato, S., Shimamoto, T., et al. (2004) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.11.35 · Cited by 7 · see citing works
Analysis of the Treatment of Acute Myocardial Infarction Using Ambulance Records in Japanese Cities
Funabashi, N., Shima, M., Adachi, M., et al. (1999) · Japanese Circulation Journal-english Edition · doi:10.1253/jcj.63.170 · Cited by 6 · see citing works
Nakamura, M., Sato, S., & Shimamoto, T. (2004) · PubMed · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Kinoshita, M., Yokote, K., Arai, H., Iida, M., Ishigaki, Y., Ishibashi, S., Umemoto, S., Egusa, G., Ohmura, H., Okamura, T., et al. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.gl2017 · Cited by 813 · see citing works
Self-citationKuwabara, K., Harada, S., Sugiyama, D., Kurihara, A., Kubota, Y., Higashiyama, A., Hirata, T., Nishida, Y., Kawasaki, M., Takebayashi, T., et al. (2016) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.33100 · Cited by 26 · see citing works
Self-citation
- Authors
- 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., & NIPPON DATA 80/90 Research Group
- Affiliations
- Keio University (JP)
- National Cerebral and Cardiovascular Center (JP)
- University of Human Arts and Sciences (JP)
- Kyoto Women's University (JP)
- Tohoku University (JP)
- Tsuruga Nursing University (JP)
- Shiga University of Medical Science (JP)
- Toho University (JP)
- Teikyo University (JP)
- Fukushima Medical University (JP)
- Research institute for lifestyle-related disease prevention
- ORCID
- Venue
- Journal of Atherosclerosis and Thrombosis
- Publisher
- Japan Atherosclerosis Society
- Published
- 2015
- Volume
- 22
- Issue
- 1
- Pages
- 95-107
- ISSN
- 1340-3478 (ISSN-L)
- 1880-3873
- OpenAlex
- W2009413879
- Cited by
- 44
- References
- 37
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 1 · 2022: 6 · 2021: 2 · 2020: 2 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 5
- FWCI
- 4.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Atherosclerosis and Thrombosis (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion)
- Funders
- Ministry of Health, Labour and Welfare
- 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
- hypercholesterolemia, population attributable fraction, cardiovascular mortality, coronary artery disease, total cholesterol, disease burden, stroke, Japanese population
- MeSH terms
- Adult, Cardiovascular Diseases, Cholesterol, Female, Follow-Up Studies, Humans, Hypercholesterolemia, Japan, Male, Middle Aged, Prognosis, Risk Factors, Cohort Studies, Survival Rate
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
