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Risk factor effects and total mortality in older Japanese men in Japan and Hawaii
Robert D Abbott1, Hirotsugu Ueshima, Atsushi Hozawa
1Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VA 22908-0717, USA. rda3e@virginia.edu
Insights
Japanese men in Japan experienced higher mortality than those in Hawaii, primarily due to higher rates of cigarette smoking and hypertension. These lifestyle factors explain the increased risk of death in Japan.
Area of Science:
- Gerontology
- Epidemiology
- Cardiovascular Disease
Background:
- Investigating mortality differences in Japanese men across geographic locations is crucial for understanding health disparities.
- Genetic similarities between Japanese populations in Japan and Hawaii allow for focused study on environmental and lifestyle factors.
Purpose of the Study:
- To identify factors associated with total mortality in older Japanese men residing in Japan and Hawaii.
- To compare the prevalence of cardiovascular disease risk factors between these two cohorts.
Main Methods:
- A longitudinal study involving 1379 men in Hawaii and 954 men in Japan, aged 61-81 years.
- Mortality follow-up was conducted over a 19-year period.
- Baseline data collected between 1980 and 1982.
Main Results:
- Hawaiian men showed higher rates of diabetes (2-fold) and coronary heart disease (4-fold) compared to Japanese men.
- Japanese men had higher systolic blood pressure and were three times more likely to smoke cigarettes.
- Despite differing risk factor profiles, men in Japan had a 1.4-fold higher risk of death, with blood pressure and smoking explaining this excess.
Conclusions:
- Cigarette smoking and hypertension are key factors driving the excess mortality observed in Japan compared to Hawaii.
- Japanese populations exhibit similar susceptibility to adverse health conditions, regardless of location.
- Environmental and lifestyle modifications are critical for reducing mortality risk in these cohorts.
Purpose:
We sought to identify factors related to total mortality in older Japanese men in Japan and Hawaii.
Methods:
Baseline data were collected from 1980 to 1982 in 1379 men in Hawaii and 954 men in Japan. Ages ranged from 61 to 81 years, with mortality follow-up during a 19-year period.
Results:
Compared with Japan, men in Hawaii had a 2-fold excess of diabetes and a 4-fold excess of prevalent coronary heart disease (P < .001). Total cholesterol and body mass index were also greater in Hawaiian men (P < .001). In contrast, men in Japan had greater systolic blood pressure and were nearly 3 times more likely to smoke cigarettes (P < .001). Although each cohort had elements of a poor risk factor profile, there was a 1.4-fold excess in the risk of death in Japan (49.4 vs. 36.2/1,000 person-years, P < .001). Although mortality was similar after risk factor adjustment, only blood pressure and cigarette smoking accounted for the higher risk of death in Japan.
Conclusions:
Cigarette smoking and hypertension explain much of the excess mortality in Japan versus Hawaii. In this comparison of genetically similar cohorts, evidence further suggests that Japanese in Japan are equally susceptible to develop the same adverse risk factor conditions that exist in Hawaii.
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