Department of Preventive Cardiology
To medicalstaff
Development of disease prediction tools
In a cohort study (Suita Study) targeting urban residents, I made a general paper on primary risk factors for cardiovascular disease. For example, we know how much ischemic heart disease and lipid levels contribute to the risk of developing it, but we need to consider other risk factors in order to predict how likely we are to develop it. Therefore, we are developing a disease prediction tool (risk score) by introducing risk factors related to the disease. The Framingham Heart Study (FHS) in the United States introduces a cardiovascular disease prediction tool as FHS Primary Risk Functions. In the Suita Study, cohorts of urban residents were randomly selected by gender and age group. The urban population accounts for 90% of the national population, and the disease prediction tool of Suita research can be said to be representative of Japan.
Suita score (10-year risk score for developing coronary artery disease)
It is possible to predict the onset of coronary heart disease 10 years later by using the test items at the time of medical examination or outpatient visit.
The Japan Atherosclerosis Society has adopted the results of the Suita research in the 2017 edition of the Guidelines for the Prevention of Arteriosclerosis, and it has become possible to easily obtain the "probability of coronary artery disease onset and the target value for lipid management based on the Suita score."
Nishimura K et al., Predicting coronary heart disease using risk factor categories for a Japanese urban population, and comparison with the Framingham Risk Score: the Suita study. J Atheroscler Thromb. 2014;21:784-98.
Suita atrial fibrillation score (10-year risk score for atrial fibrillation)
It is possible to predict atrial fibrillation 10 years later with only the test items at the time of medical examination or outpatient visit.
Model factors: sex, age, cardiovascular risk (systolic hypertension, overweight [BMI ≥ 25 kg / ㎡], arrhythmia other than atrial fibrillation, ischemic heart disease), lifestyle / serum lipids (excessive drinking [≥] 2 go / day], smoking, non-HDLC * [130-189mg / dL]), heart murmur or valvular disease
Predicted probability of atrial fibrillation (10 years): <0.5% -27%
Score file showing the probability of predicting atrial fibrillation after 10 years
Kokubo Y, et al., Development of a Basic Risk Score for Incident Atrial Fibrillation in a Japanese General Population - The Suita Study. Circ J. 2017;81:1580-1588.
Suita Cardiovascular Disease Score (10-year risk score for developing cardiovascular disease)
The prediction probability of the onset of cardiovascular disease (coronary artery disease + stroke) 10 years later can be obtained from the simple test results of a medical examination and the electrocardiogram test.
Model factors: sex, age, blood pressure, non-HDLC level*, HDL cholesterol level, smoking, diabetes, proteinuria, electrocardiography (atrial fibrillation, high left ventricular potential)
Probability of predicting the onset of cardiovascular disease (10 years): 1% or less to 25% (26% with no electrocardiogram test and with electrocardiogram test)
*: Non-HDLC = [total cholesterol level]-[HDL cholesterol level]
Nakai M, et al., Development of a Cardiovascular Disease Risk Prediction Model Using the Suita Study, a Population-Based Prospective Cohort Study in Japan. J Atheroscler Thromb. 2020;27:1160-1175.
Heart failure aggravation prevention business
As a joint project between Suita City and Suita City Medical Association, we have started measures to prevent the aggravation of heart failure in Suita City. Although heart failure is the final picture of various cardiovascular diseases, there are very few epidemiological studies of heart failure in the local population. Therefore, when a tool for predicting latent heart failure was developed, it was found that all heart diseases and cerebral infarction became risk factors, and it was difficult to use when targeting local residents. I decided to use a fibrillation prediction tool. For the examinees who agreed at the time of the medical examination conducted in Suita City, use the residual serum of the medical examination, add NT-proBNP, add a comment, return the result sheet to the examinee, and put it in the health notebook. You can use it as a personal health record based on the receipt paper.
Furthermore, if the result requires medical care, medical cooperation will be provided, and if guidance is required, health guidance will be provided. Health guidance is provided using Lifelong Health Support10, which we have developed. We want to produce the results of non-drug intervention research with very little evidence.
