Faculty Profiles - KANDA Hideyuki

Insomnia among Japanese Adolescents: A Nationwide Representative Survey,

Yoshitaka Kaneita, Takashi Ohida, Yoneatsu Osaki, Takeo Tanihata, Masumi Minowa, Kenji Suzuki, Kiyoshi Wada, Hideyuki Kanda, Kenji Hayashi

Sleep 29 ( 12 ) 1543 - 1550 2006

Language：English Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS INC

Objectives: Although a number of previous studies have examined the prevalence of insomnia among adolescents, there have been very few nationwide studies. The objectives of this nationwide study were to clarify the prevalence of insomnia, its symptoms, and associated factors among Japanese adolescents.Design and Setting: This study was designed as a cross-sectional sampling survey. The targets were junior and senior high schools throughout Japan. Sample schools were selected by cluster sampling. Self-reported anonymous questionnaires were sent to schools for all students to fill out.Participants: A total of 103,650 adolescents responded, and 102,451 questionnaires were subjected to analysis.Intervention: N/AMeasurements and Results: The prevalence of difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening was 14.8%, 11.3%, and 5.5%, respectively. Insomnia was defined as the presence of one or more of these three symptoms. The prevalence of insomnia was 23.5%. Multivariate analyses revealed that, among junior high school students, male sex, poor mental health, skipping breakfast, drinking alcohol, smoking, not participating in extracurricular activities, and late bedtime had significantly higher odds ratios for insomnia. Among senior high school students, the same characteristics were associated with a significantly higher odds ratio for insomnia, as was the additional factor of having no intent to study at university.Conclusion: Insomnia in Japanese adolescents is common and associated with multiple factors. The results of this study suggest the need for comprehensive program to prevent insomnia in Japanese adolescents.

DOI： 10.1093/sleep/29.12.1543

Web of Science

【未成年者への喫煙対策】未成年者を対象とした喫煙対策の世界的動向 Cochrane Database of Systematic Reviewsにおける文献考察

神田秀幸, 尾崎米厚, 谷畑健生

保健医療科学 54 ( 4 ) 278 - 283 2005.12

Language：Japanese Publisher：国立保健医療科学院

根拠に基づいた予防や治療の世界的動向を知ることができるデータベース"Cochrane Database of Systematic Reviews 3rd Quarter 2005"を用いて文献検索し,未成年者の喫煙防止に効果的な対策はなにか検討した.結果,最も有効な対策は「タバコ広告や販売促進事業への介入」で,「マスメディアへの介入」も効果があると考えられた.一方,「小売業者への介入」「学校における防煙プログラム」「地域介入」は効果に乏しいと思われた

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2005&ichushi_jid=J03876&link_issn=&doc_id=20060420470002&doc_link_id=0506426&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F0506426&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Impact of hypertension on medical economics: A 10-year follow-up study of national health insurance in Shiga, Japan. Reviewed International journal

Nakamura K, Okamura T, Kanda H, Hayakawa T, Kadowaki T, Okayama A, Ueshima H, Health, Promotion Research Committee of, the, Siga National, Insurance Organizations

Hypertension research : official journal of the Japanese Society of Hypertension 28 ( 11 ) 859 - 864 2005.11

Language：English Publishing type：Research paper (scientific journal)

Hypertension and related cardiovascular diseases may lead to an increase in medical costs for patients. We attempted to clarify the relationship between hypertension and long-term medical costs by a cohort study utilizing existing data as well as baseline blood pressures and medical costs over a 10-year period. The participants included 4191 Japanese National Health Insurance beneficiaries aged 40-69 years, living in one area, who were not taking anti-hypertensive medication and did not have a history of major cardiovascular disease. They were classified into four categories according to their blood pressure. We evaluated the mean medical costs per month, cumulative hospitalization, and all-cause mortality for each blood pressure category. Hypertension-related medical costs attributable to hypertensive individuals, as compared to normotensive individuals, were estimated. There was a positively graded correlation between blood pressure and personal total medical costs, especially for men. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensive men were also higher than those in normotensive men. However, the hypertension-related medical costs for mild to moderate hypertensives were higher than those for severe hypertensives. The hypertension-related medical costs for all hypertensives accounted for 23.7% of the total medical costs for the Japanese population. In conclusion, high blood pressure was a useful predictor for excess medical costs; moreover, concomitant hypertension, regardless of the grade, increased the medical costs of Japanese National Health Insurance beneficiaries.

