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Title: A prospective follow-up study of the association of radiation exposure with fatal and non-fatal stroke among atomic bomb survivors in Hiroshima and Nagasaki (1980–2003)

Abstract

Use of medical radiotherapy has increased markedly in recent decades. Whether the consequence includes an increased risk of cardiovascular disease remains to be determined. The purpose of this study was to examine the association between radiation exposure and the incidence of stroke among Japanese atomic bomb survivors. Radiation exposure from the atomic bombing was assessed in 9515 subjects (34.8% men) with 24-year follow-up from 1980. Subjects were free of prevalent stroke when follow-up began. Stroke events and the underlying cause of death were reviewed to confirm the first-ever stroke. Subtypes (ischaemic and haemorrhagic events) were categorised based on established criteria according to the definitions of typical/atypical stroke symptoms. Overall mean radiation dose (±SD) in units of gray (Gy) was 0.38±0.58 (range: 0–3.5). During the study period, 235 haemorrhagic and 607 ischaemic events were identified. For men, after adjusting for age and concomitant risk factors, the risk of haemorrhagic stroke rose consistently from 11.6 to 29.1 per 10 000 person-years as doses increased from <0.05 to ≥2 Gy (p=0.009). Incidence also rose within the dose range <1 Gy (p=0.004) with no dose threshold. In women, the risk of haemorrhagic stroke rose with increasing radiation exposure but not until doses reached amore » threshold of 1.3 Gy (95% CI 0.5 to 2.3). Among women, for doses <1.3 Gy, differences in stroke risk were modest (13.5 per 10 000 person-years), while it increased to 20.3 per 10 000 person-years for doses that ranged from 1.3 to <2.2 Gy and to 48.6 per 10 000 person-years for doses that were higher (p=0.002). In both sexes, dose was unrelated to ischaemic stroke. While the risk of haemorrhagic stroke increases with rising radiation exposure for both sexes, effects in women are less apparent until doses exceed a threshold at 1.3 Gy.« less

Authors:
 [1];  [2];  [3];  [4];  [2];  [2];  [2];  [2];  [4]
+ Show Author Affiliations
  1. Radiation Effects Research Foundation (RERF), Hiroshima (Japan); Hiroshima Univ. (Japan)
  2. Radiation Effects Research Foundation (RERF), Hiroshima (Japan)
  3. Hiroshima Univ. (Japan); Suiseikai Kajikawa Hospital, Hiroshima (Japan)
  4. Hiroshima Univ. (Japan)
Publication Date:
Research Org.:
National Academy of Sciences, Washington, DC (United States)
Sponsoring Org.:
USDOE Office of Environment, Health, Safety and Security (AU); Radiation Effects Research Foundation (RERF)
OSTI Identifier:
1904818
Grant/Contract Number:  
HS0000031
Resource Type:
Accepted Manuscript
Journal Name:
BMJ Open
Additional Journal Information:
Journal Volume: 2; Journal Issue: 1; Journal ID: ISSN 2044-6055
Publisher:
BMJ Publishing Group
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; General & Internal Medicine

Citation Formats

Takahashi, Ikuno, Abbott, Robert D., Ohshita, Tomohiko, Takahashi, Tetsuya, Ozasa, Kotaro, Akahoshi, Masazumi, Fujiwara, Saeko, Kodama, Kazunori, and Matsumoto, Masayasu. A prospective follow-up study of the association of radiation exposure with fatal and non-fatal stroke among atomic bomb survivors in Hiroshima and Nagasaki (1980–2003). United States: N. p., 2012. Web. doi:10.1136/bmjopen-2011-000654.
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Takahashi, Ikuno, Abbott, Robert D., Ohshita, Tomohiko, Takahashi, Tetsuya, Ozasa, Kotaro, Akahoshi, Masazumi, Fujiwara, Saeko, Kodama, Kazunori, & Matsumoto, Masayasu. A prospective follow-up study of the association of radiation exposure with fatal and non-fatal stroke among atomic bomb survivors in Hiroshima and Nagasaki (1980–2003). United States. https://doi.org/10.1136/bmjopen-2011-000654
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Takahashi, Ikuno, Abbott, Robert D., Ohshita, Tomohiko, Takahashi, Tetsuya, Ozasa, Kotaro, Akahoshi, Masazumi, Fujiwara, Saeko, Kodama, Kazunori, and Matsumoto, Masayasu. Fri . "A prospective follow-up study of the association of radiation exposure with fatal and non-fatal stroke among atomic bomb survivors in Hiroshima and Nagasaki (1980–2003)". United States. https://doi.org/10.1136/bmjopen-2011-000654. https://www.osti.gov/servlets/purl/1904818.
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@article{osti_1904818,
title = {A prospective follow-up study of the association of radiation exposure with fatal and non-fatal stroke among atomic bomb survivors in Hiroshima and Nagasaki (1980–2003)},
author = {Takahashi, Ikuno and Abbott, Robert D. and Ohshita, Tomohiko and Takahashi, Tetsuya and Ozasa, Kotaro and Akahoshi, Masazumi and Fujiwara, Saeko and Kodama, Kazunori and Matsumoto, Masayasu},
abstractNote = {Use of medical radiotherapy has increased markedly in recent decades. Whether the consequence includes an increased risk of cardiovascular disease remains to be determined. The purpose of this study was to examine the association between radiation exposure and the incidence of stroke among Japanese atomic bomb survivors. Radiation exposure from the atomic bombing was assessed in 9515 subjects (34.8% men) with 24-year follow-up from 1980. Subjects were free of prevalent stroke when follow-up began. Stroke events and the underlying cause of death were reviewed to confirm the first-ever stroke. Subtypes (ischaemic and haemorrhagic events) were categorised based on established criteria according to the definitions of typical/atypical stroke symptoms. Overall mean radiation dose (±SD) in units of gray (Gy) was 0.38±0.58 (range: 0–3.5). During the study period, 235 haemorrhagic and 607 ischaemic events were identified. For men, after adjusting for age and concomitant risk factors, the risk of haemorrhagic stroke rose consistently from 11.6 to 29.1 per 10 000 person-years as doses increased from <0.05 to ≥2 Gy (p=0.009). Incidence also rose within the dose range <1 Gy (p=0.004) with no dose threshold. In women, the risk of haemorrhagic stroke rose with increasing radiation exposure but not until doses reached a threshold of 1.3 Gy (95% CI 0.5 to 2.3). Among women, for doses <1.3 Gy, differences in stroke risk were modest (13.5 per 10 000 person-years), while it increased to 20.3 per 10 000 person-years for doses that ranged from 1.3 to <2.2 Gy and to 48.6 per 10 000 person-years for doses that were higher (p=0.002). In both sexes, dose was unrelated to ischaemic stroke. While the risk of haemorrhagic stroke increases with rising radiation exposure for both sexes, effects in women are less apparent until doses exceed a threshold at 1.3 Gy.},
doi = {10.1136/bmjopen-2011-000654},
journal = {BMJ Open},
number = 1,
volume = 2,
place = {United States},
year = {Fri Feb 03 00:00:00 EST 2012},
month = {Fri Feb 03 00:00:00 EST 2012}
}
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https://doi.org/10.1136/bmjopen-2011-000654
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    Association of Weight Fluctuation With Mortality in Japanese Adults
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    • Baselet, Bjorn; Rombouts, Charlotte; Benotmane, Abderrafi Mohammed
    • International Journal of Molecular Medicine, Vol. 38, Issue 6
    • DOI: 10.3892/ijmm.2016.2777
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