International Journal of Epidemiology, Vol 28, 1044-1049, Copyright © 1999 by International Epidemiological Association
A Sekikawa, LH Kuller, H Ueshima, JE Park, I Suh, SH Jee, HK Lee and WH Pan
BACKGROUND: Since World War II, people in Japan, South Korea, and Taiwan
have been exposed to a westernized lifestyle. It is most likely that the
post World War II cohorts (1950+) have been more exposed. We hypothesize
that there would be an increase in mortality from coronary heart disease
(CHD) in men aged 35-44 in these countries. METHODS AND RESULTS: Mortality
from CHD in men aged 35-44 in South Korea and Taiwan has recently
increased, and in Japan it has decreased. Mortality from CHD in men aged
35-44 is lower in Japan than in either South Korea or Taiwan, and much
lower than in the US. National sample data and several epidemiological
studies have shown that risk factors for CHD including
hypercholesterolaemia and hypertension in the past decade were not much
different between young adult men in Japan and the US. Based upon these
risk factors, CHD death rates among post World War II cohorts should be
similar in Japan and the US. However, the rates are five times higher in
the US for men aged 35-44. The majority of deaths in the category of
diseases of the heart were from heart failure in men in this age group in
Japan; the mortality from heart failure was about three times higher than
the mortality from CHD. Heart failure was rarely used in men aged 35-44 in
the US. CONCLUSIONS: The continued low mortality rates from CHD in young
men in Japan may be an artifact. It is possible that CHD death rates in
post World War II birth cohort in Japan are similar to US rates.
Coronary heart disease mortality trends in men in the post World War II birth cohorts aged 35-44 in Japan, South Korea and Taiwan compared with the United States
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, USA. akira+@pitt.edu
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