Entity

Time filter

Source Type

Takashima, Japan

Turin T.C.,University of Calgary | Nakamura Y.,Kyoto Womens University | Ueda K.,Japan National Institute of Environmental Studies | Sugihara H.,Takashima General Hospital | And 6 more authors.
Neuroepidemiology | Year: 2012

Background: Exposure to high levels of air pollution can increase the risk of cardiovascular events. However, there is no clear information in Japan on the effect of pollution on the incidence of stroke and acute myocardial infarction (AMI). Therefore, we investigated the effects of air pollution on the incidence of stroke and AMI in a setting where pollutant levels are rather low. Methods: Data were obtained from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County in central Japan. We applied a time-stratified, bidirectional, case-crossover design to estimate the effects of air pollutants, which included suspended particulate matter (SPM), sulfur dioxide (SO 2), nitrogen dioxide (NO 2) and photochemical oxidants (Ox). We used the distributed lag model to estimate the effect of pollutant exposure 0-3 days before the day of event onset and controlled for meteorological covariates in all of the models. Results: There were 2,038 first-ever strokes (1,083 men, 955 women) and 429 first-ever AMI cases (281 men, 148 women) during 1988-2004. The mean pollutant levels were as follows: SPM 26.9 μg/m 3; SO 2 3.9 ppb; NO 2 16.0 ppb, and Ox 28.4 ppb. In single-pollutant and two-pollutant models, SO 2 was associated with the risk of cerebral hemorrhage. Other stroke subtypes and AMI were not associated with air pollutant levels. Conclusions: We observed an association between SO 2 and hemorrhagic stroke; however, we found inconclusive evidence for a short-term effect of air pollution on the incidence of other stroke types and AMI. Copyright © 2012 S. Karger AG, Basel.


Turin T.C.,Shiga University of Medical Science | Kita Y.,Shiga University of Medical Science | Rumana N.,Shiga University of Medical Science | Takashima N.,Shiga University of Medical Science | And 8 more authors.
Hypertension Research | Year: 2010

Brachial-ankle pulse wave velocity (baPWV) is a relatively new non-invasive measure of arterial stiffness obtained using an automated system. We assessed the relationship between baPWV and 6.5-year overall mortality from the Takashima cohort study. The baPWV was measured in 2642 participants at baseline. When participants were divided into tertiles, all-cause mortality increased significantly as baPWV increased (P<0.001). Participants in the highest baPWV tertile showed an increased risk of all-cause mortality evidenced by a multivariable adjusted hazard ratio of 6.8 (95% confidence interval: 1.4-32.8) as compared with the lowest tertile. The present study demonstrated that increased baPWV is an independent predictor of all-cause mortality in the Japanese population. © 2010 The Japanese Society of Hypertension All rights reserved.


Turin T.C.,Shiga University of Medical Science | Kita Y.,Shiga University of Medical Science | Rumana N.,Shiga University of Medical Science | Nakamura Y.,Shiga University of Medical Science | And 9 more authors.
Stroke | Year: 2010

Background and Purpose-: Population-based information on the epidemiology of ischemic stroke (IS) subtypes is scant. In this study, we characterized IS subtypes in terms of incidence, time trend, and risk factor profiles in a community-based population. Methods-: We obtained data from the Takashima Stroke Registry on approximately 55 000 residents of Takashima County in central Japan and calculated age-adjusted stroke incidence rates for different IS subtypes. We determined the incidence time trend by calculating the average annual change across years and also compared risk factors between subtypes. Results-: There were 1389 first-ever ischemic strokes registered during 1988 to 2004. Lacunar infarction was the most frequent etiology (54.1%) followed by cardioembolic infarction (22.9%). Age-adjusted incidence rates for different IS subtypes were lacunar, 77.1; cardioembolic, 31.5; and nonlacunar, 29.7/10 person-years. The average annual change was not significant for the IS subtypes except for nonlacunar infarction, which showed a decreasing trend. Risk factor analysis showed that patients with lacunar infarctions were younger and less likely to have a history of transient ischemic attack or a drinking habit than patients with nonlacunar infarctions. Conclusion-: Lacunar infarct was the most common IS subtype in our population. We found no significant change in the incidence of subtypes during the study, except a decrease in nonlacunar infarction. © 2010 American Heart Association, Inc.


