Geographic and Occupational of Risk Factors in Cardiovascular Diseases in Japan

Komachi, Yoshio; Iida, Minoru; Satō, Takashi; Chikayama, Yukio; Takahashi, Hiroshi; Konishi, Masamitsu; Tominaga, Suketami

doi:10.1253/jcj.35.189

Cited by 105 publications

(24 citation statements)

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“…Okubo et al (2000) reported a relationship between the incidence of hypertension and job class. It has also been pointed out that the prevalence of hypertension in managers was higher than that in manual and clerical workers (Komachi et al, 1971). These reports support our results in self-employed women.…”

Section: Discussionsupporting

confidence: 90%

Cardiovascular Risk Factors in a Tourist Town: Association with Job-related Factors.

Nakamura

Kouda

Fan

et al. 2002

J. Physiol. Anthropol.

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Previous studies have shown that mortality from cardiovascular diseases in fishing villages was lower than that in farming villages. In contrast, few reports on the population living in a tourist village have appeared. Then, we report here the characteristic features of a tourist town, and that in fishing and farming towns. The rural farming town in Gunma prefecture had a population of 15100. The population working in the primary industry was 17.1%, and the farming population was 17.0%. The fishing town in Shizuoka prefecture had a population of 11700. The population working in the primary industry was 11.0%, and the fishing population was 10.2%. The rural tourist town in Shizuoka prefecture had a population of 17800. The population working in the tertiary industry was 60.2%, and the wholesaling or retailing population was 16.6%. Standardized mortality ratios of cardiovascular diseases in the tourist town reported by Shizuoka health officials were higher than the fishing town. The rate of participation at ages of 50-59 years for the basic health examination in the tourist town was lower than the fishing and the farming towns. From the results of the health examination of residents at ages of 50-59 years, the high prevalence of obesity and hypertension in men and high prevalence of hypertension in women were found in the tourist town. In the tourist town, self-employed women at ages of 50-59 years had irregular time of meals and insufficient care of diet in comparison with employed women. Furthermore, the prevalence of hypertension in self-employed women was also higher than that of employed women. We could suggest that health status in communities might be associated with job-related factors.

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Section: Discussionsupporting

confidence: 90%

Cardiovascular Risk Factors in a Tourist Town: Association with Job-related Factors.

Nakamura

Kouda

Fan

et al. 2002

J. Physiol. Anthropol.

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“…A low population level of serum total cholesterol due to a low intake of animal foods such as meat, egg, milk and dairy products is another candidate10>. Our epidemiologic observation in rural Japanese, first found an inverse association of serum total cholesterol and the incidence of cerebral hemorrhage 14,19). The inverse association was reported from several other Japanese cohorts8,2u, and from a prospective study of Japanese Americans living in Hawaii22> and from a 6-year follow-up study of over 350,000 American men screened for the Multiple Risk Factor Intervention Trial (MRFIT)25.…”

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confidence: 73%

Cardiovascular Disease Epidemiology of Cerebrovascular Disease : Stroke Epidemic in Japan

Satō

Iso

Iida

et al. 1996

Journal of Epidemiology

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Japan had the highest mortality from stroke among developed countries in 1960, but experienced rapid changes in diet and other lifestyles with economic growth between the 1960s and the 1980s, which provided an unique opportunity to observe a natural experiment of changes in risk factors and stroke. Blood pressure levels declined due to improvements of drug treatment for hypertension and to dietary improvements such as sodium reduction. An increase in mean values of ethanol intake and body mass index did not correspond with a decline of blood pressure levels. Serum total cholesterol increased with an increased intake of meat, egg, milk and dairy products. Age-adjusted mortality rate of stroke declined 70% between 1960 and 1990. The changes of diet, blood pressure levels and stroke were more evident in rural populations than in urban populations.Risk factors of stroke has been investigated prospectively, and hypertension was found to be the most important risk factor. A low blood cholesterol was associated with the increased risk of intracerebral hemorrhage, which has been confirmed in several Japanese populations, Japanese Americans and Caucasian Americans.Thus, a rise in serum cholesterol suggested to contribute in part to a decline in intracerebral hemorrhage. Risk factors for cerebral infarction include age, atrial fibrillation and hypertensive endorgan effects such as resting electrocardiogram and fundscopic examination.A community-based hypertension control program for stroke prevention has been evaluated ; a larger decline in stroke incidence in the intervention community (69%) than in the reference community (49%, the difference : p<0.001).Effective community programs stimulated the formation of the 1982 national act on health and medical care in which every municipal government is required to conduct health screenings and education for residents aged 40 and over to prevent cardiovascular diseases. J Epidemiol, 1996 ; 6 : S43-S47.stroke, blood pressure, serum total cholesterol, fat intake, sodium intake, community program Japan has a higher mortality from stroke and a lower mortality from coronary heart disease than western countries, and stroke rate was the highest among developed countries in 19601.2). The high rate of stroke incidence and mortality was confirmed by a WHO stroke registry3) and autopsy studies 4,5) The epidemic of stroke in Japan has contributed to the development of stroke epidemiology and preventive programs. A major methodology for stroke epidemiology is a prospective study for community residents under stroke prevention programs based on blood pressure control through detection, follow-up and treatment of hypertensives and health education-1o)The combination of observational prospective studies and prevention program has been an practical way to maintain a longterm follow-up for community residents because the support of municipal government can be obtained. Between 1960 and 1990, Japan showed a 70% decline in age-adjusted mortality rate of stroke, and in 1985 ranking 9 to 11 among de...

