研究者詳細 - 岡村　智教

論文 - 岡村　智教

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Serum ghrelin levels are higher in Caucasian men than Japanese men aged 40-49 years

Matsunaga-Irie S., Ueshima H., Zaky W. R., Kadowaki T., Evans R. W., Okamura T., Takamiya T., Kita Y., Kuller L. H., Sekikawa Akira

Diabetes, Obesity and Metabolism 9 （ 4 ） 591 - 593 2007年07月

ISSN 1462-8902

Background: Ghrelin, a 28-amino-acid gastric peptide hormone, has an appetite-stimulating effect and controls the energy balance. Serum ghrelin levels inversely correlate with body mass index. Recently, several papers reported the ethnic difference in the ghrelin levels. To our knowledge, however, no studies have compared the serum ghrelin levels between Caucasians in the USA and the Japanese in Japan. Methods: We conducted a cross-sectional study of 189 men 40-49 years of age (91 US Caucasians in the U.S. and 98 Japanese in Japan) to examine serum ghrelin levels and metabolic and other factors. Results: Serum ghrelin levels correlated with waist circumferences and lipid profiles among Caucasian Americans and the Japanese. Serum ghrelin levels were significantly higher among Caucasian Americans than among the Japanese (904.5 (632.0, 1132.0) pg/mL, 508.0 (399.0, 1378.3) pg/mL (median and 95% confidence interval), respectively, P < 0.01), although Caucasian Americans were much more obese (BMI: 26.9 ± 3.3 kg/m² versus 23.3 ± 3.1 kg/m² respectively, P < 0.01). The ethnic difference remained after adjusting for metabolic factors, smoking status, and other factors (P < 0.01). Conclusions: We have shown in our population-based study that serum ghrelin levels among men aged 40-49 are significantly higher in Caucasian Americans than in the Japanese in Japan. Reasons for the ethnic difference in the ghrelin levels are largely unknown and warrant further investigation. © 2006 Blackwell Publishing Ltd.

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Lifestyle and work predictors of fatigue in Japanese manufacturing workers

Yamazaki Shin, Fukuhara Shunichi, Suzukamo Yoshimi, Morita Satoshi, Okamura Tomonori, Tanaka Taichiro, Ueshima Hirotsugu

Occupational Medicine 57 （ 4 ） 262 - 269 2007年06月

ISSN 0962-7480

Background: Fatigue is one of the most common symptoms encountered in medical practice. However, little is known about the causal relationship between change in lifestyle and fatigue. Aim: To help prevent fatigue-related disorders, we investigated the association between changes in lifestyle and fatigue among employees. Methods: We studied data sets from the High-risk and Population Strategy for Occupational Health Promotion study for employees at 10 workplaces in Japan. The baseline survey was done in 1999 and the follow-up survey in 2003 via a questionnaire which examined lifestyle and fatigue variables using the vitality domain scale of the SF-36 Health Survey. The lifestyle factors focused on were diet, smoking and alcohol habits and working conditions. Four-year changes in lifestyle that predicted the vitality domain score in the follow-up survey were examined by analysis of covariance. Results: Of the 6284 participants in the baseline survey, 4507 replied to the follow-up survey, of whom 3498, with a mean age of 37 (SD 18) years, returned valid responses. A low vitality score at follow-up was predicted by a change in lifestyle factors such as an increase in overtime work, change to non-sedentary work and increased frequency of eating between meals (P < 0.01, P < 0.01 and P = 0.02, respectively). Conclusion: Fatigue in salaried workers as measured by the vitality domain of the SF-36 is predicted by an increase in overtime work, change to non-sedentary work and an increase in the frequency of eating between meals. © The Author 2007. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved.

