Honolulu Heart Program

Hypertension Clinical Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00005123
• Other study ID #: 902
• Status: Completed
• Phase: N/A
• First received: May 25, 2000
• Last updated: March 24, 2016
• Start date: July 1965
• Est. completion date: September 2002

Study information

• Verified date: September 2004
• Source: National Heart, Lung, and Blood Institute (NHLBI)
• Contact: n/a
• Is FDA regulated: No
• Health authority: Unspecified
• Study type: Observational

Clinical Trial Summary

To investigate coronary heart disease and stroke among American men of Japanese ancestry who were living on the island of Oahu in 1965. Morbidity and mortality surveillance of the original cohort is continuing.

Description:

BACKGROUND:

The Honolulu Heart Program was initiated to verify reports that men of Japanese ancestry living in the United States had a much higher risk of coronary heart disease and a lower risk of stroke than Japanese men in Japan. The Honolulu Heart Program was actually a component of the larger NI-HON-SAN Study. The NI-HON-SAN Study (from the acronyms Nippon, Honolulu, and San Francisco) was initiated in 1965. The populations under investigation included members of the Honolulu Heart Program as well as men of Japanese ancestry born between 1900 and 1919 and residing in Japan and San Francisco.

In the Honolulu Heart Program, 11,148 men were identified of whom 8,006 participated in baseline examinations between 1965 and 1968. The 1965 - 1968 examination included a detailed medical and social history with specific inquiries about smoking, alcohol consumption, diet, and physical activity. A physical examination focussed on the cardiovascular system; laboratory tests included hematocrit, serum cholesterol, triglyceride, uric acid, glucose determination, and urinalysis. A twelve lead electrocardiogram and lung function testing revealed that 301 men had evidence of coronary heart disease and 111 had a stroke. The prevalence of coronary heart disease was slightly higher than in the comparable population in Japan, but the incidence rate during the first two-year period of follow-up was twice as high in Honolulu as in Japan. Stroke prevalence was much higher in Japan than in the Honolulu cohort, with a threefold difference. The Honolulu Japanese men were more obese, ate a more Westernized diet with a higher amount of animal protein, saturated fat, and sucrose and a smaller amount of complex carbohydrates. They had higher levels of serum cholesterol, triglyceride, uric acid, and glucose than Japanese men in Japan. Cigarette smoking was more common in the Japanese cohort, while the proportion of heavy smokers was greater in the Honolulu cohort. Alcohol consumption in the Japanese cohort was twice that of the Honolulu cohort. There were no differences in mean blood pressure or prevalence of hypertension. Repeat examinations were performed near the second and sixth anniversaries of the initial examinations. The six year follow-up data identified 294 new cases of coronary heart disease and 133 new cases of stroke. Between 1970 and 1972 some 2,800 of the cohort were examined and had lipoprotein determinations performed as part of the NHLBI Lipoprotein Phenotyping Project. Survivors of the lipoprotein cohort were reexamined between 1975 and 1978 near the tenth anniversary of their initial examination and again between 1980 and 1982.

In 1985, the program was enlarged to make a comparative analysis of the 12-year incidence of coronary heart disease in the Japanese and Hawaii study cohort of the original NI-HON-SAN Study, to sample 400 offspring of the study cohort ages 45 to 60 years and to complete nutrient indicators for association with blood pressure in a manner consistent with the United States-Japan study of nutrition and blood pressure. Resulting data were compared with a comparable selected group of Japanese men and with the parents of the offspring to examine familial associations. Pulmonary function data were recorded and analyzed for association with other risk factors, respiratory disease, and other major chronic diseases.

Beginning in March 1993 and continuing through December 1994, the National Institute on Aging, with its own funds, investigated aging and dementia among Honolulu Heart Program participants.

Beginning in March 1997, the study was supported by U01HL56274.

DESIGN NARRATIVE:

In this prospective cohort study, the hospital discharge rosters of all general hospitals on the Island of Oahu were reviewed twice yearly as part of the morbidity and mortality surveillance. The appropriate chart materials were abstracted for review by study physicians for evidence of myocardial infarction and stroke. Beginning in 1986, both old and new hospital discharge records were reviewed for the additional endpoints of congestive heart failure, aortic aneurysm, bronchitis, emphysema, asthma, chronic obstructive lung disease, dementia, organic brain syndrome, and Parkinson's disease. Deaths were monitored by following obituary columns as well as reviewing death certificates from the State Health Department. There was daily contact with hospitals to find out about impending autopsies in which study personnel could participate. However, only 20-25 percent of the deaths had protocol autopsies.

