Akira Sekikawa

  • Professor, Director, T32 Cardiovascular Epidemiology Training Program
  • Faculty in Epidemiology

Dr. Sekikawa is a physician from Japan who practiced between 1983 and 1994. Dr. Sekikawa has been trained in epidemiology at the University of Pittsburgh and obtained his second Ph.D. in 1999. Dr. Sekikawa has integrated the findings in Japanese into implications for the US. Japanese in Japan have >67% lower mortality from coronary heart disease than in the US, despite a worse profile of lifetime exposure to many traditional risk factors in Japanese. This observation led Dr. Sekikawa to conduct international epidemiological studies of cardiovascular disease contrasting the US, including Japanese Americans, and Japan (R01 NHLBI 2004-2014). The study revealed that native Japanese have significantly lower levels of atherosclerosis than US Whites, while Japanese Americans had higher levels than white Americans. These observations have led Dr. Sekikawa to investigate the association of cardiovascular disease and atherosclerosis with the Japanese diet.

Having built a strong foundation in cardiovascular and nutritional epidemiologic research, Dr. Sekikawa has recently expanded his research into Alzheimer’s Disease and Related Dementias. His many years of experience in international observational studies have generated innovative hypotheses. Dr. Sekikawa leads a multi-center randomized controlled trial of a dietary supplement unique to the Japanese diet (equol) among 400 older adults without dementia - the ACE trial. This trial tests the hypotheses that equol will slow the progression of arterial stiffness, white matter lesions in the brain, and cognitive decline (R01 NIA 2022-2027).

Dr. Sekikawa serves as a site Principal Investigator for the ACTIV-6 trial. ACTIV-6 is a COVID-19 Outpatient randomized trial to evaluate the efficacy of repurposed medications approved for purposes other than COVID-19 (National Center for Advancing Translational Science 2021023).

T32 Cardiovascular Epidemiology Training Program


1983 | Tohoku University, Sendai, Japan | M.D.
1990 | Yamagata University, Yamagata, Japan | Ph.D.
1996 | University of Pittsburgh, Pittsburgh, PA | MPH
1999 | University of Pittsburgh, Pittsburgh, PA | Ph.D.


EPIDEM 2150 Epidemiology of Cardiovascular Disease (2005 - present) Primary instructor since 2016

EPIDEM 2260 Epidemiological Basis of Disease Control 2021

NHLBI T32 Cardiovascular Training Grant. (2013- present) Director since 2019

EPIDEM 2152 Workshop in Cardiovascular Epidemiology (2013-present) Associate Instructor

EPIDEM 2170 Chronic Disease Epidemiology (2014- 2021) Guest lecturer

EPIDEM 2900 Advanced Epidemiology of Aging (2019, 2021) Guest lecturer


As a primary mentor, I have trained 8 Ph.D. students, 14 master's students, and six post-doctoral fellows.


Selected Publications

Publications in 2019-2022

Zhang, X, Fujiyoshi A, Ahuja V, Vishnu A, Barias-Mitchell E, Kadota A, Miura K, Edmundowics D, Ueshima H,Sekikawa A.Association of equol producing status with aortic calcification in middle-aged Japanese men: The ERA JUMP study. Intl J Cardiol 2022;352:158-64

Zhang X, Veliky CV, Birru RL, Barinas-Mitchell E, Magnani JW, Sekikawa A.Potential Protective Effects of Equol on Coronary Heart Disease – From Molecular Mechanisms to Studies in Human. Nutrients 2021, 13:3739

Cui C, Higashiyama A, Lopresti BJ, Ihara M, Aizenstein HJ, Watanabe M, Chang Y Kakuta C, Yu Z, Mathis CA, Kokubo Y, Fukuda T, Villemegne VL, Klunk WE, Lopez OL, Kuller LH, Miyamoto Y, Sekikawa A. Comparing pathological risk factors for dementia between cognitively normal Japanese and Americans. Brain Sci. 2021;11:1180