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Does self-reported history of hypertension predict cardiovascular death? Comparison with blood pressure measurement in a 19-year prospective study

Higashiyama Aya, Murakami Yoshitaka, Hozawa Atsushi, Okamura Tomonori, Hayakawa Takehito, Kadowaki Takashi, Kita Yoshikuni, Okayama Akira, Ueshima Hirotsugu

Journal of Hypertension 25 （ 5 ） 959 - 964 2007年05月

ISSN 0263-6352

OBJECTIVES: Hypertension as assessed by blood pressure (BP) measurement is one of the most important risk factors for cardiovascular diseases (CVD). Self-reported history of hypertension (self-reported HT) is an easy way to obtain information on BP and is known to have a certain sensitivity and high specificity for hypertension confirmed by BP measurement (confirmative HT). Thus, it might predict CVD mortality, but few studies have reported on this relationship. METHODS: We followed 6427 participants aged 30-59 years without a history of CVD for 19 years. The multivariate-adjusted hazard ratio (HR) of CVD mortality was estimated by the Cox proportional hazard model. RESULTS: The sensitivity and specificity of self-reported HT for confirmative HT were 52-65% and 95%, respectively. The multivariate-adjusted HR of self-reported HT for CVD death was 2.49 [95% confidence interval (CI) = 1.72-3.61]. Compared to participants with neither self-reported HT nor confirmative HT, those with confirmative HT showed a consistently higher HR for CVD mortality. Self-reported HT without confirmative HT was also significantly related to CVD mortality (HR = 2.10, 95% CI = 1.04-4.26). These tendencies were unchanged when we further adjusted for systolic BP (SBP) level. The age-adjusted mortality rate of individuals with self-reported HT corresponded to the age-adjusted mortality rate of individuals whose SBP was 160-179 mmHg. CONCLUSION: Self-reported HT could screen one-half of the participants for confirmative HT and was significantly associated with CVD mortality. These results indicate that self-reported HT can be a useful tool to screen for individuals with high BP if it is difficult to perform BP measurements continuously among all members of a community. © 2007 Lippincott Williams & Wilkins, Inc.

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Relationship between metabolic risk factor clustering and cardiovascular mortality stratified by high blood glucose and obesity

Kadota Aya, Hozawa Atsushi, Okamura Tomonori, Kadowak Takashi, Nakmaura Koshi, Murakami Yoshitaka, Hayakawa Takehito, Kita Yoshikuni, Okayama Akira, Nakamura Yasuyuki, Kashiwagi Atsunori, Ueshima Hirotsugu

Diabetes Care 30 （ 6 ） 1533 - 1538 2007年05月

ISSN 0149-5992

OBJECTIVE - Metabolic syndrome is diagnosed according to several criteria. Of these, some require glucose intolerance and others require obesity for the diagnosis. We investigated the relationship between metabolic risk factor clustering and cardiovascular disease (CVD) mortality stratified by high blood glucose or obesity. RESEARCH DESIGN AND METHODS - We followed 7,219 Japanese men and women without a history of CVD for 9.6 years. We defined high blood pressure, high blood glucose, high triglycerides, low HDL cholesterol, and obesity as metabolic factors. The multivariate adjusted hazard ratio (HR) for CVD mortality according to the number of clustering metabolic factors was calculated using the Cox proportional hazards model. RESULTS - During follow-up, 173 participants died of CVD. The numbers of metabolic risk factors and CVD mortality were positively correlated (P_trend = 0.07). The HR was obviously higher among participants with than among those without high blood glucose and clustering of ≥2 other metabolic risk factors (HR 3.67 [95% CI 1.49-9.03]). However, the risk increase was only modest in participants without high blood glucose even if they had ≥2 other metabolic risk factors (1.99 [0.93-4.28]). Conversely, metabolic risk factor clustering was related to CVD mortality irrespective of obesity. CONCLUSIONS - Our findings suggest that glucose tolerance plays an important role in CVD mortality. Because the prevalence of nonobese participants with several metabolic risk factors was quite high and their CVD risk was high, excluding them from the diagnosis of metabolic syndrome because of the absence of obesity might overlook their risk. © 2007 by the American Diabetes Association.

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Life expectancy among Japanese of different smoking status in Japan

Murakami Yoshitaka, Ueshima Hirotsugu, Okamura Tomonori, Kadowaki Takashi, Hozawa Atsushi, Kita Yoshikuni, Hayakawa Takehito, Okayama Akira