The fifth and final complete examination of the surviving cohort concluded in Spring, 1996 under a contract with the National Institute on Aging. While the emphasis of this exam was the investigation of dementia, NHLBI funded the recording of blood pressures and ECGs as well as the continued surveillance for morbidity and mortality. A cooperative agreement extends the surveillance for an additional five years. As part of the close-out phase of the study, frozen blood samples collected since the study's inception have been sent to a repository in Rockville, MD. A review board for screening prospective users of this resource holds quarterly meetings.

As the study group includes both migrants from Japan and Hawaii-born men, there is a spectrum of cultural lifestyles and varying grades of acculturation which are being examined as risk factors for cardiovascular and other chronic diseases. The existing baseline and follow-up examination data and the surveillance information on the incidence of most major diseases provide opportunities for a great variety of research projects concerning the predictors of cardiovascular disease, as well as studies of the broader concepts of health and disease in the aging population. The low out-migration rate and the well-defined sources of medical care have provided an ideal setting for maintaining disease morbidity and mortality surveillance; nearly 100 per cent of hospital discharge episodes have been recorded. As the study participants range in age from 75-95 in 1996, the rates of coronary heart disease, stroke, and other chronic diseases are increasing rapidly and thus are providing a large number of disease endpoints for study. Other Institutes are also currently supporting activities which utilize the original cohort.

Stored sera provide an opportunity to test new ideas and etiologic hypotheses using both prospective and case-control study designs. Protocol autopsy information can now be utilized to examine relationships among risk factors, clinical manifestations of CHD, and stroke and pathological evidence of atherosclerosis.

Beginning in 1997, a cooperative agreement extends the surveillance for an additional five years through February, 2002. As part of the close-out of the study, frozen blood samples collected since the study's inception have been sent to a repository in Rockville, Maryland.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 0
• Est. completion date: September 2002
• Accepts healthy volunteers: No
• Gender: Male
• Age group: N/A to 100 Years
• Eligibility: No eligibility criteria

Study Design

N/A

Related Conditions & MeSH terms

• Aortic Aneurysm
• Aortic Aneurysm, Abdominal
• Asthma
• Bronchitis
• Cardiovascular Diseases
• Cerebrovascular Accident
• Chronic Obstructive Pulmonary Disease
• Coronary Artery Disease
• Coronary Disease
• Dementia
• Emphysema
• Heart Diseases
• Heart Failure
• Heart Failure, Congestive
• Hypertension
• Lung Diseases
• Lung Diseases, Obstructive
• Myocardial Infarction
• Pulmonary Disease, Chronic Obstructive
• Stroke

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
National Heart, Lung, and Blood Institute (NHLBI)

References & Publications (244)

Abbott RD, Ando F, Masaki KH, Tung KH, Rodriguez BL, Petrovitch H, Yano K, Curb JD. Dietary magnesium intake and the future risk of coronary heart disease (the Honolulu Heart Program). Am J Cardiol. 2003 Sep 15;92(6):665-9. — View Citation

Abbott RD, Behrens GR, Sharp DS, Rodriguez BL, Burchfiel CM, Ross GW, Yano K, Curb JD. Body mass index and thromboembolic stroke in nonsmoking men in older middle age. The Honolulu Heart Program. Stroke. 1994 Dec;25(12):2370-6. — View Citation

Abbott RD, Curb JD, Rodriguez BL, Masaki KH, Popper JS, Ross GW, Petrovitch H. Age-related changes in risk factor effects on the incidence of thromboembolic and hemorrhagic stroke. J Clin Epidemiol. 2003 May;56(5):479-86. — View Citation

Abbott RD, Curb JD, Rodriguez BL, Masaki KH, Yano K, Schatz IJ, Ross GW, Petrovitch H. Age-related changes in risk factor effects on the incidence of coronary heart disease. Ann Epidemiol. 2002 Apr;12(3):173-81. — View Citation

Abbott RD, Curb JD, Rodriguez BL, Sharp DS, Burchfiel CM, Yano K. Effect of dietary calcium and milk consumption on risk of thromboembolic stroke in older middle-aged men. The Honolulu Heart Program. Stroke. 1996 May;27(5):813-8. — View Citation

