Population Attributable Fraction of Smoking and Metabolic Syndrome on Cardiovascular Disease Mortality in Japan: a 15-Year Follow Up of NIPPON DATA90

BMC Public Health

Research Article

Naoyuki Takashima¹  Nagako Okuda¹  Shin-ya Nagasawa¹  Yoshitaka Murakami¹  Katsuyuki Miura¹  Aya Kadota¹  Takashi Kadowaki¹  Akira Fujiyoshi¹  Yoshikuni Kita¹  Hirotsugu Ueshima¹  Atsushi Hozawa²  Takehito Hayakawa³  Tomonori Okamura⁴  Yasuyuki Nakamura⁵  Akira Okayama⁶ 

[1] Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Shiga 520-2192, Otsu, Japan;Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Shiga 520-2192, Otsu, Japan;Department of Public Health, Yamagata University School of Medicine, Iida Nishi 2-2-1, Yamagata, 990-9585, Yamagata, Japan;Department of Hygiene and Preventive Medicine, Fukushima Medical University, Hikarigaoka1, Fukushima, 960-1295, Fukushima, Japan;Department of Preventive Cardiology, National Cardiovascular Center, Fujishirodai 5-7-1, 565-8565, Suita, Osaka, Japan;The Cardiovascular Epidemiology, Kyoto Women's University, Imakumanokitahiyoshi-cho35, Kyoto, 605-8501, Kyoto, Japan;The First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Misaki-cho1-3-12, 101-061, Chiyoda, Tokyo, Japan;

关键词: Obesity;    Metabolic Syndrome;    Smoking Rate;    Metabolic Risk Factor;    Public Health Nurse;   

DOI  :  10.1186/1471-2458-10-306

 received in 2009-09-29, accepted in 2010-06-03,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundSmoking and metabolic syndrome are known to be related to cardiovascular diseases (CVD) risk. In Asian countries, prevalence of obesity has increased and smoking rate in men is still high. We investigated the attribution of the combination of smoking and metabolic syndrome (or obesity) to excess CVD deaths in Japan.MethodsA cohort of nationwide representative Japanese samples, a total of 6650 men and women aged 30-70 at baseline without history of CVD was followed for 15 years. Multivariate-adjusted hazard ratio for CVD death according to the combination of smoking status and metabolic syndrome (or obesity) was calculated using Cox proportional hazard model. Population attributable fraction (PAF) of CVD deaths was calculated using the hazard ratios.ResultsDuring the follow-up period, 87 men and 61 women died due to CVD. The PAF component of CVD deaths in non-obese smokers was 36.8% in men and 11.3% in women, which were higher than those in obese smokers (9.1% in men and 5.2% in women). The PAF component of CVD deaths in smokers without metabolic syndrome was 40.9% in men and 11.9% in women, which were also higher than those in smokers with metabolic syndrome (7.1% in men and 3.9% in women).ConclusionOur results indicated that a large proportion of excess CVD deaths was observed in smokers without metabolic syndrome or obesity, especially in men. These findings suggest that intervention targeting on smokers, irrespective of the presence of metabolic syndrome, is still important for the prevention of CVD in Asian countries.

【 授权许可】

CC BY   
© Takashima et al; licensee BioMed Central Ltd. 2010