Epidemiology of stroke and coronary artery disease in Asia
1Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. junhata@envmed.med.kyushu-u.ac.jp
Insights
Preventing stroke and coronary artery disease (CAD) in Asia is vital. While blood pressure control and reduced smoking lower stroke risk, managing metabolic factors like hypercholesterolemia is key for CAD prevention.
Area of Science:
- Cardiovascular epidemiology
- Global health
Background:
- Stroke and coronary artery disease (CAD) are leading global causes of mortality.
- Asia's large population necessitates focused prevention strategies for stroke and CAD.
- Mortality patterns differ, with higher stroke than CAD mortality in East Asia, and vice versa in other regions and Western countries.
Purpose of the Study:
- To analyze trends and risk factors for stroke and coronary artery disease (CAD) in Asia.
- To identify key areas for public health interventions in Asian populations.
Main Methods:
- Observational study analysis in Japan examining stroke and CAD incidence over time.
- Review of vital statistics and risk factor prevalence (hypertension, diabetes, hypercholesterolemia, smoking) in Asian and Western populations.
Main Results:
- Stroke incidence declined in Japan due to improved blood pressure control and reduced smoking rates.
- Coronary artery disease (CAD) incidence showed no clear secular change, potentially due to rising glucose intolerance and hypercholesterolemia.
- Asian populations exhibit increasing hypercholesterolemia and high smoking rates among men, despite generally lower baseline cholesterol levels than Western populations.
Conclusions:
- Blood pressure control and smoking cessation are crucial for reducing stroke incidence in Asia.
- Management of metabolic risk factors, particularly hypercholesterolemia and glucose intolerance, is essential for preventing both stroke and CAD in Asian populations.
- Targeted public health initiatives addressing lifestyle and metabolic factors are needed for cardiovascular disease prevention in Asia.
Abstract:
Stroke and coronary artery disease (CAD) are major causes of death throughout the world. As half of the world's population lives in Asian countries, prevention of stroke and CAD in Asia is crucial. According to the vital statistics, East Asian countries have a lower mortality rate for CAD than for stroke. In contrast, CAD is a more common cause of death than stroke in other Asian countries and Western countries. Hypertension, diabetes, hypercholesterolemia, and smoking are major risk factors for stroke and CAD in Asia as well as in Western countries. In an observational study in Japan, the stroke incidence decreased as a result of improvements in blood pressure control and reduction in the smoking rate over the past half century, whereas the CAD incidence did not show a clear secular change, probably because the benefits of blood pressure control and smoking cessation were negated by increasing prevalence of both glucose intolerance and hypercholesterolemia. Although Asian populations have lower serum cholesterol levels than Western populations, the prevalence of hypercholesterolemia has increased during the past half century in Asia. In addition, the smoking rate among Asian men is higher than for Western men. These results underscore that, in addition to blood pressure control, smoking cessation and the management of metabolic risk factors are very important for prevention of stroke and CAD in Asia.
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