Abbott RD, Donahue RP, MacMahon SW, Reed DM, Yano K. Diabetes and the risk of stroke. The Honolulu Heart Program. JAMA. 1987 Feb 20;257(7):949-52. — View Citation

Abbott RD, Petrovitch H, Rodriguez BL, Yano K, Schatz IJ, Popper JS, Masaki KH, Ross GW, Curb JD. Ankle/brachial blood pressure in men >70 years of age and the risk of coronary heart disease. Am J Cardiol. 2000 Aug 1;86(3):280-4. — View Citation

Abbott RD, Rodriguez BL, Burchfiel CM, Curb JD. Physical activity in older middle-aged men and reduced risk of stroke: the Honolulu Heart Program. Am J Epidemiol. 1994 May 1;139(9):881-93. — View Citation

Abbott RD, Rodriguez BL, Petrovitch H, Yano K, Schatz IJ, Popper JS, Masaki KH, Ross GW, Curb JD. Ankle-brachial blood pressure in elderly men and the risk of stroke: the Honolulu Heart Program. J Clin Epidemiol. 2001 Oct;54(10):973-8. — View Citation

Abbott RD, Sharp DS, Burchfiel CM, Curb JD, Rodriguez BL, Hakim AA, Yano K. Cross-sectional and longitudinal changes in total and high-density-lipoprotein cholesterol levels over a 20-year period in elderly men: the Honolulu Heart Program. Ann Epidemiol. 1997 Aug;7(6):417-24. Review. — View Citation

Abbott RD, White LR, Ross GW, Masaki KH, Curb JD, Petrovitch H. Walking and dementia in physically capable elderly men. JAMA. 2004 Sep 22;292(12):1447-53. — View Citation

Abbott RD, Yano K, Hakim AA, Burchfiel CM, Sharp DS, Rodriguez BL, Curb JD. Changes in total and high-density lipoprotein cholesterol over 10- and 20-year periods (the Honolulu Heart Program). Am J Cardiol. 1998 Jul 15;82(2):172-8. — View Citation

Abbott RD, Yin Y, Reed DM, Yano K. Risk of stroke in male cigarette smokers. N Engl J Med. 1986 Sep 18;315(12):717-20. — View Citation

Alagiakrishnan K, Masaki K, Schatz I, Curb JD, Blanchette P. Postural hypertension in elderly men--the Honolulu Heart Program. Hawaii Med J. 2000 Feb;59(2):48-50. — View Citation

Benfante R, Hwang LJ, Masaki K, Curb JD. To what extent do cardiovascular risk factor values measured in elderly men represent their midlife values measured 25 years earlier? A preliminary report and commentary from the Honolulu Heart Program. Am J Epidemiol. 1994 Aug 1;140(3):206-16. — View Citation

Benfante R, Reed D, Brody J. Biological and social predictors of health in an aging cohort. J Chronic Dis. 1985;38(5):385-95. — View Citation

Benfante R, Reed D, Frank J. Does cigarette smoking have an independent effect on coronary heart disease incidence in the elderly? Am J Public Health. 1991 Jul;81(7):897-9. — View Citation

Benfante R, Reed D, MacLean C, Kagan A. Response bias in the Honolulu Heart Program. Am J Epidemiol. 1989 Dec;130(6):1088-100. — View Citation

Benfante R, Reed D. Is elevated serum cholesterol level a risk factor for coronary heart disease in the elderly? JAMA. 1990 Jan 19;263(3):393-6. — View Citation

Benfante R, Yano K, Hwang LJ, Curb JD, Kagan A, Ross W. Elevated serum cholesterol is a risk factor for both coronary heart disease and thromboembolic stroke in Hawaiian Japanese men. Implications of shared risk. Stroke. 1994 Apr;25(4):814-20. — View Citation

Benfante R. Studies of cardiovascular disease and cause-specific mortality trends in Japanese-American men living in Hawaii and risk factor comparisons with other Japanese populations in the Pacific region: a review. Hum Biol. 1992 Dec;64(6):791-805. — View Citation

Benfante RJ, Reed DM, MacLean CJ, Yano K. Risk factors in middle age that predict early and late onset of coronary heart disease. J Clin Epidemiol. 1989;42(2):95-104. — View Citation

Blackwelder WC, Kagan A, Gordon T, Rhoads GG. Comparison of methods for diagnosing angina pectoris: the Honolulu heart study. Int J Epidemiol. 1981 Sep;10(3):211-5. — View Citation

Blackwelder WC, Yano K, Rhoads GG, Kagan A, Gordon T, Palesch Y. Alcohol and mortality: the Honolulu Heart Study. Am J Med. 1980 Feb;68(2):164-9. — View Citation

Burchfiel CM, Abbott RD, Curb JD, Sharp DS, Rodriguez BL, Arakaki R, Yano K. Association of insulin levels with lipids and lipoproteins in elderly Japanese-American men. Ann Epidemiol. 1998 Feb;8(2):92-8. — View Citation

Burchfiel CM, Abbott RD, Sharp DS, Curb JD, Rodriguez BL, Yano K. Distribution and correlates of lipids and lipoproteins in elderly Japanese-American men. The Honolulu Heart Program. Arterioscler Thromb Vasc Biol. 1996 Nov;16(11):1356-64. — View Citation

Burchfiel CM, Curb JD, Arakaki R, Abbott RD, Sharp DS, Rodriguez BL, Yano K. Cardiovascular risk factors and hyperinsulinemia in elderly men: the Honolulu Heart Program. Ann Epidemiol. 1996 Nov;6(6):490-7. — View Citation

Burchfiel CM, Curb JD, Rodriguez BL, Abbott RD, Chiu D, Yano K. Glucose intolerance and 22-year stroke incidence. The Honolulu Heart Program. Stroke. 1994 May;25(5):951-7. — View Citation

Burchfiel CM, Curb JD, Rodriguez BL, Yano K, Hwang LJ, Fong KO, Marcus EB. Incidence and predictors of diabetes in Japanese-American men. The Honolulu Heart Program. Ann Epidemiol. 1995 Jan;5(1):33-43. — View Citation

Burchfiel CM, Curb JD, Sharp DS, Rodriguez BL, Arakaki R, Chyou PH, Yano K. Distribution and correlates of insulin in elderly men. The Honolulu Heart Program. Arterioscler Thromb Vasc Biol. 1995 Dec;15(12):2213-21. — View Citation

Burchfiel CM, Enright PL, Sharp DS, Chyou PH, Rodriguez BL, Curb JD. Factors associated with variations in pulmonary function among elderly Japanese-American men. Chest. 1997 Jul;112(1):87-97. — View Citation

Burchfiel CM, Laws A, Benfante R, Goldberg RJ, Hwang LJ, Chiu D, Rodriguez BL, Curb JD, Sharp DS. Combined effects of HDL cholesterol, triglyceride, and total cholesterol concentrations on 18-year risk of atherosclerotic disease. Circulation. 1995 Sep 15;92(6):1430-6. — View Citation

Burchfiel CM, Marcus EB, Curb JD, Maclean CJ, Vollmer WM, Johnson LR, Fong KO, Rodriguez BL, Masaki KH, Buist AS. Effects of smoking and smoking cessation on longitudinal decline in pulmonary function. Am J Respir Crit Care Med. 1995 Jun;151(6):1778-85. — View Citation

Burchfiel CM, Marcus EB, Sharp DS, Enright PL, Rodriguez BL, Masaki KH, Hwang LJ, Curb JD. Characteristics associated with rapid decline in forced expiratory volume. Ann Epidemiol. 1996 May;6(3):217-27. — View Citation

Burchfiel CM, Reed DM, Marcus EB, Strong JP, Hayashi T. Association of diabetes mellitus with coronary atherosclerosis and myocardial lesions. An autopsy study from the Honolulu Heart Program. Am J Epidemiol. 1993 Jun 15;137(12):1328-40. — View Citation

Burchfiel CM, Reed DM, Strong JP, Sharp DS, Chyou PH, Rodriguez BL. Predictors of myocardial lesions in men with minimal coronary atherosclerosis at autopsy. The Honolulu heart program. Ann Epidemiol. 1996 Mar;6(2):137-46. — View Citation

Burchfiel CM, Sharp DS, Curb JD, Rodriguez BL, Abbott RD, Arakaki R, Yano K. Hyperinsulinemia and cardiovascular disease in elderly men: the Honolulu Heart Program. Arterioscler Thromb Vasc Biol. 1998 Mar;18(3):450-7. — View Citation