Schuchardt, JP, Sasla-Vila A, von Schacky C, Tintle N, Park Y, Monson JE, Mora S, Ramachandran V, Tucker KL, Kleber M, Delgado G, Maerz W, Sekikawa A, Kadota A, Defina LF, Howard BV, Gellet S, Hahn A, Harris WS.Red blood cell fatty acid patterns from 7 countries: Focus on the Omega-3 Index. Prostaglandins, Leukotrienes and Essential Fatty Acids (Accepted)

Kondo K, Arima H, Fujiyoshi A, Sekikawa A, Kadota A, Hisamatsu T, Torii S, Shiino A, Morino K, Miyagawa N, Segawa H, Watanabe Y, Maegawa H, Nozaki K, Miura K, Ueshima H.Differential association of serum n-3 polyunsaturated fatty acids with various cerebrovascular lesions in Japanese men. Cerebrovascular Disease (Accepted)

Sullivan KJ, Ran X, Wu F, Chang CH, Sharma R, Jacobsen E, Berman S, Snitz BE, Sekikawa A, Talbott EO and Ganguli M.Ambient fine particulate matter exposure and incident mild cognitive impairment and dementia. J Am Geriatr Soc. 2021 (Accepted)

Marron MM, Moore SC, Wendell SG, Boudreau RM, Miljkovic I, Sekikawa A, Newman AB. Using lipid profiling to better characterize metabolic differences in apolipoprotein E (APOE) genotype among community-dwelling older Black men. Geroscience. 2021 (Accepted).

Zaid M, Fujiyoshi A, Hisamatsu T, Kadota A, Kadowaki S, Satoh A, Sekikawa A, Barinas-Mitchell E, Horie M, Miura K and Ueshima H.A Comparison of Segment-Specific and Composite Measures of Carotid Intima-Media Thickness and their Relationships with Coronary Calcium. J Atheroscler Thromb. 2021 (Accepted)

Man B, Cui C, Zhang X, Sugiyama D, Barinas-Mitchell E, Sekikawa AThe Effect of Soy Isoflavones on Arterial Stiffness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. European Journal of Nutrition 2021 60:603-14

Sekikawa A, Higashiyama A, Lopresti B, Ihara M, Aizenstein H, Watanabe M, Chang Y, Kakuta C, Yu Z, Mathis C, Kokubo Y, Klunk W, Lopez O, Kuller LH, Miyamoto Y, Cui C.Associations of equol-producing status with white matter lesion and amyloid-� deposition in cognitively normal elderly Japanese Alzheimer & Dementia Translational Research and Clinical Interventions. 2020; 16:1402-11 PMCID PMC7580022

Cui C, Mackey R, Shaaban E, Kuller LH, Lopez O, Sekikawa AAssociation of body composition with incident dementia in older adults: Cardiovascular Health Study-Cognition Study. Alzheimer’s and Dementia 2020; 16:1402-11

Sekikawa A, Cui C, Sugiyama D, Fabio A, Harris WS, Zhang X.Effect of high-dose marine omega-3 fatty acids on atherosclerosis: A systematic review and meta-analysis of randomized clinical trials. Nutrients 2019;11: 2599 PMID 3167524

Mahajan H, Choo J, Masaki K, Fujiyoshi A, Guo J, Evans R, Shangguan S, Willcox B, Barinas-Mitchell E, Kadota A, Miura K, Kuller LH, Shin C, Ueshima H, Sekikawa ASerum long-chain n-3 polyunsaturated fatty acids and aortic calcification in middle-aged men: the population-based cross-sectional ERA JUMP Study. Nutr Metab Cardiovasc Dis 2019 8: 837-46

Sagawa N, Rockette-Wagner B, Azuma K, Ueshima H, Hisamatsu T, Takamiya T, El-Saed A, Miura K, Kriska A, Sekikawa APhysical activity levels in American and Japanese men from the ERA-JUMP Study and associations with metabolic syndrome J Sport Health Science 2020, 9; 170-178

