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

本文通过对秋田和大阪人群1960年的S、1970年的S和1980年的S的跟踪调查，阐明了中风和冠心病的年龄-性别发病趋势及其危险特征，以及随着社会经济发展对西方生活和饮食方式的适应而饮食习惯的变化。结果表明，环境因素和行为因素对心血管疾病发生的影响在老年组之间存在明显差异(50岁左右)。(1)秋田农村人口血压均值显著下降，血清总胆固醇(TC)均值在30~69岁各年龄段均显著升高。然而，大阪人口的TC水平仍然低于大阪城市人口。在所有年龄性别的人群中，中风，特别是脑出血(CH)的发病率都有所下降。多因素Logistic回归分析显示，高血压是积极的危险因素，TC是消极的危险因素，对CH风险的贡献变小。在1970年的S和1980年的S，30-39岁和40-49岁的男性高血压与体重指数呈显著正相关，而1960年的S则没有。因此，应密切观察年轻年龄组高血压合并肥胖的患病率趋势。(2)城市人群的血压水平低于农村人群，平均TC和BMI高于农村人群。40~59岁男性职员和体力劳动者卒中发病率呈下降趋势，冠心病发病率呈上升趋势，冠心病发病率高于卒中。

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.