Burchfiel CM, Sharp DS, Curb JD, Rodriguez BL, Hwang LJ, Marcus EB, Yano K. Physical activity and incidence of diabetes: the Honolulu Heart Program. Am J Epidemiol. 1995 Feb 15;141(4):360-8. — View Citation

Burchfiel CM, Tracy RE, Chyou PH, Strong JP. Cardiovascular risk factors and hyalinization of renal arterioles at autopsy. The Honolulu Heart Program. Arterioscler Thromb Vasc Biol. 1997 Apr;17(4):760-8. — View Citation

Carter C, McGee D, Reed D, Yano K, Stemmermann G. Hematocrit and the risk of coronary heart disease: the Honolulu Heart Program. Am Heart J. 1983 Apr;105(4):674-9. — View Citation

Carter C, McGee D, Yano K. Morbidity and mortality rates in Okinawan Japanese vs. mainland Japanese: the Honolulu Heart Program. Hum Biol. 1984 May;56(2):339-53. — View Citation

Castelli WP, Cooper GR, Doyle JT, Garcia-Palmieri M, Gordon T, Hames C, Hulley SB, Kagan A, Kuchmak M, McGee D, Vicic WJ. Distribution of triglyceride and total, LDL and HDL cholesterol in several populations: a cooperative lipoprotein phenotyping study. J Chronic Dis. 1977 Mar;30(3):147-69. — View Citation

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Castelli WP, Doyle JT, Gordon T, Hames CG, Hjortland MC, Hulley SB, Kagan A, Zukel WJ. HDL cholesterol and other lipids in coronary heart disease. The cooperative lipoprotein phenotyping study. Circulation. 1977 May;55(5):767-72. — View Citation

Ceria CD, Masaki KH, Rodriguez BL, Chen R, Yano K, Curb JD. The relationship of psychosocial factors to total mortality among older Japanese-American men: the Honolulu Heart Program. J Am Geriatr Soc. 2001 Jun;49(6):725-31. — View Citation

Chyou PH, Burchfiel CM, Yano K, Sharp DS, Rodriguez BL, Curb JD, Nomura AM. Obesity, alcohol consumption, smoking, and mortality. Ann Epidemiol. 1997 May;7(4):311-7. — View Citation

Chyou PH, White LR, Yano K, Sharp DS, Burchfiel CM, Chen R, Rodriguez BL, Curb JD. Pulmonary function measures as predictors and correlates of cognitive functioning in later life. Am J Epidemiol. 1996 Apr 15;143(8):750-6. — View Citation

Coffee consumption and the incidence of coronary heart disease. N Engl J Med. 1987 Apr 9;316(15):945-7. — View Citation

Cohen JB, Reed D. The type A behavior pattern and coronary heart disease among Japanese men in Hawaii. J Behav Med. 1985 Dec;8(4):343-52. — View Citation

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Criqui MH, Langer RD, Reed DM. Dietary alcohol, calcium, and potassium. Independent and combined effects on blood pressure. Circulation. 1989 Sep;80(3):609-14. — View Citation

Curb JD, Abbott RD, MacLean CJ, Rodriguez BL, Burchfiel CM, Sharp DS, Ross GW, Yano K. Age-related changes in stroke risk in men with hypertension and normal blood pressure. Stroke. 1996 May;27(5):819-24. — View Citation

Curb JD, Abbott RD, Rodriguez BL, Masaki K, Chen R, Sharp DS, Tall AR. A prospective study of HDL-C and cholesteryl ester transfer protein gene mutations and the risk of coronary heart disease in the elderly. J Lipid Res. 2004 May;45(5):948-53. Epub 2004 Feb 16. — View Citation

Curb JD, Abbott RD, Rodriguez BL, Masaki KH, Chen R, Popper JS, Petrovitch H, Ross GW, Schatz IJ, Belleau GC, Yano K. High density lipoprotein cholesterol and the risk of stroke in elderly men: the Honolulu heart program. Am J Epidemiol. 2004 Jul 15;160(2):150-7. — View Citation

Curb JD, Abbott RD, Rodriguez BL, Sakkinen P, Popper JS, Yano K, Tracy RP. C-reactive protein and the future risk of thromboembolic stroke in healthy men. Circulation. 2003 Apr 22;107(15):2016-20. Epub 2003 Apr 7. — View Citation

