Evidence map›Paper›PMID 41003451›Full record

ArticleJACC. Asia2026

Constipation and Incident Cardiovascular Disease: A Nationwide, Real-World Cohort Study.

Keiichiro Iwasaki, Kentaro Ejiri, Hidehiro Kaneko, Yuta Suzuki, Toru Miyoshi, Satoshi Taya, Takuro Masuda, Yoichi Takaya, Satoshi Akagi, Akira Okada and 6 more

Abstract read
In one paragraph

Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Keiichiro IwasakiDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Kentaro EjiriDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. Electronic address: kejiri1@s.okayama-u.ac.jp.
Hidehiro KanekoDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.
Yuta SuzukiDepartment of Advanced Cardiology, The University of Tokyo, Tokyo, Japan; Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan.
Toru MiyoshiDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Satoshi TayaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Takuro MasudaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Yoichi TakayaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Satoshi AkagiDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Akira OkadaDepartment of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Katsuhito FujiuDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.
Norifumi TakedaDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Hiroyuki MoritaDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Hideo YasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Norihiko TakedaDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Shinsuke YuasaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe association of constipation with incident cardiovascular disease (CVD) has been suggested; however, there are few studies including general population and assessing whether constipation can improve the predictive performance for future CVD.

objectivesThis study aims to quantify the association of constipation with the risk and attribution of developing CVD using a nationwide epidemiological database in Japan.

methodsIn 1,516,763 individuals without prior CVD from the DeSC database between April 2014 and November 2022, constipation was defined by International Classification of Diseases-10th revision code before the initial health checkup. We assessed the association of constipation with incident CVDs including myocardial infarction (MI), angina pectoris, stroke, heart failure (HF), atrial fibrillation (AF), and a composite of them using multivariable Cox models.

resultsConstipation was observed in 186,448 individuals (12.3%), showing a significant association with composite and each CVD, particularly with HF (HR: 1.30; 95% CI: 1.29-1.32 and HR: 1.32; 95% CI: 1.29-1.34, respectively). Followed by hypertension, constipation was the second highest population attributable fractions for the composite CVD, stroke, HF, and AF. Adding constipation to the established risk factors showed a modest but significant improvement in the prediction for the CVDs (net reclassification improvement for composite CVD: 0.122; 95% CI: 0.116-0.127; P < 0.001).

conclusionsIn individuals without prior CVD, constipation was associated with incident CVDs including myocardial infarction, angina pectoris, stroke, HF, and AF. Constipation may be promising for the prediction of future CVD other than established risk factors, suggesting the importance of constipation not just as a quality-of-life issue but as a potential cardiovascular risk in the general population.

Indexed as

cardiovascular diseaseconstipationheart failuremyocardial infarctionstroke

Identifiers

PMID41003451
PMCPMC13491088

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.