Journal of Epidemiology 17 （ 2 ） 31 - 37 2007年04月

ISSN 0917-5040

Background: The life expectancy is an important measure for describing health status among population. Several studies from the United States and Europe showed the harm of smoking by describing the life expectancies with different smoking status. No such study is examined in Japan, the country with the world's highest life expectancy irrespective of high smoking rate among men. Methods: The abridged life table method was applied to calculate the life expectancies of men and women among different smoking status from age 40 until age 85. Age-specific mortality rates stratified by different smoking status were obtained from follow-up data from random sample in Japanese population (NIPPON DATA80). Results: Proportion of current smokers was 62.9% in men and 8.8% in women at the baseline survey in 1980. The life expectancies of 40-year-old never smokers, ex-smokers and current smokers were 42.1, 40.4, and 38.6 years in men and 45.6, 45.9, and 43.4 years in women. The life expectancy of 40-year-old men who smoked less than one pack per day was 39.0 and was longer than that of those who smoked one or two packs (38.8) and more than two packs (38.1). Conclusion: Life expectancy decreased gradually as the grade of smoking increased in the Japanese population. Copyright © 2007 by Japan Epidemiological Association.

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Both angiotensinogen M235T and α-adducin G460W polymorphisms are associated with hypertension in the Japanese population

Nakamura Y., Tabara Y., Miki T., Tamaki S., Kita Y., Okamura T., Ueshima H.

Journal of Human Hypertension 21 （ 3 ） 253 - 255 2007年03月

ISSN 0950-9240

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Medical costs of individuals with proteinuria

Nakamura Koshi, Okamura Tomonori, Kanda Hideyuki, Hayakawa Takehito, Okayama Akira, Ueshima Hirotsugu

Public Health 121 （ 3 ） 174 - 176 2007年03月

ISSN 0033-3506

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The association between high-density lipoprotein cholesterol level and cholesteryl ester transfer protein TaqIB gene polymorphism is influenced by alcohol drinking in a population-based sample

Tsujita Yasuyuki, Nakamura Yasuyuki, Zhang Qishan, Tamaki Shinji, Nozaki Akihiko, Amamoto Kenji, Kadowaki Takashi, Kita Yoshikuni, Okamura Tomonori, Horie Minoru, Ueshima Hirotsugu

Atherosclerosis 191 （ 1 ） 199 - 205 2007年03月

ISSN 0021-9150

Cholesteryl ester transfer protein (CETP) is a key enzyme in high-density lipoprotein (HDL) cholesterol metabolism. We studied the association between CETP TaqIB polymorphism and the HDL cholesterol levels considering environmental factors in a population-based sample consisting of 1729 participants who did not use lipid-lowering agents (659 men and 1070 women). The CETP TaqIB genotypes were determined by PCR-RFLP analysis. The serum HDL cholesterol levels of female participants with the B2B2 genotype were significantly higher than those with other genotypes (p < 0.001). Multiple regression analysis with covariates such as age, waist to hip (W/H) ratio, alcohol drinking, current smoking, non-HDL cholesterol, and logarithm of triglyceride revealed that the CETP TaqIB genotype was an independent determinant of HDL cholesterol levels in men (p = 0.049) and women (p < 0.001). Subgroup analysis revealed that an interaction was observed between the CETP TaqIB polymorphism and alcohol consumption in the regulation of HDL cholesterol levels in men (p = 0.049) and women (p = 0.022). No interactions were observed between the CETP TaqIB polymorphism and current smoking status, body mass index, or W/H ratio in the regulation of HDL cholesterol levels. The association between the CETP TaqIB polymorphism and HDL cholesterol levels was more evident in alcohol consumers than in non-drinkers. © 2006 Elsevier Ireland Ltd. All rights reserved.

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Less subclinical atherosclerosis in Japanese men in Japan than in white men in the United States in the post-world war II birth cohort

Sekikawa Akira, Ueshima Hirotsugu, Kadowaki Takashi, El-Saed Aiman, Okamura Tomonori, Takamiya Tomoko, Kashiwagi Atsunori, Edmundowicz Daniel, Murata Kiyoshi, Sutton-Tyrrell Kim, Maegawa Hiroshi, Evans Rhobert W., Kita Yoshikuni, Kuller Lewis H.

