Association between Chlamydophila pneumoniae infection and risk of coronary heart disease for Japanese: the JPHC study.

BACKGROUND: Chlamydophila pneumoniae infection is considered a risk factor for atherosclerosis and coronary heart disease in western countries. However, evidence of it being a risk for Japanese is very limited because of a lower risk of coronary heart disease than for western people. The aim of this study was to examine further the association between C. pneumoniae infection and risk of coronary heart disease in Japanese. METHODS: We conducted a nested case-control study of 49,011 Japanese men and women who participated in The Japan Public Health Center (JPHC) study. By the end of 2004, 196 cases of coronary heart disease and 155 cases of myocardial infarction had been documented among the participants. Two controls were selected for each case. For these subjects, we examined the association between serum anti C. pneumoniae IgA and IgG on the one hand and risk of coronary heart disease on the other. RESULTS: Concentration of C. pneumoniae IgA antibody was positively associated with risk of coronary heart disease and more specifically myocardial infarction. Subjects with the highest quartile of IgA antibody showed 2.29 (95%CI, 1.21-4.33) times higher risk of coronary heart disease and 2.58 (95%CI, 1.29-5.19) times higher risk of myocardial infarction than those with lowest quartile. However, no such association was detected for IgG antibody. CONCLUSION: C. pneumoniae infection was found to be positively associated with risk of coronary heart disease.

Chlamydia pneumoniae infection was associated with risk of mortality from coronary heart disease in Japanese women but not men: the JACC Study.

AIM: To investigate the association between Chlamydia pneumoniae infection and mortality from coronary heart disease, a nested case-control study was conducted for 39,242 Japanese who participated in the JACC Study. METHODS: Immunoglobulin A and G titers of C. pneumoniae were measured in stored serum samples collected from 209 patients (113 men and 96 women) who subsequently died of coronary heart disease after 13-year follow-up; and 209 controls matched for gender, age (+/-5 years) and area of residence. RESULTS: After adjustment for high-sensitive CRP and other cardiovascular risk factors, the multivariate odds ratio (OR) of coronary heart disease for highest vs. lowest tertiles of IgA titers was 2.69 (95%CI, 1.00-7.20), p=0.049 for women and 0.58 (0.23-1.46), p=0.25 for men (p for interaction=0.03). A similar association was observed by high (++) vs. low (-/+/-) titers of IgA: multivariate OR was 4.09 (0.86-19.4), p=0.07 for women. CONCLUSIONS: Since high IgA titers indicate persistent and repeated infection, such a state is associated with an increased risk of coronary heart disease mortality for women.

Effects of habitual alcohol intake on ambulatory blood pressure, heart rate, and its variability among Japanese men.

We sought to examine effects of habitual alcohol intake on ambulatory blood pressure (BP), heart rate (HR), and HR variability among Japanese men. Subjects were 539 men aged 35 to 65 years from rural and urban communities. Ambulatory BP and HR were monitored with an automated, portable, noninvasive multibiomedical recorder. Power spectral analysis of the RR intervals on the ECG was performed every 5 minutes. Compared with nondrinkers, moderate drinkers (alcohol intake 23 to 45 g/d) and heavy drinkers (alcohol intake >or=46 g/d) showed higher age- and field-adjusted mean values of systolic and diastolic BPs during the morning and while awake, but there were no differences in BPs over 24-hour periods and while asleep among the alcohol intake categories. Alcohol intake was positively associated with mean values of sleep-morning differences and daytime variability in BPs, HRs while awake and asleep, and low frequency:high frequency ratio while asleep. The results were virtually unchanged after adjustment for body mass index, smoking, and diabetes mellitus. Compared with the nondrinkers, age- and field-adjusted odds ratios of the morning BP surge (excess elevation of BP in the morning: morning systolic BP minus sleep systolic BP >or=37 mm Hg) for light (alcohol intake 0 to 22 g/d), moderate, and heavy drinkers were 0.96 (95% CI: 0.34 to 2.78), 1.68 (95% CI: 0.64 to 4.38), and 2.73 (95% CI: 1.12 to 6.67), respectively. Habitual alcohol intake was associated with increased BP in the morning, HR while awake and asleep, and sympathetic activity while asleep, which may explain some of the mechanisms of the relationship between heavy alcohol intake and risk of cardiovascular diseases.

