Abstract
Background: We aimed to quantify contributions of changes in risks and uptake of evidence-based treatment to coronary heart disease (CHD) mortality trends in Japan between 1980 and 2012. Methods: We conducted a modelling study for the general population of Japan aged 35 to 84 years using the validated IMPACT model incorporating data sources like Vital Statistics. The main outcome was difference in the number of observed and expected CHD deaths in 2012. Results: From 1980 to 2012, age-adjusted CHD mortality rates in Japan fell by 61%, resulting in 75,700 fewer CHD deaths in 2012 than if the age and sex-specific mortality rates had remained unchanged. Approximately 56% (95% uncertainty interval [UI]: 54–59%) of the CHD mortality decrease, corresponding to 42,300 (40,900–44,700) fewer CHD deaths, was attributable to medical and surgical treatments. Approximately 35% (28–41%) of the mortality fall corresponding to 26,300 (21,200–31,000) fewer CHD deaths, was attributable to risk factor changes in the population, 24% (20–29%) corresponding to 18,400 (15,100–21,900) fewer and 11% (8–14%) corresponding to 8400 (60,500–10,600) fewer from decreased systolic blood pressure (8.87 mm Hg) and smoking prevalence (14.0%). However, increased levels of cholesterol (0.28 mmol/L), body mass index (BMI) (0.68 kg/m 2 ), and diabetes prevalence (1.6%) attenuated the decrease in mortality by 2% (1–3%), 3% (2–3%), and 4% (1–6%), respectively. Conclusions: Japan should continue their control policies for blood pressure and tobacco, and build a strategy to control BMI, diabetes, and cholesterol levels to prevent further CHD deaths.
| Original language | English |
|---|---|
| Journal | International Journal of Cardiology |
| DOIs | |
| Publication status | Published - 2019 Jan 1 |
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Keywords
- Coronary heart disease
- Mortality
- Population of Japan
- Risk factors
- Treatment
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
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. / Ogata, Soshiro; Nishimura, Kunihiro; Guzman-Castillo, Maria; Sumita, Yoko; Nakai, Michikazu; Nakao, Yoko M.; Nishi, Nobuo; Noguchi, Teruo; Sekikawa, Akira; Saito, Yoshihiko; Watanabe, Taeko; Kobayashi, Yasuki; Okamura, Tomonori; Ogawa, Hisao; Yasuda, Satoshi; Miyamoto, Yoshihiro; Capewell, Simon; O'Flaherty, Martin.
In: International Journal of Cardiology, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Explaining the decline in coronary heart disease mortality rates in Japan
T2 - Contributions of changes in risk factors and evidence-based treatments between 1980 and 2012
AU - Ogata, Soshiro
AU - Nishimura, Kunihiro
AU - Guzman-Castillo, Maria
AU - Sumita, Yoko
AU - Nakai, Michikazu
AU - Nakao, Yoko M.
AU - Nishi, Nobuo
AU - Noguchi, Teruo
AU - Sekikawa, Akira
AU - Saito, Yoshihiko
AU - Watanabe, Taeko
AU - Kobayashi, Yasuki
AU - Okamura, Tomonori
AU - Ogawa, Hisao
AU - Yasuda, Satoshi
AU - Miyamoto, Yoshihiro
AU - Capewell, Simon
AU - O'Flaherty, Martin
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: We aimed to quantify contributions of changes in risks and uptake of evidence-based treatment to coronary heart disease (CHD) mortality trends in Japan between 1980 and 2012. Methods: We conducted a modelling study for the general population of Japan aged 35 to 84 years using the validated IMPACT model incorporating data sources like Vital Statistics. The main outcome was difference in the number of observed and expected CHD deaths in 2012. Results: From 1980 to 2012, age-adjusted CHD mortality rates in Japan fell by 61%, resulting in 75,700 fewer CHD deaths in 2012 than if the age and sex-specific mortality rates had remained unchanged. Approximately 56% (95% uncertainty interval [UI]: 54–59%) of the CHD mortality decrease, corresponding to 42,300 (40,900–44,700) fewer CHD deaths, was attributable to medical and surgical treatments. Approximately 35% (28–41%) of the mortality fall corresponding to 26,300 (21,200–31,000) fewer CHD deaths, was attributable to risk factor changes in the population, 24% (20–29%) corresponding to 18,400 (15,100–21,900) fewer and 11% (8–14%) corresponding to 8400 (60,500–10,600) fewer from decreased systolic blood pressure (8.87 mm Hg) and smoking prevalence (14.0%). However, increased levels of cholesterol (0.28 mmol/L), body mass index (BMI) (0.68 kg/m 2 ), and diabetes prevalence (1.6%) attenuated the decrease in mortality by 2% (1–3%), 3% (2–3%), and 4% (1–6%), respectively. Conclusions: Japan should continue their control policies for blood pressure and tobacco, and build a strategy to control BMI, diabetes, and cholesterol levels to prevent further CHD deaths.
AB - Background: We aimed to quantify contributions of changes in risks and uptake of evidence-based treatment to coronary heart disease (CHD) mortality trends in Japan between 1980 and 2012. Methods: We conducted a modelling study for the general population of Japan aged 35 to 84 years using the validated IMPACT model incorporating data sources like Vital Statistics. The main outcome was difference in the number of observed and expected CHD deaths in 2012. Results: From 1980 to 2012, age-adjusted CHD mortality rates in Japan fell by 61%, resulting in 75,700 fewer CHD deaths in 2012 than if the age and sex-specific mortality rates had remained unchanged. Approximately 56% (95% uncertainty interval [UI]: 54–59%) of the CHD mortality decrease, corresponding to 42,300 (40,900–44,700) fewer CHD deaths, was attributable to medical and surgical treatments. Approximately 35% (28–41%) of the mortality fall corresponding to 26,300 (21,200–31,000) fewer CHD deaths, was attributable to risk factor changes in the population, 24% (20–29%) corresponding to 18,400 (15,100–21,900) fewer and 11% (8–14%) corresponding to 8400 (60,500–10,600) fewer from decreased systolic blood pressure (8.87 mm Hg) and smoking prevalence (14.0%). However, increased levels of cholesterol (0.28 mmol/L), body mass index (BMI) (0.68 kg/m 2 ), and diabetes prevalence (1.6%) attenuated the decrease in mortality by 2% (1–3%), 3% (2–3%), and 4% (1–6%), respectively. Conclusions: Japan should continue their control policies for blood pressure and tobacco, and build a strategy to control BMI, diabetes, and cholesterol levels to prevent further CHD deaths.
KW - Coronary heart disease
KW - Mortality
KW - Population of Japan
KW - Risk factors
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85062089035&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062089035&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2019.02.022
DO - 10.1016/j.ijcard.2019.02.022
M3 - Article
C2 - 30826193
AN - SCOPUS:85062089035
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -