Control Status of Atherosclerotic Cardiovascular Risk Factors Among Japanese High-Risk Subjects:Analyses of a Japanese Health Check Database from 2008 to 2011

Abstract

Aims: Several guidelines propose target levels (TLs) of atherosclerotic risk factors (ARFs) to reduce atherosclerotic cardiovascular diseases; however, few data are available regarding the attainment statuses of TLs in Japan. In this study, utilizing the data obtained from the annual "Specific Health Check and Guidance in Japan" conducted from 2008 to 2011 (approximately 280,000 subjects each year), we determined TL attainments of ARFs in cardiovascular high-risk subjects. Methods: Those who had suffered from cerebrovascular disease (pCVD) or coronary heart disease (pCHD) or were receiving diabetes mellitus treatment (DM) were selected, and the rates of subjects that attained TLs of blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs) and glycated hemoglobin (HbA1c) were analyzed. Results: Approximately 70% of pCVD or pCHD and 35% of subjects with DM attained TLs of BP. With regard to HbA1c, 90% of pCVD or pCHD and approximately 50% of subjects with DM attained TLs. With regard to LDL-C, 25% of pCHD females and approximately 35% of pCHD males and 50%-55% of subjects with pCVD or DM attained TLs. The TL-attainment rates of HDL-C and TGs were approximately 90% and 75%, respectively, for the three diseases. Analyses of time course changes in their attainment statuses revealed that the attainment rates of BP and LDL-C significantly improved in all the diseases. Conclusions: TL-attainment rates of BP and LDL-C were not as high as those for HDL-C, TGs, and HbA1c; however, they both showed highly significant improvements during the study period.

Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017

“…However, in managing dyslipidemia expressed by hypertriglyceridemia, the non-HDL-C level is more useful than the LDL-C level. This has been reported in a number of studies 177 – 179 , 623 , 624 , 626 , 627 , 647 ) . The standard non-HDL-C level is defined as a value 30 mg/dL higher than LDL-C in NCEP-ATP Ⅲ.…”

“…Thus, controlling the LDL-C level at a target of < 120 mg/dL for high-risk populations in primary prevention appears to be appropriate. However, despite recent efforts to increase the awareness of and familiarity with guidelines, it has been reported that the achievement of the LDL-C management target by high-risk patients with type 2 diabetes, noncardiogenic cerebral infarction, or PAD is still not adequate in Japanese clinical practice 626 , 627 ) .…”

Low fasting plasma glucose level as a predictor of new-onset diabetes mellitus on a large cohort from a Japanese general population

“…This study used data of the annual health check program, “The Specific Health Check and Guidance System” (SHCG) in Japan 22 – 25 , launched by the Ministry of Health, Labour and Welfare (MHLW), Japan in 2008. The target of SHCG was the Japanese general population between the ages of 40 and 74 years, estimated to be 51,919,920.…”

“…This database is the largest nation-wide scale samples with personal data matched over the years. The individual data of the SHCG from 2008 to 2011 had been sent to and verified by an independent data centre, the NPO Japan Clinical Support Unit (Tokyo, Japan) 23 , 25 .…”

Is the Association between Dietary Trans Fatty Acids and Insulin Resistance Remarkable in Japan?

“…In Japan, a recent cohort study demonstrated the significant associations of high-energy intake with allcause and cancer mortality among men, and associations with CHD mortality among men and women 10 ) . Data obtained from the annual “Specific Health Check and Guidance in Japan” showed that target level-attainment rates of blood pressure and LDL-C recommended by the Japanese Society for Hypertension and the Japan Atherosclerosis Society were improved from 2008 to 2011 11 ) . Actually, total risk management that focused on LDL-C, blood pressure, and HbA1c has a beneficial impact on the coronary plaque regression in diabetic patients with acute coronary syndrome 12 ) .…”