Less subclinical atherosclerosis in Japanese men in Japan than in white men in the United States in the post-world war II birth cohort

Akira Sekikawa, Hirotsugu Ueshima, Takashi Kadowaki, Aiman El-Saed, Tomonori Okamura, Tomoko Takamiya, Atsunori Kashiwagi, Daniel Edmundowicz, Kiyoshi Murata, Kim Sutton-Tyrrell, Hiroshi Maegawa, Rhobert W. Evans, Yoshikuni Kita, Lewis H. Kuller

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102 Citations (Scopus)

Abstract

Coronary heart disease incidence and mortality remain very low in Japan despite major dietary changes and increases in risk factors that should have resulted in a substantial increase in coronary heart disease rates (Japanese paradox). Primary genetic effects are unlikely, given the substantial increase in coronary heart disease in Japanese migrating to the United States. For men aged 40-49 years, levels of total cholesterol and blood pressure have been similar in Japan and the United States throughout their lifetimes. The authors tested the hypothesis that levels of subclinical atherosclerosis, coronary artery calcification, and intima-media thickness of the carotid artery in men aged 40-49 years are similar in Japan and the United States. They conducted a population-based study of 493 randomly selected men: 250 in Kusatsu City, Shiga, Japan, and 243 White men in Allegheny County, Pennsylvania, in 2002-2005. Compared with the Whites, the Japanese had a less favorable profile regarding many risk factors. The prevalence ratio for the presence of a coronary calcium score of ≥10 for the Japanese compared with the Whites was 0.52 (95% confidence interval: 0.35, 0.76). Mean intima-media thickness was significantly lower in the Japanese (0.616 mm (standard error, 0.005) vs. 0.672 (standard error, 0.005) mm, p < 0.01). Both associations remained significant after adjusting for risk factors. The findings warrant further investigations.

Original languageEnglish
Pages (from-to)617-624
Number of pages8
JournalAmerican Journal of Epidemiology
Volume165
Issue number6
DOIs
Publication statusPublished - 2007 Mar 1
Externally publishedYes

Keywords

  • Atherosclerosis
  • Cohort studies
  • Coronary disease
  • Japan
  • Men
  • Risk factors

ASJC Scopus subject areas

  • Epidemiology

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    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. W., Kita, Y., & Kuller, L. H. (2007). Less subclinical atherosclerosis in Japanese men in Japan than in white men in the United States in the post-world war II birth cohort. American Journal of Epidemiology, 165(6), 617-624. https://doi.org/10.1093/aje/kwk053