DOI： 10.1291/hypres.28.859

神田秀幸, 中村幸志, 早川岳人, 岡村智教, 上島弘嗣

日本アルコール・薬物医学会雑誌 40 ( 3 ) 171 - 180 2005.6

Language：Japanese Publisher：(一社)日本アルコール・アディクション医学会

平成元年または2年度に滋賀県の7町1村で基本健康診査を受診した4496名(40〜69歳)のうち,飲酒習慣を有する2039名(男1520名,女519名)の国民健康保険被保険者を対象に,飲酒習慣と長期的な医療費の関連について検討した.平均9.0±2.9年間の追跡調査の結果,男性において毎日日本酒換算で3合以上の多量飲酒群は,他群に比べ1ヵ月で約2000〜3000円の医療費が高く,この傾向はベースラインから5年以内では統計学的に有意であった.健康日本21の現状(成人男性の4.1%が多量飲酒者)と目標(多量飲酒者の2割減少)に当てはめると,目標達成により年間約84億円の総医療費減少が期待された.また多量飲酒者への対策により,過剰医療費削減にもつながると考えられた

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2005&ichushi_jid=J02993&link_issn=&doc_id=20050714080001&doc_link_id=10016593127&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F10016593127&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

[The influence of alcohol drinking on medical care expenditures among National Health Insurance beneficiaries]. Reviewed

Kanda H, Nakamura K, Hayakawa T, Okamura T, Ueshima H

Nihon Arukoru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence 40 ( 3 ) 171 - 180 2005.6

What factors are associated with high plasma B-type natriuretic peptide levels in a general Japanese population?

Kanda H, Kita Y, Okamura T, Kadowaki T, Yoshida Y, Nakamura Y, Ueshima H

Journal of Human Hypertension 19 ( 2 ) 165 - 172 2005.2

Language：English

There are few community-based epidemiologic studies that have dealt with risk factors for heart failure in non-Western populations. It has been reported that the measurement of plasma B-type natriuretic peptide (BNP) is useful for detecting patients with asymptomatic heart failure. To clarify the determinants of high plasma BNP level, the association of BNP with cardiovascular risk factors in community dwelling residents was examined. The plasma BNP levels were measured in 686 residents aged 35-69 years who received annual health check-up. The relationship of BNP to blood pressure, blood haemoglobin, serum cholesterol (total and high-density lipoprotein cholesterol), plasma glucose, electrocardiographic (ECG) findings, urinary salt excretion, and lifestyle factors (smoking and alcohol consumption) were cross-sectionally analysed. The plasma BNP geometric mean was 13.7 pg/ml. Both linear and logistic regression analyses indicated that the plasma BNP levels were positively associated with age, urinary salt excretion, higher blood pressure, high R-wave voltage in the 12-lead ECG (Minnesota Code 3-1 or 3-3), and female gender. Plasma BNP levels were inversely associated with blood h

DOI： 10.1038/sj.jhh.1001792

Much lower prevalence of coronary calcium detected by electron-beam computed tomography among men aged 40-49 in Japan than in the US, despite a less favorable profile of major risk factors Reviewed

A Sekikawa, H Ueshima, WR Zaky, T Kadowaki, D Edmundowicz, T Okamura, K Sutton-Tyrrell, Y Nakamura, K Egawa, H Kanda, A Kashiwagi, Y Kita, H Maegawa, K Mitsunami, K Murata, Y Nishio, S Tamaki, Y Ueno, LH Kuller

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY 34 ( 1 ) 173 - 179 2005.2

Language：English Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS

Background Since World War II (WWII), exposures to westernized lifestyle have occurred in many non-Western countries, including Japan. National surveys showed that risk factor profiles for atherosclerosis around 1990 were similar in men in the post WWII birth cohorts in the US and Japan. We compared the degree of coronary calcium and other factors in men in the post WWII birth cohort: men aged 40-49 in the US and Japan.
Methods We conducted a cross-sectional study examining randomly selected 100 men from Kusatsu, Japan, and 100 men from Allegheny County, US. Coronary calcium was assessed using electron-beam computed tomography.
Results Systolic blood pressure, total cholesterol, low density lipoprotein (LDL)-cholesterol, and smoking rates were higher among the Japanese (122.6 +/- 14.1 versus 113.7 +/- 9.6 mmHg, P < 0.01; 5.72 +/- 0.90 versus 4.99 +/- 0.81 mmol/l (220.9 +/- 34.6 versus 192.8 +/- 31.3 mg/dl), P < 0.01; 3.52 +/- 1.01 versus 3.10 +/- 0.78 mmol/l (136.0 +/- 39.0 versus 119.7 +/- 30.0 mg/dl), P < 0.01; and 48 versus 15%, P < 0.01, respectively). Triglycerides and fibrinogen were similar. High density lipoprotein (HDL)-cholesterol was higher among the Japanese. Body mass index, fasting insulin, and C-reactive protein were higher among the Americans. Prevalence of coronary artery calcium score >0 was strikingly lower among the Japanese than the Americans (13% versus 47%, P < 0.01).
Conclusions Much lower prevalence of coronary calcium despite a less favourable profile of many major independent risk factors in the Japanese might imply that there are strong protective factors against atherosclerosis in the Japanese. Further investigation is of critical importance.

