title: Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950-2003.
abstract: OBJECTIVE
  To investigate the degree to which ionising radiation confers risk of mortality from heart disease and stroke.
  
  
  METHODS
  Prospective cohort study with more than 50 years of follow-up.
  
  
  METHODS
  Atomic bomb survivors in Hiroshima and Nagasaki, Japan.
  
  
  METHODS
  86 611 Life Span Study cohort members with individually estimated radiation doses from 0 to >3 Gy (86% received <0.2 Gy).
  
  
  METHODS
  Mortality from stroke or heart disease as the underlying cause of death and dose-response relations with atomic bomb radiation.
  
  
  RESULTS
  About 9600 participants died of stroke and 8400 died of heart disease between 1950 and 2003. For stroke, the estimated excess relative risk per gray was 9% (95% confidence interval 1% to 17%, P=0.02) on the basis of a linear dose-response model, but an indication of possible upward curvature suggested relatively little risk at low doses. For heart disease, the estimated excess relative risk per gray was 14% (6% to 23%, P<0.001); a linear model provided the best fit, suggesting excess risk even at lower doses. However, the dose-response effect over the restricted dose range of 0 to 0.5 Gy was not significant. Prospective data on smoking, alcohol intake, education, occupation, obesity, and diabetes had almost no impact on the radiation risk estimates for either stroke or heart disease, and misdiagnosis of cancers as circulatory diseases could not account for the associations seen.
  
  
  CONCLUSIONS
  Doses above 0.5 Gy are associated with an elevated risk of both stroke and heart disease, but the degree of risk at lower doses is unclear. Stroke and heart disease together account for about one third as many radiation associated excess deaths as do cancers among atomic bomb survivors.
authors.affiliation: Department of Epidemiology, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan. shimizu@rerf.or.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kodama
authors.forename: Nobuo
authors.initials: N
authors.lastname: Nishi
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Kasagi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Suyama
authors.forename: Midori
authors.initials: M
authors.lastname: Soda
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Grant
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Ritsu
authors.initials: R
authors.lastname: Sakata
authors.forename: Hiroko
authors.initials: H
authors.lastname: Moriwaki
authors.forename: Mikiko
authors.initials: M
authors.lastname: Hayashi
authors.forename: Manami
authors.initials: M
authors.lastname: Konda
authors.forename: Roy E
authors.initials: RE
authors.lastname: Shore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009689:Nuclear Warfare; D054043:Nuclear Weapons; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000401:mortality*; D020521:Stroke / Q000401:mortality*; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult