Trend of macroangiopathy in diabetics studied by postmortem examination

In recent years, both a numerical and relative increase in the morbidity of cardiovascular and cerebral vascular diseases has been noted in Japanese diabetics. The trend of macroangiopathy in the period between 1953 and 1980 was studied in 210 autopsy cases (Group A: 1953-62, 27 cases, Group B: 1963-72, 43 cases and Group C: 1973-80, 140 cases). The incidence of myocardial infarction and cerebral infarction as a primary cause of death was 25. 9% in Group A, 23.3% in Group B and 37.9% in Group C. From the autopsy findings, the morbidity of cardiovascular disease was 14.8%, 30.2% and 34.3% respectively. In order to elucidate the clinical risk factors, the age at death, duration of diabetes at the time of death, and incidence of hypertension and serum cholesterol in the past history were studied. The percentages of those aged over 70 at death was 18.5%, 23.3% and 42.8% respectively, and those of the cases with durations of more than 10 years was 25.9%, 40.5% and 51.8% respectively. The prevalence of hypertension and hypercholesterolemia was almost identical in each group. From the above, the previous increase in the death-rate due to coronary heart disease and cerebrovascular disease in Japanese diabetics is thought to be attributable to the increasing number of elderly diabetics of long duration.