Serum total homocysteine concentrations and risk of mortality from stroke and coronary heart disease in Japanese: The JACC study.

Evidence for association between serum total homocysteine (tHcy) level and cardiovascular disease is limited in Asian populations. We conducted a nested case-control study under JACC Study. A total of 39,242 subjects aged 40-79 years provided serum samples at baseline surveys between 1988 and 1990. Control subjects were selected by matching for sex, age, community and year of serum storage. Serum tHcy levels were measured by high-performance liquid chromatography. During the 10-year follow-up, there were 444 deaths due to total cardiovascular disease, including 310 total stroke (131 hemorrhage and 101 ischemic strokes) and 134 coronary heart diseases. The risks of mortality from ischemic stroke, coronary heart disease, and total cardiovascular disease were significantly higher in individuals with the highest serum tHcy quartile (>or=15.3micromol/L) than in those with the lowest quartile (<10.5micromol/L); the respective multivariable odds ratios (95% CI) were 4.35 (1.12-16.9), 3.40 (1.17-9.86), and 1.68 (1.02-2.77). The multivariable odds ratios associated with a 5-micromol/L increase in tHcy were 1.49 (1.01-2.18), 2.01 (1.21-3.35), and 1.15 (1.00-1.32), respectively. High serum tHcy levels were associated with increased mortality from ischemic stroke, coronary heart disease and total cardiovascular disease among Japanese.

Risk of transmission of imipenem-resistantPseudomonas aeruginosa through use of mobile bathing service.

OBJECTIVES: The demand for mobile bathing service (MBS) is increasing in the Japanese society. Therefore, we assessed the risk of MBS-associated infection in MBS clients and their caregivers by examining the bacterial colonization of MBS equipment and utensils. METHODS: Bacterial isolates collected by the stamp agar culture method were examined by disk diffusion assay for their susceptibility to the following drugs: imipenem, ciprofloxacin, amikacin, azutreonam, ceftazidim, meropenem, piperacillin, tobramycin, ofloxacin and cefoperazone. Furthermore, these isolates were subtyped bySpeI-pulsed field gel electrophoresis (SpeI-PFGE). RESULTS: Fifty-fourP. aeruginosa isolates were recovered from different sampling sites, and of these, 26 (47.3%) were isolated from pillows. Eighteen isolates (33.3%) were imipenem (IPM) resistant. The minimum inhibitory concentrations (MICs) of 17 isolates were between 16 and 32 µg/ml, and the MIC of one isolate was greater than 32 µg/ml. TheSpeI-PFGE typing of IPM-resistant isolates revealed that 13 of the 18 isolates were closely related (F=1.0-0.87). CONCLUSION: Our findings suggest that MBS equipment and utensils, particularly pillows, are the primary sources of bacterial contamination and transmission and that there is a risk of MBS-mediated infection among MBS clients and their caregivers.

Possible effects of diets on serum lipids, fatty acids and blood pressure levels in male and female Japanese university students.

OBJECTIVES: To prepare a dietary recommendation for young Japanese for the prevention of coronary heart disease, we surveyed the dietary habits, serum lipids, serum fatty acids and blood pressure levels among male and female students. METHODS: In this study, 175 male and 246 female university students were interviewed for the frequency of consumption of selected food items and the habit of skipping breakfast. Serum fatty acids were analyzed by gas chromatography. RESULTS: The frequencies of consumption of dishes cooked with oil and intake of vegetables were higher in female students than in male students. Serum n-6 polyunsaturated fatty acids were slightly higher in females students than in male students while that of serum n-3 polyunsaturated fatty acids was 6.4% in both sexes. For both males and females, those who skipped breakfast at least once a week were less likely to consume vegetables and fruits than those who did not. Female students who skipped breakfast were also less likely to consume fish and had lower composition of n-3 polyunsaturated fatty acid and higher systolic and diastolic blood pressure levels than males. For female, the intake of milk and dairy products correlated inversely with systolic blood pressure levels and the intake of n-3 polyunsaturated fatty acids correlated inversely with diastolic blood pressure levels. For males, the intake of fruits and consumption of dishes cooked with oil correlated inversely with systolic and diastolic blood pressure levels. CONCLUSION: Our findings suggest that increased intake of fish, milk and dairy products, fruits and vegetables from early adulthood and a regular dietary pattern are important to reduce the risk factors for coronary heart disease.