DOI： 10.1093/ije/dyh285

Web of Science

Effectiveness of annual interventions for smoking cessation in an occupational setting in Japan. Reviewed International journal

Kadowaki T, Okamura T, Funakoshi T, Okayama A, Kanda H, Miyamatsu N, Kita Y, Ueshima H

Environmental health and preventive medicine 9 ( 4 ) 161 - 164 2004.7

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To examine the effectiveness of a small-scale smoking cessation intervention program conducted annually for ten years in an occupational setting in Japan. METHODS: We conducted an annual intervention program promoting smoking cessation in male smokers from 1993 to 2002 in an occupational setting in Hyogo, Japan. Trends in smoking prevalence in this worksite were compared with a control group from two similar worksites of the same company. The intervention program was carried out by medical students (the fourth year of a six-year course) who received training on the protocol prior to the intervention. This protocol consisted of one initial group session, followed by periodical correspondence for two months. Successful cessation of smoking was determined by self-declaration of abstinence for longer than four weeks after intervention, confirmed by an expiratory carbon monoxide concentration of less than nine ppm. Smoking prevalence was determined by a self-administered questionnaire provided at the annual health checkup. RESULTS: The proportion of smokers who participated in the program was 3.47% on average. Abstinence rates following each intervention ranged from 13.3% to 60.0%, with the prevalence of male smokers at the intervention worksite decreasing from 56.2% in 1993 to 47.0% in 2002. In contrast, the smoking prevalence of the control worksites remained largely unchanged, being 60.2% in 1995 and 57.6% in 2002. At the end of the study, the intervention worksite had a significantly lower prevalence of smokers in either the crude or age-adjusted rate. CONCLUSION: A small-scale but repeated smoking cessation intervention program at a worksite can reduce smoking prevalence more efficiently than the natural trends.

DOI： 10.1007/BF02898095

Non-invasive measurement of brachial-ankle pulse wave velocity is associated with serum C-reactive protein but not with alpha-tocopherol in Japanese middle-aged male workers. Reviewed

Okamura T, Moriyama Y, Kadowaki T, Kanda H, Ueshima H

Hypertension research : official journal of the Japanese Society of Hypertension 27 ( 3 ) 173 - 180 2004.3

Language：English Publisher：The Japanese Society of Hypertension

Pulse wave velocity (PWV) is an indicator of arterial stiffness, especially in the aorta, and a marker for vascular damage. We examined the association of brachial-ankle PWV (baPWV) with serum α-tocopherol and C-reactive protein (CRP) levels in addition to the traditional risk factors. Study subjects were 178 Japanese male workers aged 50-59 without past histories of cardiovascular diseases. The relation of baPWV with serum α-tocopherol and CRP levels was cross-sectionally analyzed after adjusting for other cardiovascular risk factors. The arithmetic mean of serum α-tocopherol was 38.9μmol/l, and the geometric mean of serum CRP was 0.47 mg/l. Multiple linear regression analysis indicated that serum CRP levels were associated with an elevation of baPWV, in addition to age, systolic blood pressure and heart rate. However, serum α-tocopherol, serum lipids (triglyceride, low and high density lipoprotein cholesterol), fasting plasma glucose, body mass index, smoking and alcohol drinking did not significantly correlate to baPWV. Multivariate-adjusted means of baPWV according to serum CRP quartile were 1,431, 1,436, 1,507 and 1,508 cm/s (p =0.033). The serum CRP level might be an important marker for arterial stiffness in Japanese middle-aged males. However, no relation was observed between α-tocopherol and baPWV. (Hypertens Res 2004; 27: 173-180)

DOI： 10.1291/hypres.27.173

What expectations do young Japanese epidemiologists have for the future of epidemiology? A questionnaire survey of members of the young epidemiologists society for discussing the future of epidemiology. Reviewed

Gen Kobashi, Tsutomu Hoshuyama, Hiroki Sugimori, Izumi Oki, Takashi Kadowaki, Hideyuki Kanda, Tetsuya Otani, Motoki Iwasaki, Mariko Naito, Soshi Takao

Journal of epidemiology 14 ( 2 ) 69 - 71 2004.3

[Smoking scenes in Japanese television dramas]. Reviewed

Kanda H, Okamura T, Kadowaki T, Hayakawa T, Kita Y, Ueshima H

[Nihon koshu eisei zasshi] Japanese journal of public health 50 ( 1 ) 62 - 70 2003.1

Language：Japanese Publisher：Japanese Society of Public Health

Background Exposure to smoking scenes in movies and TV dramas has been known to be a trigger for young people starting habitual smoking, but it has not been clarified to what extent youth is routinely exposed to smoking scenes in television programs in Japan. Objective To clarify the status quo of smoking scenes and smoking-related items in serial TV dramas targeting young audience in Japan. Method Seven TV dramas targeting a young audience broadcast between July and September, 2001 were analyzed. A total of 63 hours of TV programs were divided into units of three minutes (a total of 1,264 units). All the units were reviewed for smoking scenes, description of social contexts related to smoking behavior, existence of smoking and smoking-related items. Findings Among the 1,264 three-minute units, 129 (10.2%) contained smoking behavior, and 258 (20.4%) depicted smoking environment with presence of smoking-related items. Smokers were male actors (126 units, 97.7%), aged 20-40 years (118 units, 91.5%), leading actors (72 units, 55.8%), and were smoking alone (80 units, 62.0%). Smoking places mainly took place in indoor settings (56 units, 43.4%). Ashtrays were the most frequently observed smoking-related items (8.1% of the total units). The smoking scenes with actions other than smoking itself accounted for 70 units (54.3% of the smoking scenes). As for the actions other than smoking, working (28 units, 21.7%) and eating (17 units, 13.2%) were commonly observed. Regarding smoking scenes without any other actions, 32 units (24.8%) were observed in the beginning or ending telops, and 27 units (20.9%) showed a person smoking without doing anything else. There were only 3 units (0.2%) which were against smoking behavior. Approximately 30% of the Japanese serial television drama scenes featured tobacco use in story plots. As the general features of the smoking scenes, most of them do not necessarily require smoking in the story. Furthermore, there was little consideration about separation of designated smoking areas.

DOI： 10.11236/jph.50.1_62

ELECTRON-BEAM COMPUTED TOMOGRAPHY FOR IDENTIFICATION OF HIGH-RISK PERSONS IN PRIMARY PREVENTION OF CORONARY HEART DISEASE IN THE UNITED STATES AND ITS IMPLICATION FOR JAPAN

SEKIKAWA Akira, OKAMURA Tomonori, KADOWAKI Takashi, MITSUNAMI Kenichi, MURATA Kiyoshi, KASHIWAGI Atsunori, NAKAMURA Yasuyuki, KANDA Hideyuki, EDMUNDOWICZ Daniel, SUTTON-TYRRELL Kim, CURB J. David, KULLER Lewis H., UESHIMA Hirotsugu

Jpn J Public Health 50 ( 3 ) 183 - 193 2003

Language：Japanese Publisher：Japanese Society of Public Health

Coronary heart disease (CHD) is the leading cause of death in the United States (US). Approximately half of deaths from CHD occur out of hospital, most being sudden. The majority of sudden cardiac deaths occur in asymptomatic subjects. Recent lipid-lowering trials in asymptomatic subjects have demonstrated the potential for risk reduction for CHD events by primary prevention. It is, however, generally acknowledged that risk will be underestimated in asymptomatic subjects who fall into the category of intermediate risk by the traditional risk factors. Non-invasive measurements of subclinical atherosclerosis, which is the end result of risk-factor exposure, have the possibility of improving the risk stratification of asymptomatic subjects in intermediate-risk. Electron-beam computed tomography (EBCT) is a non-invasive and highly sensitive means to detect calcification within coronary arterial wall. Coronary artery calcification (CAC) is a recognized marker of atherosclerosis. Atherosclerotic burden of coronary arteries correlates strongly with the amount of CAC measured by EBCT. Studies examining the predictive value of CAC among asymptomatic subjects consistently reported that CAC is a risk for CHD. Two studies reported that unadjusted odds ratios of CAC for CHD were over 20. Incremental value of EBCT over the traditional risk assessment models, however, has not been established. Although CHD mortality in Japan remains uniquely low in industrialized countries, among men aged 30-49, risk factor profiles for CHD are similar between men in the US and Japan, except higher prevalence of cigarette smoking in Japan and higher prevalence of obesity in the US. It is reported that the declining trend in CHD mortality in Japan has recently slowed down in metropolitan areas, especially in men aged 30-49, and that the incidence has increased in middle-aged workers in a metropolitan area. A mortality validation study reported that the differences in CHD mortality between the US and Japan were not as large as suggested by vital statistics. It is, therefore, important to evaluate subclinical atherosclerosis measured by EBCT in men in recent birth cohorts in Japan and compare it to that in men in the US in order to predict future trend in CHD in Japan.

DOI： 10.11236/jph.50.3_183