Development of prediction of cardiovascular disease event using carotid echography
In the "Standard Evaluation Method for Carotid Artery Lesions by Ultrasound 2017"guideline, classification by efficacy is "C2: not recommended because it is unfounded"for the general public and "C1: recommended for atherosclerotic diseases". The rationale for this is not clear. "Therefore, using the Suita study, (1) we determined the measurement site of all carotid arteries that can easily predict the risk of developing cardiovascular disease and found that the maximum intima-media complex thickness of the common carotid artery is more than 1.1 mm. Using it, we reported to J Am Heart Assoc (2018) for the first time in the world that (2) carotid plaque growth is a factor in the risk of developing cardiovascular disease. The group with the plaque contraction was characterized by non-weight gain, adherence to medication (antihypertensives, statins), smoking cessation, and proper drinking. From now on, we will provide evidence for the prevention of arteriosclerosis, including the risk of predicting carotid artery sclerosis.
Kokubo Y, et al., Impact of Intima-Media Thickness Progression in the Common Carotid Arteries on the Risk of Incident Cardiovascular Disease in the Suita Study.
J Am Heart Assoc. 2018;7:e007720.
Oral health and cardiovascular disease
In joint research between the Faculty of Dentistry at Osaka University and the Faculty of Dentistry at Niigata University, we are investigating the subjects of the Suita Study on oral examinations, saliva tests, masticatory ability measurements, and maximum occlusal force. In cross-sectional studies, we showed the following research results: (1) Salivary inflammatory cytokines could be markers for periodontal disease and carotid arteriosclerosis; (2) Regular use of dental treatment services leads to maintenance of masticatory ability; (3) It is related to carotid plaque due to decreased masticatory ability.
In addition, a similar test was performed again after an average of 4 years, and the following longitudinal studies were also conducted: (1) Regular dental visits are effective in preventing deterioration of the masticatory ability; (2) Even if the number of teeth does not change, the masticatory ability decreases as the periodontal disease progresses.
We also conducted a follow-up study with the development of cardiovascular disease: low masticatory function increases the risk of developing cardiovascular disease.
Staff introduction
Specially Appointed Director, Yoshihiro Kokubo
Chief Section of Clinical Research and Development Department; Visiting Professor of University of Glasgow; Invited Professor of Graduate School of Medicine, Osaka University, Part-time Lecturer of Tokyo Medical and Dental University
Guest Director, Hiroyasu Iso
Professor of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
Guest Director, Toshiharu Ninomiya
Professor, Department of Hygiene and Public Health, Graduate School of Medicine, Kyushu University
Specially Appointed Researcher, Tomoharu Dohi
Osaka University Graduate School of Medicine Department of Cardiovascular Medicine Specially Appointed Assistant Professor of Future Medical Development Department
Part-time Researcher, Masayuki Teramoto
Specially Appointed Researcher, Department of Public Health, Graduate School of Medicine, Osaka University; Part-time consultant at WHO Center for Health Development
Part-time Researcher Sheerah Haytham Abdulwhab I
Specially Appointed Researcher in Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University (Kingdom of Saudi Arabia)
Part-time Researcher Ahmed Emadeldin Arafa Abdellatif
Department of Social Medicine, Graduate School of Medicine, Osaka University Public Health; Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
Part-time researcher, Jiaqi li
Department of Social Medicine, Graduate School of Medicine, Osaka University Public Health
Part-time researcher, Emi Watanabe
Registered dietitian, part-time lecturer at Doshisha Women's University
Part-time researcher, Yukie Sakai
Public health nurse
Visiting Researcher, Michihiro Araki
Deputy Director, National Institutes of Biomedical Innovation, AI Health and Pharmaceutical Research Center
Visiting Researcher, Miho Ogiri
Professor, Department of Food and Nutrition, Faculty of Life Sciences, Doshisha Women's University
Visiting Researcher, Masahiro Tsuji
Professor, Department of Food and Nutrition, Faculty of Home Economics, Kyoto Women's University
Visiting Researcher, Takashi Kobayashi
National Center for Global Health and Medicine, Department of Cardiovascular Medicine, Kounodai Hospital
Visiting Researcher, Yuko Sugita
Specially Appointed Assistant Professor, Institute for Protein Research, Osaka University
Dispatch training, Rena Kashima
Doctor, Osaka Prefecture Ibaraki Public Health Center
Dispatch training, Masateru Yamamoto
National Institutes of Biomedical Innovation AI Health and Pharmaceutical Research Center
Dispatch training, Mai Inoue
National Institutes of Biomedical Innovation AI Health and Pharmaceutical Research Center
Part-time staff: Nurses, laboratory technicians, dental hygienists, registered dietitians, Clark, System engineers, and research assistants.
Dispatch training: 6 public health trainees 4th-year Faculty of Medicine, Osaka University
last updated : 2021/10/01