American Journal of Epidemiology 165 （ 6 ） 617 - 624 2007年03月

ISSN 0002-9262

Coronary heart disease incidence and mortality remain very low in Japan despite major dietary changes and increases in risk factors that should have resulted in a substantial increase in coronary heart disease rates (Japanese paradox). Primary genetic effects are unlikely, given the substantial increase in coronary heart disease in Japanese migrating to the United States. For men aged 40-49 years, levels of total cholesterol and blood pressure have been similar in Japan and the United States throughout their lifetimes. The authors tested the hypothesis that levels of subclinical atherosclerosis, coronary artery calcification, and intima-media thickness of the carotid artery in men aged 40-49 years are similar in Japan and the United States. They conducted a population-based study of 493 randomly selected men: 250 in Kusatsu City, Shiga, Japan, and 243 White men in Allegheny County, Pennsylvania, in 2002-2005. Compared with the Whites, the Japanese had a less favorable profile regarding many risk factors. The prevalence ratio for the presence of a coronary calcium score of ≥10 for the Japanese compared with the Whites was 0.52 (95% confidence interval: 0.35, 0.76). Mean intima-media thickness was significantly lower in the Japanese (0.616 mm (standard error, 0.005) vs. 0.672 (standard error, 0.005) mm, p < 0.01). Both associations remained significant after adjusting for risk factors. The findings warrant further investigations. Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved.

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Hypertension and medical expenses

Nakamura Koshi, Okamura Tomonori, Ueshima Hirotsugu

Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine 96 （ 1 ） 101 - 105 2007年01月

ISSN 0021-5384

Relation of adult height with stroke mortality in Japan NIPPON DATA80

Hozawa Atsushi, Murakami Yoshitaka, Okamura Tomonori, Kadowaki Takashi, Nakamura Koshi, Hayakawa Takehito, Kita Yoshikuni, Nakamura Yasuyuki, Okayama Akira, Ueshima Hirotsugu, Okamura T., Kadowaki T., Hayakawa T., Kita Y., Okayama A., Ueshima H.

Stroke 38 （ 1 ） 22 - 26 2007年01月

ISSN 0039-2499

BACKGROUND AND PURPOSE - The age-adjusted stroke mortality rate in Japan was the highest in the world from 1950 to the 1970s, but it started to dramatically decrease after 1965. In addition to improved management of high blood pressure, the increase in average height might also contribute to this reduction. The present study investigates whether height is an independent risk for stroke mortality in Japan. METHODS - Among participants of the National Survey on Cardiovascular Diseases in 1980 who were randomly selected from the Japanese population, we followed up 3969 and 4955 Japanese men and women without prior cardiovascular disease for a maximum of 19 years and observed 158 and 132 stroke deaths. RESULTS - Height was inversely correlated with age and with crude stroke mortality. The relationship was attenuated in men when we adjusted for age or other possible confounders (multivariate adjusted relative hazards of a 5-cm increase of height for stroke mortality: 0.92, 95% CI: 0.79 to 1.08). For women, the inverse relationship (relative hazard: 0.77: 95% CI: 0.64 to 0.91) remained after multivariate adjustment. These relationships persisted when we stratified participants by age. CONCLUSIONS - Height is inversely related to stroke mortality and the relationship is statistically significant among Japanese women. © 2007 American Heart Association, Inc.

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The relationship between serum total cholesterol and all-cause or cause-specific mortality in a 17.3-year study of a Japanese cohort

Okamura Tomonori, Tanaka Hideo, Miyamatsu Naomi, Hayakawa Takehito, Kadowaki Takashi, Kita Yoshikuni, Nakamura Yasuyuki, Okayama Akira, Ueshima Hirotsugu

Atherosclerosis 190 （ 1 ） 216 - 223 2007年01月

ISSN 0021-9150

No study has shown a positive relationship between hypercholesterolemia and all-cause mortality in the Japanese population. Therefore, a cohort study of 17.3 years' duration was conducted on 9216 participants aged 30 years or older, selected randomly from throughout Japan. In both the lowest (<4.14 mmol/L, 160 mg/dl) and highest (≥6.71 mmol/L, 260 mg/dl) total cholesterol (TC) groups, there was a positive association between TC and risk of all-cause mortality (hazard ratio (HR) 1.19; 95% confidence interval (CI), 1.03-1.37 and 1.36 (95% CI, 1.05-1.77), respectively). The lowest TC group had an increased risk of liver disease (HR 3.03; 95% CI, 1.70-5.43), whereas the highest TC group had an increased risk of coronary heart disease (HR 3.81; 95% CI, 1.70-5.43). After exclusion of deaths due to liver disease during the entire follow-up period and all-cause deaths within the first 5 years of follow-up, the increased HR in the lowest TC group disappeared (HR 1.05; 95% CI, 0.89-1.24). Although the cut-off point seemed to be higher than that for Western populations, hypercholesterolemia was shown to be positively associated with all-cause mortality in Japan. © 2006 Elsevier Ireland Ltd. All rights reserved.

