Circulation, Vol 79, 503-515, Copyright © 1989 by American Heart Association
T Shimamoto, Y Komachi, H Inada, M Doi, H Iso, S Sato, A Kitamura, M Iida, M Konishi and N Nakanishi
Disease surveillance and population surveys of risk characteristics in a
northeast rural community of Japan (1965 census population, 7,030) are
combined in an attempt to relate morbidity and risk factor trends for
coronary heart disease and stroke during the last 2 decades. Between 1964
and 1983, the incidence of coronary heart disease (i.e., combined
myocardial infarction, angina pectoris, and sudden death) did not change
significantly among men and women ages 40-69, and was lower than that for
stroke. The incidence of all stroke declined about 60% for both men and
women, ages 40-69, with a significant decrease in cerebral hemorrhage for
both sexes and in cerebral infarction for men. Between 1963-1966 and
1980-1983, significant upward shifts occurred in the means and
distributions of serum total cholesterol and serum total protein in every
age and sex group, primarily during the 1st decade. Age-adjusted mean
cholesterol levels rose 22 mg/dl to the 1980-1983 mean of 179 mg/dl in men
ages 40-69. In women ages 40-69, the mean rose 29 mg/dl to 192 mg/dl. Among
nutrients, animal fat intake doubled in men ages 40-59 from 4.5% of daily
calories in 1969 to 9.6% in 1980- 1983. Animal protein intake also
increased, from 5.8% to 7.1%. Most of this increase occurred between 1969
and 1972-1975 and may be attributable to an increased intake of meat, eggs
and dairy products. From 1963-1966 to 1980-1983, mean relative weight index
rose significantly for all age-sex groups except men ages 50-69. Mean
systolic and diastolic blood pressure levels declined for every age-sex
group, with a 15-mm Hg age-adjusted decrease in systolic, 4-mm Hg decrease
in diastolic pressure among men ages 40-69, and a 11-mm Hg systolic and
4-mm Hg diastolic decrease for women. Two cohorts of men and women ages
40-69 at baseline were followed for disease incidence: an early cohort
(2,257 persons) followed from 1963-1966 to 1973 and a later cohort (2,711
persons) followed from 1972-1975 to 1983. In these cohorts, significant
risk prediction for cerebral hemorrhage and infarction was obtained with
blood pressure level and end organ effects in the electrocardiogram and
fundus photographs. Serum cholesterol was inversely associated with
cerebral hemorrhage in the early cohort but not in the later.(ABSTRACT
TRUNCATED AT 400 WORDS)
ARTICLES
Trends for coronary heart disease and stroke and their risk factors in Japan
Institute of Community Medicine, University of Tsukuba, Ibaraki-ken, Japan.
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