Changing pattern of cardiovascular disease in the Japanese population in relation to hypertension control programs.

The changing pattern of cardiovascular disease during the last 30 years in Japan is described. The most striking change was a reduction in deaths caused by hypertensive cerebral hemorrhage. There was no increase in ischemic heart disease in the rural area studied but such a trend was shown in the urban area. A change in risk factors for cardiovascular disease, reduction in blood pressure, and increase in serum cholesterol were more marked in the rural than the urban area. Institution of a hypertension control program and marked changes in lifestyle, including diet, could explain the relatively rapid change in the frequency and the type of cardiovascular disease, particularly cerebral stroke. The prevention of atherosclerotic complications such as cerebral infarction and ischemic heart disease is becoming a more important task in preventive cardiology.