title: A report from the 2013 international workshop: radiation and cardiovascular disease, Hiroshima, Japan.
abstract: Two longitudinal cohort studies of Japanese atomic bomb survivors-the life span study (LSS) and the adult health study (AHS)-from the Radiation Effects Research Foundation (RERF) indicate that total body irradiation doses less than 1 Gy are associated with an increased risk of cardiovascular disease (CVD), but several questions about this association remain.In particular, the diversity of heart disease subtypes and the high prevalence of other risk factors complicate the estimates of radiation effects. Subtype-specific analyses with more reliable diagnostic criteria and measurement techniques are needed. The radiation effects on CVD risk are probably tissue-reaction (deterministic) effects, so the dose-response relationships for various subtypes of CVD may be nonlinear and therefore should be explored with several types of statistical models.Subpopulations at high risk need to be identified because effects at lower radiation doses may occur primarily in these susceptible subpopulations. Whether other CVD risk factors modify radiation effects also needs to be determined. Finally, background rates for various subtypes of CVD have historically differed substantially between Japanese and Western populations, so the generalisability to other populations needs to be examined.Cardiovascular disease mechanisms and manifestations may differ between high-dose local irradiation and low-dose total body irradiation (TBI)-microvascular damage and altered metabolism from low-dose TBI, but coronary artery atherosclerosis and thrombotic myocardial infarcts at high localised doses. For TBI, doses to organs other than the heart may be important in pathogenesis of CVD, so data on renal and liver disorders, plaque instability, microvascular damage, metabolic disorders, hypertension and various CVD biomarkers and risk factors are needed. Epidemiological, clinical and experimental studies at doses of less than 1 Gy are necessary to clarify the effects of radiation on CVD risk.
authors.affiliation: Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Hiroshima, Japan.
authors.forename: Ikuno
authors.initials: I
authors.lastname: Takahashi
authors.forename: Waka
authors.initials: W
authors.lastname: Ohishi
authors.forename: Fred A
authors.initials: FA
authors.lastname: Mettler
authors.forename: Kotaro
authors.initials: K
authors.lastname: Ozasa
authors.forename: Peter
authors.initials: P
authors.lastname: Jacob
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Ban
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lipshultz
authors.forename: Fiona Anne
authors.initials: FA
authors.lastname: Stewart
authors.forename: Toru
authors.initials: T
authors.lastname: Nabika
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Niwa
authors.forename: Norio
authors.initials: N
authors.lastname: Takahashi
authors.forename: Masazumi
authors.initials: M
authors.lastname: Akahoshi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kodama
authors.forename: Roy
authors.initials: R
authors.lastname: Shore
mesh_terms: D000328:Adult; D001822:Body Burden; D002318:Cardiovascular Diseases / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D054043:Nuclear Weapons / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000401:mortality*; D011834:Radiation Monitoring / Q000706:statistics & numerical data*; D012307:Risk Factors; D015996:Survival Rate; D017741:Survivors; D014915:Whole-Body Counting / Q000706:statistics & numerical data*