Turin T.C.,University of Calgary | Turin T.C.,Shiga University of Medical Science | Kita Y.,Shiga University of Medical Science | Rumana N.,Shiga University of Medical Science | And 11 more authors.
Cerebrovascular Diseases | Year: 2012

Background: Apart from the conventional risk factors, cerebro- cardiovascular disease (CVD) are also reported to be associated with air pollution, thus lowering the level of exposure might contribute in prevention activities to reduce the associated adverse outcomes. Though few studies conducted in Japan have reported on the CVD mortality but none have explored the effect of air pollutant exposure on the acute case-fatality of CVD. We investigated the effects of air pollution exposure on acute case-fatality of stroke and acute myocardial infarction (AMI) in a setting where pollutant levels are rather low. Methods: We leveraged the data from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County located in central Japan. The study period of 6,210 days (16 years, leap years also taken into account) were divided into quartiles of daily average pollutant concentration; suspended particulate matter (SPM), sulfur dioxide (SO2), nitrogen dioxide (NO2), and photochemical oxidants (Ox). The stroke and AMI events were categorized to corresponding quartiles based on the pollution levels of the onset day. To study the effects of air pollutants, we estimated the fatality rate ratio across quartiles of the pollutants where the lowest quartile served as the reference. Results: There were 307 (men: 153 and women: 154) fatal stroke cases within 28 days of onset among the 2,038 first ever stroke during 1988-2004. In the same period, there were 142 (men: 94 and women: 54) fatal AMI cases within 28 days of onset among the 429 first ever AMI events. The mean of the measured pollutant levels were as follows: SPM 26.9 μg/m3, SO2 3.9 ppb, NO2 16.0 ppb, and Ox 28.4 ppb. Among the pollutants, higher levels of NO2 showed increased fatality risk. In multi-pollutant model, the highest quartile of NO2 was associated with 60% higher stroke case-fatality risk in comparison to lowest quartile of NO2. In the fully adjusted model the fatality-rate ratio was 1.65 (95% CI 1.06-2.57). This association was more prominent among stroke subtype of cerebral infarction. Other pollutant levels did not show any association with stroke or AMI case-fatality. Conclusion: We observed association between NO2 levels, an index of traffic related air pollution, with the acute case-fatality of stroke, especially cerebral infarction in our study population. Further studies are needed in different regions to determine the association between ambient air pollutants and acute cardiovascular fatalities. © 2012 S. Karger AG, Basel.


Rumana N.,Shiga University of Medical Science | Rumana N.,Sleep Center | Kita Y.,Shiga University of Medical Science | Kita Y.,University of Fukui | And 14 more authors.
International Journal of Stroke | Year: 2014

Background: Few comprehensive stroke and acute myocardial infarction registries of long duration exist in Japan to illustrate trends in acute case-fatality of stroke and acute myocardial infarction with greater precision. We examined 17-year case-fatality rates of stroke and acute myocardial infarction using an entire community-monitoring registration system to investigate trends in these rates over time in a Japanese population. Methods: Data were obtained from the Takashima Stroke and AMI Registry covering a stable population of approximately 55000 residents of Takashima County in central Japan. We divided the total observation period of 17 years into four periods, 1989-1992, 1993-1996, 1997-2000, and 2001-2005. We calculated gender, age-specific and age-adjusted acute case-fatality rates (%) of stroke and acute myocardial infarction across these four periods. Results: During the study period of 1989-2005, there were 341 fatal cases within 28 days of onset among 2239 first-ever stroke events and 163 fatal cases among 433 first-ever acute myocardial infarction events. The age-adjusted acute case-fatality rate of stroke was 14·9% in men and 15·7% in women. The age-adjusted acute case-fatality rate of acute myocardial infarction was 34·3% in men and 43·3% in women. The age-adjusted acute case-fatality rates of stroke and acute myocardial infarction showed insignificant differences across the four time periods. The average annual change in the acute case-fatality rate of stroke (-0·2%; 95% CI: -2·4-2·1) and acute myocardial infarction (2·7%; 95% CI: -0·7-6·1) did not change significantly across the study years. Conclusions: The acute case-fatality rates of stroke and acute myocardial infarction have remained stable from 1989 to 2005 in a rural and semi-urban Japanese population. © 2014 World Stroke Organization.

Discover hidden collaborations