[Mathematical Models for Evidence-Based Primary Prevention Policy of Cerebrovascular and Cardiovascular Disease : An...

Cardiovascular diseases, including stroke and coronary heart disease (CHD), remain the leading causes of mortality in Japan. Although age-standardized mortality rates have declined, population aging has likely resulted in higher crude mortality rates and an increased absolute number of deaths. To provide quantitative policy evidence, we apply two modeling approaches: the Bayesian age-period-cohort (BAPC) model and the IMPACT_NCD-JPN microsimulation model. The BAPC model projects mortality trends until 2040 by incorporating age, period, and cohort effects using Bayesian inference, offering probabilistic forecasts that capture uncertainty. These results suggest a gradual national decline in stroke and CHD deaths, while highlighting persistent regional disparities that may be linked to salt intake and lipid levels. IMPACT_NCD-JPN quantified the contributions of changes in risk factors and showed that improvements in blood pressure control and smoking reduction substantially prevented cardiovascular events and deaths between 2001 and 2019. Together, these models clarify not only "how much mortality will decline" but also "how to achieve further reductions" through risk factor interventions. Their integration enables scenario-based evaluation of prevention strategies, medical resource planning, and cost-effectiveness. This evidence-based framework can strengthen the Japanese National Plan for the Promotion of Measures Against Cerebrovascular and Cardiovascular Diseases and illustrate the value of combining predictive and explanatory modeling for future health policies.