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“…In Japan, however, some ecological studies compared stroke incidence rates among several defined populations, and showed that the rates were inversely correlated with mean serum cholesterol and fat intake (3,4). Afterwards, some cohort studies indicated that the level of serum cholester ol was inversely associated with the risk of stroke; particularly cerebral hemorrhage and cerebral infarction in perforating artery regions after adjustment for some confounding variables such as sex, age and blood pressure (5)(6)(7).…”

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confidence: 99%

Dietary Lipids and Incidence of Cerebral Infarction in a Japanese Rural Community.

Seino¹,

Date

Nakayama³

et al. 1997

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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SummaryObjective: To assess the relationship between dietary lipids and incidence of cerebral infarction in a Japanese rural population. Design: A cohort study from July 1977 through December 1992. Setting: Akadani-Ijimino (A-I) district, Niigata Prefecture, Japan. Subjects and methods: All the residents, 1,182 men and 1,469 women, aged 40 years and over. Out of these members, 954 men and 1,329 women who were initially free of stroke completed a semiquantitative food frequency ques tionnaire in 1977, and were then subjected to a follow-up for 15.5 years. The occurrence of stroke was determined by the annual follow-up exam ination and registry. Dietary lipid was adjusted for total energy or fat intake by the residual method. Sex and age-stratified and blood pressure and atrial fibrillation-adjusted relative risk for cerebral infarction was estimated by the Cox proportional hazard model. Results: There were 75 new cases of cerebral infarction during the observation period. The relative risk for cerebral infarction was less than one in the highest quartile level of total fat, saturated fatty acids (S), Keys score and west ernized dietary pattern: 0.68-0.94. It ranged between 1.36 and 1.57 in the highest level of polyunsaturated (P), n-3 and n-6 fatty acids, and P/S ratio. Conclusion: This study suggests the possibility that the traditional Japanese diet, very low fat intake, was likely to increase the risk of stroke through the low level of serum cholesterol as an intermediary factor. Key Words dietary lipids, cerebral infarction, cohort study, serum cho lesterol, "diet-stroke" hypothesis According to the "diet-heart" hypothesis (1, 2), a high intake of saturated fatty acids and cholesterol and low intake of polyunsaturated fatty acids increase the 83 84 F. SEINO et al. level of serum cholesterol, and hypercholesterolemia results in the occurrence of coronary heart disease and stroke. In Japan, however, some ecological studies compared stroke incidence rates among several defined populations, and showed that the rates were inversely correlated with mean serum cholesterol and fat intake (3, 4). Afterwards, some cohort studies indicated that the level of serum cholester ol was inversely associated with the risk of stroke; particularly cerebral hemorrhage and cerebral infarction in perforating artery regions after adjustment for some confounding variables such as sex, age and blood pressure (5-7).To date, however, there have been few prospective studies on the relationship between dietary fat and stroke among Japanese in Japan. Using all of the residents aged 40 years and over in Akadani-Ijimino district (hereinafter referred to as A-I district), Shibata City, Niigata Prefecture, Japan, their dietary lipid intakes were assessed by a semiquantitative food frequency questionnaire in July 1977. Those who were initially free of stroke have been subjected to a follow-up ever since. In this report, we deal with the relationship of dietary lipid intake to the subsequent 15.5-year incidence of cerebral infarction which sho...

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Geographic and Occupational of Risk Factors in Cardiovascular Diseases in Japan

Cited by 105 publications

References 0 publications

Cardiovascular Risk Factors in a Tourist Town: Association with Job-related Factors.

Cardiovascular Risk Factors in a Tourist Town: Association with Job-related Factors.

Cardiovascular Disease Epidemiology of Cerebrovascular Disease : Stroke Epidemic in Japan

Dietary Lipids and Incidence of Cerebral Infarction in a Japanese Rural Community.

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