Cui C, Birru R, Snitz B, Ihara M, Lopresti B, Aizenstein H, Lopez O, Mathis C, Miyamoto Y, Kuller LH, Sekikawa AEffects of soy isoflavones on cognitive function: a systematic review and meta-analysis of randomized controlled trials. Nutrition Reviews 2020; 78: 134-144

Satoh A, Arima H, Hozawa A, Ohkubo T, Hisamatsu T, Kadowaki S, Kadota A, Miyagawa N, Zaid M, Torii S, Okamura T, Sekikawa A, Miura K, Ueshima H; SESSA Research Group. The association of home and accurately measured office blood pressure with coronary artery calcification among general Japanese men. J Hypertens 2019; 15: 183-188 PMID 3094824

Sekikawa A, Ihara M, Lopez O, Kakuta C, Lopresti B, Higashiyama A, Aizenstein H, Change YF, Mathis C, Miyamoto Y, Kuller L, Cui C. Effect of S-equol and soy isoflavones on heart and brain. Curr Cardiol Rev 2019; 15: 114-135 PMID 3056108

Cui C, Sekikawa A, Kuller LH, Lopez OL, Newman AB, Kuipers AL, Macheky RH. Aortic stiffness is associated with increased risk of incident dementia in older adults. J Alzh Dis 2018; 66: 297-306 PMID 30282361

Ogata S, Nishimura, K, Guzman-Castillo M, Sumita Y, Nakai M, Nakao YM, Nishi N, Noguchi T, Sekikawa A, Saito Y, Watanabe T, Kobayashi Y, Okamura T, Ogawa H, Yasuda S, Miyamoto Y, Capewell S, O’Flaherty M. Explaining the decline in coronary heart disease mortality rates in Japan: Contributions of changes in risk factors and evidence-based treatments between 1980 and 2012. Intl J Cardiol (Accepted) PMID 30826193

Sekikawa A, Mahajan H, Kadowaki S, Hisamatsu T, Miyagawa N, Fujiyoshi A, Kadota A, Maegawa H, Murata K, Miura K, Edmundowicz D, Ueshima H.Association of blood levels of marine omega-3 fatty acids with coronary calcification and calcium density in Japanese men. Eur J Clin Nutr 2019; 73: 7783-92&nbsp PMID 3050076

Other selected publications from 150+ peer-reviewed articles

Sekikawa A, Miyamoto Y, Miura K, Nishimura K, Willcox BJ, Masaki KH, Rodriguez B, Tracy RP, Okamura T, Kuller LH. Continuous decline in mortality from coronary heart disease in Japan despite a continuous and marked rise in total cholesterol: Japanese experience after the Seven Country Study. Intl J Epidemiol 2015: 44: 1614-24

Sekikawa A, Miura K, Lee S, Fujiyoshi A, Edmundowicz D, Kadowaki T, Evans RW, Kadowaki S, Sutton-Tyrrell K, Okamura T, Bertolet M, Masaki KH, Nakamura Y, Barinas-Mitchell EJM, Willcox BJ, Kadota A, Seto TB, Maegawa H, Kuller LH, Ueshima H for the ERA JUMP Study Group. Long-chain n-3 polyunsaturated fatty acids and incidence rate of coronary artery calcification in Japanese in Japan and United States whites – population-based prospective cohort study. Heart 100(7):569-73. PMID:24352736. PMCID:PMC3949146

Kadowaki S, Miura K, Kadowaki T, Fujiyoshi A, El-Saed A, Masaki KH, Okamura T, Edmundowicz D, Rodriguez BL, Nakamura Y, Barinas-Mitchell EJM, Kadota A, Willcox BJ, Abbott RD, Kuller LH, Choo J, Shin C, Ueshima H, Sekikawa A: ERA JUMP Study Group. International comparison of abdominal fat distribution among four populations: The ERA JUMP Study. Metab Syndr Relat Disord 2018; 16: 166-173