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Associations of obesity measures with metabolic risk factors in a community-based population in Japan

Nakamura Yasuyuki, Turin Tanvir C., Kita Yoshikuni, Tamaki Shinji, Tsujita Yasuyuki, Kadowaki Takashi, Murakami Yoshitaka, Okamura Tomonori, Ueshima Hirotsugu

Circulation Journal 71 （ 5 ） 776 - 781 2007年

ISSN 1346-9843

Background: The association of obesity measures (ie, body mass index (BMI), waist circumference (WC) and waist-to hip ratio (WHR)) with metabolic risk factors in community-based populations has not been well studied. Methods and Results: In the present study 759 men and 1,255 women aged between 30 and 79 years, without histories of stroke or coronary heart diseases, were dichotomized at the medians of BMI-WHR, WC-WHR and BMI-WC. The accumulation of 4 metabolic risk factors (risk _ sum) were examined: high blood pressure (≥130/85 mmHg or on antihypertensive therapy); high triglycerides (≥170 mg/dl); low high-density lipoprotein-cholesterol (<40 mg/dl); and impaired glucose tolerance (hemoglobin A1c ≥5.6% or on antidiabetic therapy). BMI and WC correlated well in both men (r=0.871) and women (r=0.874). All 3 obesity measures related with the metabolic risk factors. The area under the receiver-operating characteristic curve for BMI, WC and WHR to predict the risk sum ≥2 for men was 0.683, 0.709, and 0.700, respectively, and 0.715, 0.739, and 0.746, respectively, for women. Conclusions: BMI may be used instead of WC if the latter is not available. When WC is measured, hip circumference also should be measured because the WHR may be the most valuable measure of obesity.

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Mortality risk attributable to atrial fibrillation in middle-aged and elderly people in the Japanese general population - Nineteen-year follow-up in NIPPON DATA80

Ohsawa Masaki, Okayama Akira, Okamura Tomonori, Itai Kazuyoshi, Nakamura Motoyuki, Tanno Kozo, Kato Karen, Yaegashi Yumi, Onoda Toshiyuki, Sakata Kiyomi, Ueshima Hirotsugu

Circulation Journal 71 （ 6 ） 814 - 819 2007年

ISSN 1346-9843

Background: The extent to which atrial fibrillation (AF) contributes to mortality in the Japanese general population has not been clarified. Methods and Results: A randomly sampled general population from all over Japan (4,154 men, 5,329 women; age ≥30 years) was enrolled. Single electrocardiogram recordings were taken in the baseline survey. Stroke death, cardiovascular deaths and all-cause deaths during the subsequent 19 years were analyzed by the presence of AF at baseline. Cox's regression analysis was carried out to estimate the hazard ratios (HRs) of each cause of death attributable to AF after adjusting for other risk factors. Prevalence of AF was 0.64% in the study. The observed person-years were 162,980 among persons without AF and 699 among persons with AF. There were 1,919 deaths. Multivariate adjusted HRs for stroke death, cardiovascular death and all-cause death were 2.69, 2.76 and 1.88, respectively (p<0.05). These HRs were 14.7, 9.63 and 4.00 among persons aged 64 years or younger (p<0.05). Conclusion: AF affects stroke mortality, cardiovascular mortality and all-cause mortality in the Japanese general population. Careful attention should be paid to persons with AF in order to prevent future cardiovascular events.

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Discussion

Crabb David W., Yin Shih Jiun, Apte Minoti V., Emery Peter, Preedy Victor R., Peter Eriksson C. J., Salaspuro Mikko, Quertemont Etienne, Deitrich Richard A., Okamura Tomonori

63 - 68 2007年

Effect of combined cardiovascular risk factors on individual and population medical expenditures - A 10-year cohort study of National Health Insurance in a Japanese population

Okamura Tomonori, Nakamura Koshi, Kanda Hideyuki, Hayakawa Takehito, Hozawa Atsushi, Murakami Yoshitaka, Kadowaki Takashi, Kita Yoshikuni, Okayama Akira, Ueshima Hirotsugu

Circulation Journal 71 （ 6 ） 807 - 813 2007年

ISSN 1346-9843

Background: Although obesity is required for some criteria defining metabolic syndrome, clustering of other risk factors also indicates an increased risk of cardiovascular disease. Whether the relationship between cardiovascular risk factor clustering and medical expenditures differs with body mass index (BMI) requires investigation, especially in a population with a low prevalence of obesity such as that in Japan. Methods and Results: A 10-year cohort study of 4,478 Japanese National Health Insurance beneficiaries aged 40-69 years in a community between 1990 and 2001 was carried out in the present study. The clustering of cardiovascular risk factors showed a positive and graded relationship to personal medical expenditures in participants who are overweight (BMI ≥25.0) and normal weight (BMI <25.0). The individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and overweight than for those without these factors (26,782 vs 15,377 Japanese yen). Differences in the geometric means were similarly significant after adjustment for other confounding factors. However, the excess medical expenditures by risk clustering of normal weight categories within the total medical expenditures were higher than those of overweight categories because more participants were of normal weight. Conclusions: Cardiovascular risk factor clustering and being overweight can be a useful predictor of medical expenditures in a Japanese population.

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Cardiovascular risk clustering with obesity

Okamura Tomonori

Circulation Journal 71 （ 10 ） 1667 2007年

ISSN 1346-9843

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Discussion

Seitz Helmut K., Deitrich Richard A., Peter Eriksson C. J., Apte Minoti V., Preedy Victor R., Morris John B., Albano Emanuele, Worrall Simon, Emery Peter, Ren Jun, Crabb David W., Salaspuro Mikko, Quertemont Etienne, Thornalley Paul J., Rao Radhakrishna K., Aranda Agustin, Okamura Tomonori, Shukla Shivendra D., Niemelä Onni, Jamal Mostofa

40 - 51 2007年

Discussion

Preedy Victor R., Peter Eriksson C. J., Morris John B., Salaspuro Mikko, Emery Peter, Thornalley Paul J., Seitz Helmut K., Rao Radhakrishna K., Worrall Simon, Apte Minoti V., Okamura Tomonori, Yin Shih Jiun

256 - 260 2007年

White blood cell count and risk of all-cause and cardiovascular mortality in nationwide sample of Japanese - Results from the NIPPON DATA90

Tamakoshi Koji, Toyoshima Hideaki, Yatsuya Hiroshi, Matsushita Kunihiro, Okamura Tomonori, Hayakawa Takehito, Okayama Akira, Ueshima Hirotsugu

Circulation Journal 71 （ 4 ） 479 - 485 2007年

ISSN 1346-9843

Background: The association of white blood cell (WBC) count with all-cause and cardiovascular disease (CVD) mortality were examined in the National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged (NIPPON DATA) 90. Methods and Results: A total of 6,756 Japanese residents (2,773 men and 3,983 women) throughout Japan without a history of CVD were followed for 9.6 years. A Cox proportional hazards regression model was used to estimate the relative risk (RR) and 95% confidence interval (CI). We documented 576 deaths with 161 deaths from CVD. Overall, after adjusting for several confounders including age, sex, body mass index at baseline, smoking status, alcohol consumption, regular exercise, diastlic blood pressure, total cholesterol, high-density lipoprotein-cholesterol and hemoglobin A1c, a graded association between WBC count and higher risk of allcause mortality was observed (WBC of 9,000-10,000 cells/mm³ vs WBC of 4,000-4,900: RR =1.61, 95% CI: 1.07-2.40, p for trend=0.02). Elevated WBC count was almost significantly associated with high risk of CVD mortality (WBC of 9,000-10,000 vs WBC of 4,000-4,900: RR=1.79, 95% CI: 0.97-3.71). These associations strengthened among women. Stratified by smoking status, never-smokers with WBC counts of 9,000-10,000 had a 3.2 fold elevated risk for CVD death compared with those with WBC counts of 4,000-4,900. Conclusions: The WBC count may have potential as a predictor for all-cause mortality, particularly CVD mortality.

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