EPIDEMIOLOGICAL STUDY ON EFFECTS OF ENVIRONMENTAL AND BEHAVIORAL FACTORS ON CARDIOVASCULAR DISEASES AND ON DISEASE TREND PREDICTION

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Complete surveys were conducted in Akita and Osaka follow-up populations in 1960's, 1970's and 1980's to elucidate age-sex morbidity trends in stroke and coronary heart disease(CHD) and their risk characteristics, and changes in dietary habits with the acculturation to western living and eating patterns due to socio-economic developments. It was shown that effects of environmental and behavioral factors on the occurrence of cardiovascular diseases were clearly different between the older age groups(50y.o. and over) who had not been in the acculturation until the middle age, and the younger age groups(30-49) who had been from the young adult ages.(1)There were a significant decline in mean values of blood pressures and remarkable increase in mean serum total cholesterol(TC) at every age decade between 30 and 69 in both sexes in the Akita rural population. However, TC levels are still lower in the population than in Osaka urban populations. A decline in stroke, especially cerebral hemorrhage(CH) was seen at all age-sex groups. Multiple logistic analysis showed that contributions to CH risk became small for hypertension as a positive risk factor and for TC as a negative one. The positive correlation between hypertension and body mass index (BMI) become significant for men aged 30-39 and 40-49 in 1970's and 1980's whereas it was not in 1960's. Therefore, trends in the prevalence of hypertension associated with obesity should be carefully observed in the younger age groups.(2)In urban populations, blood pressure level were lower, and mean TC and BMI were higher during the past two decades compared with the rural population. There were decreasing trends in stroke incidence and increasing trends in coronary heart disease for men aged 40-59 in clerical and manual wokers so that the incidence rate of CHD became higher than that of stroke.