Ueshima H, Tatara K, Asakura S
Am J Epidemiol. 1987 Jan;125(1):62-72. doi: 10.1093/oxfordjournals.aje.a114512.
Mortality from ischemic heart disease has declined in Japan since 1970. This paper addresses the declining mortality from ischemic heart disease and the possible contributing factors for 1956-1980. Mortality figures were obtained from Vital Statistics reports by the Ministry of Health and Welfare in Japan. National trends in blood pressure levels, prevalence of hypertension, Keys' lipid factor phi instead of the serum cholesterol level, and body mass index were obtained from the National Nutrition Survey which is carried out annually from random samples in Japan. The smoking rate which was obtained from other national surveys was also reviewed for this purpose. The age-adjusted (30-69 years) mortality from ischemic heart disease declined by 24% and 37% for men and women, respectively, between 1968 and 1978. It seemed that the decline in blood pressure levels and in the prevalence of hypertension and the increasing treatment rate for cardiovascular disease might contribute to the declining mortality from ischemic heart disease. The decline in cigarette smoking may, in part, also play a role. On the other hand, the increase in intake of lipids which resulted in Keys' lipid factor phi was compatible with the increase in mortality from ischemic heart disease during 1956-1970. The experience in Japan shows that the treatment of hypertension or the lowering of blood pressure and the recommendation to stop smoking help to prevent ischemic heart disease.
自1970年以来，日本缺血性心脏病的死亡率有所下降。本文探讨了1956 - 1980年期间缺血性心脏病死亡率下降的情况及其可能的影响因素。死亡率数据来自日本厚生省的人口动态统计报告。血压水平、高血压患病率、用基斯脂质因子φ而非血清胆固醇水平以及体重指数的全国趋势数据，取自日本每年对随机样本进行的全国营养调查。为此目的，还查阅了从其他全国性调查中获得的吸烟率数据。1968年至1978年间，年龄调整后（30 - 69岁）的缺血性心脏病死亡率，男性和女性分别下降了24%和37%。血压水平和高血压患病率的下降以及心血管疾病治疗率的提高，似乎是缺血性心脏病死亡率下降的原因。吸烟率的下降在一定程度上可能也起到了作用。另一方面，导致基斯脂质因子φ上升的脂质摄入量增加，与1956 - 1970年期间缺血性心脏病死亡率的上升是相符的。日本的经验表明，高血压治疗或血压降低以及戒烟建议有助于预防缺血性心脏病。
