Okui Tasuku
Medical Information Center, Kyusyu University Hospital, Fukuoka, Japan.
J Prev Med Public Health. 2020 May;53(3):198-204. doi: 10.3961/jpmph.20.037. Epub 2020 Apr 14.
This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis.
We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases' mortality rates into age, period, and cohort effects.
The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later.
The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.
本研究旨在通过年龄-时期-队列(APC)分析来分析心脏病(HD)、缺血性心脏病(IHD)和脑血管疾病(CeVD)的死亡率。
我们使用了日本1995年至2018年按生命统计确定的心血管疾病死亡率数据。0岁至99岁的年龄组按5年增量定义,队列按每年每个年龄组1年的偏移来定义。我们使用贝叶斯APC分析将疾病死亡率的变化分解为年龄、时期和队列效应。
在分析期间,男性和女性所有疾病的时期效应均下降。对于所有类型的心血管疾病,男性出生于1940年左右至20世纪70年代的队列中,队列效应大幅增加。HD的队列效应在20世纪70年代及以后出生的男性和女性队列中均下降。关于IHD和CeVD,对于20世纪70年代及以后出生的男性队列,确认队列效应要么没有增加要么下降,但对于女性,在20世纪60年代及以后出生的队列中,效应呈持续上升趋势。
IHD和CeVD的队列效应在年轻一代女性中呈上升趋势。这表明需要针对心血管疾病采取预防措施,尤其是针对女性。