Ahuja V, Miura K, Vishnu A, Fujiyoshi A, Evans R, Zaid M, Miyagawa N, Hisamatsu T, Kadota A, Okamura T, Ueshima H, Sekikawa A. Significant inverse association of equol-producer status with coronary artery calcification but not dietary isoflavones in healthy Japanese men. Br J Nutr. 2017 117(2):260-266, PMID: 28205492

Ahuja V, Kadowaki T, Evans RW, Kadota A, Okamura T, El Koudary S, Fujiyoshi A, Barinas-Mitchell E, HIsamatsu T, Vishnu a, Miura K, Maegawa H, El-Saed A, Kashiwagi A, Kuller LH, Ueshima H, Sekikawa A for the ERA JUMP study. Comparison of HOMA-IR, HOMA-� and disposition index between US white men and Japanese men in Japan; the ERA JUMP study. Diabetologia 2015; 58: 265-71 PMID 25316435


Guo J, Fujiyoshi A, Willcox B, Choo J, Vishnu A, Hisamatsu T, Ahuja V, Takashima N, Barinas-Mitchell E, Kadota A, Evans RW, Miura K, Edmundowicz D, Masaki K, Shin C, Kuller LH, Ueshima H, Sekikawa A; ERA JUMP Study Group. Increased Aortic Calcification Is Associated With Arterial Stiffness Progression in Multiethnic Middle-Aged Men. Hypertension. 2017 Jan;69(1):102-108. Epub 2016 Nov 7. PubMed PMID: 27821619; PubMed Central PMCID: PMC5145727.

Sekikawa A, Willcox BJ, Usui T, Carr JJ, Barinas-Mitchell EJM, Masaki KH, Watanabe M, Tracy RP, Bertolet M, Evans RW, Nishimura K, Sutton-Tyrrell K, Kuller LH, Miyamoto Y. Do differences in risk factors explain the lower rates of coronary heart disease in Japanese versus U.S. women? J Women’s Health 2013; 22: 966-977

Sekikawa A, Willcox BJ, Usui T, Carr JJ, Barinas-Mitchell EJM, Masaki KH, Watanabe M, Tracy RP, Bertolet M, Evans RW, Nishimura K, Sutton-Tyrrell K, Kuller LH, Miyamoto Y. Do differences in risk factors explain the lower rates of coronary heart disease in Japanese versus U.S. women? J Women’s Health 2013; 22: 966-977

Sekikawa A, Shin C, Masaki K, Barinas Mitchell EJ, Hirooka N, Willcox BJ, Choo J, White J, Evans RW, Fijiyoshi A, Okamura T, Miura K, Muldoon MF, Ueshima H, Kuller LH, Sutton-Tyrrell K.Association of Total Marine Fatty Acids, Eicosapentaenoic and Docosahexaenoic Acids, With Aortic Stiffness in Koreans, Whites, and Japanese Americans. Am J Hypertens. 2013; 26: 1321-7

Sekikawa A, Steingrimsdottir L, Ueshima H, Shin C, Curb JD, Evans RW, Hauksdottir AM, Kadota A, Choo J, Masaki K, Thorsson B, Launer LJ, Garcia ME, Maegawa H, Willcox BJ, Eiriksdottir G, Fujiyoshi A, Miura K, Harris TB, Kuller LH, Gudnason V.Serum levels of marine-derived n-3 fatty acids in Icelanders, Japanese, Koreans, and Americans - A descriptive epidemiologic study. Prostaglandins, Leukotrienes & Essential Fatty Acids 2012; 87: 11-6

