Soshiro Ogata1, Kunihiro Nishimura2, Maria Guzman-Castillo3, Yoko Sumita4, Michikazu Nakai4, Yoko M Nakao5, Nobuo Nishi6, Teruo Noguchi7, Akira Sekikawa8, Yoshihiko Saito9, Taeko Watanabe10, Yasuki Kobayashi11, Tomonori Okamura12, Hisao Ogawa7, Satoshi Yasuda7, Yoshihiro Miyamoto4, Simon Capewell3, Martin O'Flaherty3. 1. Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Japan; Faculty of Nursing, School of Health Science, Fujita Health University, Toyoake, Japan. 2. Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Japan. Electronic address: knishimu@ncvc.go.jp. 3. Department of Public Health and Policy, University of Liverpool, Liverpool, UK. 4. Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Japan. 5. Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Japan. 6. International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan. 7. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan. 8. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA. 9. First Department of Internal Medicine, Nara Medical University, Kashihara, Japan. 10. Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 11. Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 12. Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan.
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/m2), 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.
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/m2), 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.
Authors: David M Cutler; Kaushik Ghosh; Kassandra L Messer; Trivellore Raghunathan; Allison B Rosen; Susan T Stewart Journal: Am Econ Rev Date: 2022-02
Authors: Carmen Arroyo-Quiroz; Martin O'Flaherty; Maria Guzman-Castillo; Simon Capewell; Eduardo Chuquiure-Valenzuela; Carlos Jerjes-Sanchez; Tonatiuh Barrientos-Gutierrez Journal: PLoS One Date: 2020-12-03 Impact factor: 3.240