Curb JD, Aluli NE, Huang BJ, Sharp DS, Rodriguez BL, Burchfiel CM, Chiu D. Hypertension in elderly Japanese Americans and adult native Hawaiians. Public Health Rep. 1996;111 Suppl 2:53-5. — View Citation

Curb JD, Marcus EB. Body fat and obesity in Japanese Americans. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1552S-1555S. — View Citation

Curb JD, Masaki K, Rodriguez BL, Abbott RD, Burchfiel CM, Chen R, Petrovitch H, Sharp D, Yano K. Peripheral artery disease and cardiovascular risk factors in the elderly. The Honolulu Heart Program. Arterioscler Thromb Vasc Biol. 1996 Dec;16(12):1495-500. — View Citation

Curb JD, Reed DM, Kautz JA, Yano K. Coffee, caffeine, and serum cholesterol in Japanese men in Hawaii. Am J Epidemiol. 1986 Apr;123(4):648-55. — View Citation

Curb JD, Reed DM, Miller FD, Yano K. Health status and life style in elderly Japanese men with a long life expectancy. J Gerontol. 1990 Sep;45(5):S206-11. — View Citation

Curb JD, Reed DM, Yano K, Kautz JA, Albers JJ. Plasma lipids and lipoproteins in elderly Japanese-American men. J Am Geriatr Soc. 1986 Nov;34(11):773-80. — View Citation

Curb JD, Rodriguez BL, Abbott RD, Petrovitch H, Ross GW, Masaki KH, Foley D, Blanchette PL, Harris T, Chen R, White LR. Longitudinal association of vascular and Alzheimer's dementias, diabetes, and glucose tolerance. Neurology. 1999 Mar 23;52(5):971-5. — View Citation

Curb JD, Rodriguez BL, Burchfiel CM, Abbott RD, Chiu D, Yano K. Sudden death, impaired glucose tolerance, and diabetes in Japanese American men. Circulation. 1995 May 15;91(10):2591-5. — View Citation

Donahue RP, Abbott RD, Bloom E, Reed DM, Yano K. Central obesity and coronary heart disease in men. Lancet. 1987 Apr 11;1(8537):821-4. — View Citation

Donahue RP, Abbott RD, Reed DM, Yano K. Alcohol and hemorrhagic stroke. The Honolulu Heart Program. JAMA. 1986 May 2;255(17):2311-4. — View Citation

Donahue RP, Abbott RD, Reed DM, Yano K. Physical activity and coronary heart disease in middle-aged and elderly men: the Honolulu Heart Program. Am J Public Health. 1988 Jun;78(6):683-5. — View Citation

Donahue RP, Abbott RD, Reed DM, Yano K. Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program. Diabetes. 1987 Jun;36(6):689-92. — View Citation

Edwards KL, Burchfiel CM, Sharp DS, Curb JD, Rodriguez BL, Fujimoto WY, LaCroix AZ, Vitiello MV, Austin MA. Factors of the insulin resistance syndrome in nondiabetic and diabetic elderly Japanese-American men. Am J Epidemiol. 1998 Mar 1;147(5):441-7. — View Citation

Foley DJ, Masaki KH, Ross GW, White LR. Driving cessation in older men with incident dementia. J Am Geriatr Soc. 2000 Aug;48(8):928-30. — View Citation

Foley DJ, Monjan AA, Masaki KH, Enright PL, Quan SF, White LR. Associations of symptoms of sleep apnea with cardiovascular disease, cognitive impairment, and mortality among older Japanese-American men. J Am Geriatr Soc. 1999 May;47(5):524-8. — View Citation

Frank JW, Reed DM, Grove JS, Benfante R. Will lowering population levels of serum cholesterol affect total mortality? Expectations from the Honolulu Heart Program. J Clin Epidemiol. 1992 Apr;45(4):333-46. — View Citation

Galanis DJ, Harris T, Sharp DS, Petrovitch H. Relative weight, weight change, and risk of coronary heart disease in the Honolulu Heart Program. Am J Epidemiol. 1998 Feb 15;147(4):379-86. — View Citation

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Goldberg RJ, Burchfiel CM, Benfante R, Chiu D, Reed DM, Yano K. Lifestyle and biologic factors associated with atherosclerotic disease in middle-aged men. 20-year findings from the Honolulu Heart Program. Arch Intern Med. 1995 Apr 10;155(7):686-94. — View Citation