Sekikawa A, Kadowaki T, El-Saed E, Okamura T, Sutton-Tyrrell K, Nakamura Y, Evans EW, Matsunami K, Edmundowicz D, Nishio Y, Nkata K, Kadota A, Otake T, Miura K, Choo, J, Abbott RD, Kuller LH, Ueshima H. Differential association of docosahexaenoic and eicosapentaenoic acids with carotid intima-media thickness. Stroke 2011; 42:2538-43

Sekikawa A, Kadowaki T, Curb JD, Evans RW, Maegawa H, Abbott RD, Kim Sutton-Tyrrell K, Okamura T, Shin C, Edmundowicz D, Kadota A, Choo J, El-Saed A, Ueshima H, Kuller LHfor the ERA JUMP Study group, Circulating levels of eight cytokines and marine n-3 fatty acids and indices of obesity and in Japanese, white and Japanese American middle-aged men. Cytokine Research 2010; 30: 541-8

Sekikawa A, Curb JD, Ueshima H, El-Saed A, Kadowaki T, Abbott RD, Evans RW, Rodriguez BL, Okamura T, Sutton-Tyrrell K, Nakamura Y, Masaki K, Edmundowicz D, Kashiwagi A, Willcox BJ, Takamiya T, Matsunami K, Seto TB, Murata K, White RL, Kuller LH. Marine-derived n-3 fatty acids and atherosclerosis in Japanese, Japanese Americans, and Whites. J Am Coll Cardiol 2008; 52: 417-24

Sekikawa A, Ueshima H, Sutton-Tyrrell K, Kadowaki T, El-Saed A, Okamura T, Takamiya T, Ueno Y, Evans RW, Nakamura Y, Edmundowicz D, Kashiwagi A, Maegawa H, Kuller LH.Intima-media thickness of the carotid artery and the distribution of lipoprotein subclasses in men aged 40-49 between whites in the U.S. and the Japanese in Japan for the ERA JUMP Study. Metabolism 2008;57:177-82

Sekikawa A, Ueshima H, Kadowaki T, El-Saed A, Okamura T, Takamiya T, Kashiwagi A, Edmundowicz D, Murata K, Sutton-Tyrrell K, Maegawa H, Evans R, Kita Y, Kuller L.Less subclinical atherosclerosis in Japanese men in Japan than in white men in the United States in the post-World-War-II birth cohort Am J Epidemiol 2007; 165: 617-24

Sekikawa A, Horiuchi BY, Edmundowicz D, Ueshima H, Curb JD, Sutton-Tyrrell K, Okamura T, Kadowaki T, Kashiwagi A, Matsunami K, Murata K, Nakamura Y, Rodriguez BL, Kuller LH. A "natural experiment" in cardiovascular epidemiology in the early 21st century. Heart 2003;89: 255-7

Sekikawa A, Satoh T, Hayawaka T, Ueshima H, Kuller LH. Coronary heart disease mortality among men aged 35-44 by prefecture in Japan in 1995-1999 and its comparison with that among white men aged 35-44 by state in the United States in 1995-1998: Vital statistics data in recent birth cohorts. Jpn Circ J 2001;65:887-892

Sekikawa A, Eguchi H, Tominaga M, Igarashi K, Abe T, Manaka H, Sasaki H, Fukuyama H, Kato T, Kihohara Y, Fujishima M. Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in a rural area of Japan, the Funagata diabetes study. J Diab Complications 14: 78-83; 2000

Sekikawa A, Kuller LH, Ueshima H, Park JE, Suh I, Jee SH, Lee HK, Pan WH.Coronary heart disease trends in the post World War II birth cohorts aged 35-44 in men in Japan, South Korea, and Taiwan, and a comparison with the United States. Intl J Epidemiol 28: 1044-49; 1999

Sekikawa A, Tominaga M, Takahashi K, Eguchi H, Igarashi M, Ohnuma H, Sugiyama K, Manaka H, Sasaki H, Fukuyama H, Miyazawa K. Prevalence of Diabetes and Impaired Glucose Tolera nce in Funagata area, Japan. Diabetes Care 16 570-574, 1993