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Risk factors for ischemic heart disease in an urban area of Japan: a case-control study in AMHTS
H Kashihara1, H Ohno, M Tamura
1PL Tokyo Health Care Center, Japan. kashy@pl-tokyo-kenkan.gr.jp
Insights
Risk factors for myocardial infarction (MI) in Japanese males mirror Western patterns, including total cholesterol. Fasting blood sugar is a key predictor for angina pectoris (AP).
Area of Science:
- Cardiovascular Epidemiology
- Preventive Cardiology
- Public Health
Background:
- Debate exists regarding the applicability of Western ischemic heart disease (IHD) risk factors to Japanese populations.
- Understanding urban Japanese male-specific IHD risk factors is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate and clarify the risk factors for ischemic heart disease (IHD) in males residing in an urban Japanese setting.
- To compare identified risk factors with those established in Western countries.
Main Methods:
- A case-control study design was employed, utilizing data from an automated multiphasic health testing and services (AMHTS) system.
- Cases were individuals diagnosed with IHD post-health check-up (1987-1994); controls were matched individuals without IHD.
- Health data were analyzed at three time points: 11 years, 6 years, and immediately prior to disease onset.
Main Results:
- Eleven years pre-onset: Total cholesterol (T-Chol) for myocardial infarction (MI); fasting blood sugar (FBS) for angina pectoris (AP).
- Six years pre-onset: T-Chol, ECG findings, and palpitations/breathlessness for MI; FBS and palpitations/breathlessness for AP.
- Just before onset: T-Chol, chest pain, FBS, smoking index, and hypertension for MI; palpitations/breathlessness, ECG, chest pain, systolic blood pressure, and ESR for AP.
Conclusions:
- The risk factors identified for MI in urban Japanese males align with those observed in Western populations.
- Fasting blood sugar emerges as the most significant risk factor for angina pectoris (AP) in this demographic.
Objectives:
In Japan controversy exists as to whether or not the risk factors for ischemic heart disease (IHD) are the same as in western countries. We conducted a case-control study on IHD to clarify the risk factors in males in an urban area of Japan using our automated multiphasic health testing and services (AMHTS) system.
Method:
Cases were the clients who took the health check-up between January 1987 and July 1994 and had onset of IHD after the check-up. For each case five clients were selected as controls by conditional matching. The check-up data were compared between cases and controls 11 years, 6 years and just before the onset of the heart diseases.
Results:
The statistically significant items were as follows: (1) Eleven years before the onset: Total cholesterol (T-Chol) for myocardial infarction (MI), and fasting blood sugar (FBS) for angina pectoris (AP). (2) Six years before the onset: T-Chol, electrocardiographic (ECG) findings and the complaint of palpitation or breathlessness for MI, and FBS and palpitation or breathlessness for AP. (3) Just before the onset: T-Chol, the complaint of chest pain, FBS, smoking index and hypertensive status for MI and palpitation or breathlessness, ECG findings, chest pain, systolic blood pressure and erythrocyte sedimentation rate at 60 minutes for AP. In conclusion, the risk factors for MI in males in an urban area of Japan are the same as in western countries. The most significant risk factor for AP in males in an urban area of Japan is fasting blood sugar.