Goldberg RJ, Burchfiel CM, Reed DM, Wergowske G, Chiu D. A prospective study of the health effects of alcohol consumption in middle-aged and elderly men. The Honolulu Heart Program. Circulation. 1994 Feb;89(2):651-9. — View Citation

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Hakim AA, Curb JD, Burchfiel CM, Rodriguez BL, Sharp DS, Yano K, Abbott RD. Screening for coronary heart disease in elderly men based on current and past cholesterol levels. J Clin Epidemiol. 1999 Dec;52(12):1257-65. — View Citation

Hakim AA, Curb JD, Petrovitch H, Rodriguez BL, Yano K, Ross GW, White LR, Abbott RD. Effects of walking on coronary heart disease in elderly men: the Honolulu Heart Program. Circulation. 1999 Jul 6;100(1):9-13. — View Citation

Hakim AA, Petrovitch H, Burchfiel CM, Ross GW, Rodriguez BL, White LR, Yano K, Curb JD, Abbott RD. Effects of walking on mortality among nonsmoking retired men. N Engl J Med. 1998 Jan 8;338(2):94-9. — View Citation

Hakim AA, Ross GW, Curb JD, Rodriguez BL, Burchfiel CM, Sharp DS, Yano K, Abbott RD. Coffee consumption in hypertensive men in older middle-age and the risk of stroke: the Honolulu Heart Program. J Clin Epidemiol. 1998 Jun;51(6):487-94. — View Citation

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Huang B, Rodriguez BL, Burchfiel CM, Chyou PH, Curb JD, Yano K. Acculturation and prevalence of diabetes among Japanese-American men in Hawaii. Am J Epidemiol. 1996 Oct 1;144(7):674-81. — View Citation

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Iribarren C, Reed DM, Chen R, Yano K, Dwyer JH. Low serum cholesterol and mortality. Which is the cause and which is the effect? Circulation. 1995 Nov 1;92(9):2396-403. — View Citation

Iribarren C, Reed DM, Wergowske G, Burchfiel CM, Dwyer JH. Serum cholesterol level and mortality due to suicide and trauma in the Honolulu Heart Program. Arch Intern Med. 1995 Apr 10;155(7):695-700. — View Citation

Iribarren C, Sharp D, Burchfiel CM, Sun P, Dwyer JH. Association of serum total cholesterol with coronary disease and all-cause mortality: multivariate correction for bias due to measurement error. Am J Epidemiol. 1996 Mar 1;143(5):463-71. — View Citation

Iribarren C, Sharp DS, Burchfiel CM, Petrovitch H. Association of weight loss and weight fluctuation with mortality among Japanese American men. N Engl J Med. 1995 Sep 14;333(11):686-92. — View Citation

Iribarren C, Sharp DS, Curb JD, Yano K. High uric acid: a metabolic marker of coronary heart disease among alcohol abstainers. J Clin Epidemiol. 1996 Jun;49(6):673-8. — View Citation

Joffres M, Reed DM, Nomura AM. Psychosocial processes and cancer incidence among Japanese men in Hawaii. Am J Epidemiol. 1985 Apr;121(4):488-500. — View Citation

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Worth RM, Kagan A. Ascertainment of men of Japanese ancestry in Hawaii through World War II Selective Service registration. J Chronic Dis. 1970 Nov;23(5):389-97. — View Citation

Worth RM, Kato H, Rhoads GG, Kagan K, Syme SL. Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: mortality. Am J Epidemiol. 1975 Dec;102(6):481-90. — View Citation

Yamamoto L, Yano K, Rhoads GG. Characteristics of joggers among Japanese men in Hawaii. Am J Public Health. 1983 Feb;73(2):147-52. — View Citation

Yano K, Blackwelder WC, Kagan A, Rhoads GG, Cohen JB, Marmot MG. Childhood cultural experience and the incidence of coronary heart disease in Hawaii Japanese men. Am J Epidemiol. 1979 Apr;109(4):440-50. — View Citation

Yano K, Grove JS, Chen R, Rodriguez BL, Curb JD, Tracy RP. Plasma fibrinogen as a predictor of total and cause-specific mortality in elderly Japanese-American men. Arterioscler Thromb Vasc Biol. 2001 Jun;21(6):1065-70. — View Citation

Yano K, Grove JS, Masaki KH, White LR, Petrovitch H, Chen R, Teng EL, Ross GW, Rodriguez BL, Curb JD. The effects of childhood residence in Japan and testing language on cognitive performance in late life among Japanese American men in Hawaii. J Am Geriatr Soc. 2000 Feb;48(2):199-204. — View Citation

Yano K, Grove JS, Reed DM, Chun HM. Determinants of the prognosis after a first myocardial infarction in a migrant Japanese population. The Honolulu Heart Program. Circulation. 1993 Dec;88(6):2582-95. — View Citation

Yano K, Kagan A, McGee D, Rhoads GG. Glucose intolerance and nine-year mortality in Japanese men in Hawaii. Am J Med. 1982 Jan;72(1):71-80. — View Citation

Yano K, Kodama K, Shimizu Y, Chyou PH, Sharp DS, Tracy RP, Rodriguez BL, Curb JD, Kusumi S. Plasma fibrinogen and its correlates in elderly Japanese men living in Japan and Hawaii. J Clin Epidemiol. 1999 Dec;52(12):1201-6. — View Citation

Yano K, MacLean CJ, Reed DM, Shimizu Y, Sasaki H, Kodama K, Kato H, Kagan A. A comparison of the 12-year mortality and predictive factors of coronary heart disease among Japanese men in Japan and Hawaii. Am J Epidemiol. 1988 Mar;127(3):476-87. — View Citation

Yano K, MacLean CJ. The incidence and prognosis of unrecognized myocardial infarction in the Honolulu, Hawaii, Heart Program. Arch Intern Med. 1989 Jul;149(7):1528-32. — View Citation

Yano K, McCarthy LJ, Reed DM, Kagan A. Postmortem findings in sudden and non-sudden deaths among Japanese-American men in Hawaii. Am J Med. 1987 Dec;83(6):1037-44. — View Citation

Yano K, McGee D, Reed DM. The impact of elevated blood pressure upon 10-year mortality among Japanese men in Hawaii: the Honolulu Heart Program. J Chronic Dis. 1983;36(8):569-79. — View Citation

Yano K, Peskoe SM, Rhoads GG, Moore JO, Kagan A. Left axis deviation and left anterior hemiblock among 8,000 Japanese-American men. Am J Cardiol. 1975 Jun;35(6):809-15. — View Citation

Yano K, Popper JS, Kagan A, Chyou PH, Grove JS. Epidemiology of stroke among Japanese men in Hawaii during 24 years of follow-up: the Honolulu Heart Program. Health Rep. 1994;6(1):28-38. English, French. — View Citation

Yano K, Reed DM, Curb JD, Hankin JH, Albers JJ. Biological and dietary correlates of plasma lipids and lipoproteins among elderly Japanese men in Hawaii. Arteriosclerosis. 1986 Jul-Aug;6(4):422-33. — View Citation

Yano K, Reed DM, Kagan A. Coronary heart disease, hypertension and stroke among Japanese-American men in Hawaii: the Honolulu Heart Program. Hawaii Med J. 1985 Aug;44(8):297-300, 312. — View Citation

Yano K, Reed DM, MacLean CJ. Serum cholesterol and hemorrhagic stroke in the Honolulu Heart Program. Stroke. 1989 Nov;20(11):1460-5. — View Citation

Yano K, Reed DM, McGee DL. Ten-year incidence of coronary heart disease in the Honolulu Heart Program. Relationship to biologic and lifestyle characteristics. Am J Epidemiol. 1984 May;119(5):653-66. — View Citation

Yano K, Rhoads G, Kagan A. Epidemiology of serum uric acid among 8000 Japanese-American men in Hawaii. J Chronic Dis. 1977 Mar;30(3):171-84. — View Citation

Yano K, Rhoads GG, Kagan A, Tillotson J. Dietary intake and the risk of coronary heart disease in Japanese men living in Hawaii. Am J Clin Nutr. 1978 Jul;31(7):1270-9. — View Citation

Yano K, Rhoads GG, Kagan A. Coffee, alcohol and risk of coronary heart disease among Japanese men living in Hawaii. N Engl J Med. 1977 Aug 25;297(8):405-9. — View Citation

Young DR, Masaki KH, Curb JD. Associations of physical activity with performance-based and self-reported physical functioning in older men: the Honolulu Heart Program. J Am Geriatr Soc. 1995 Aug;43(8):845-54. — View Citation

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