Whether coronary heart disease (CHD) is increasing among Japanese population is still a controversial question. A possible approach to help elucidation of this question is determining precisely the incidence of CHD in relation with its risk factor in a defined general population. The Hisayama study is an autopsy-based prospective population survey conducted since 1961 in a rural community in Fukuoka, Japan.
The annual incidence of CHD including myocardial infarction and sudden cardiac deaths (within one hour) was 3.0/1, 000 among those aged 40 year or over during the 23-year follow-up. Risk factors detected by Cox's proportional hazard madel were hypertension, serum total cholesterol, cigarette-smoking and obesity. Incident rates and risk factors of myocardial infarction only for the early cohort of the study (1961-70) were compared with the later cohort (1974-83). While there was no difference in incidence of myocardial infarction between the two cohort populations, serum total cholesterol and obesity had a greater contribution to the increased risk for myocardial infarction in women from the later cohort. These results provide the basis for forecasting further trends in CHD and its risk factors among the Japanese.

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The purpose of this study was to evaluate the relationship between the decline of stroke and mass examination in Taki town, one of the rural districts in Shimane Prefecture where a high mortality rate from stroke had been observed. Taki town instituted a preventive plan for cerebral stroke during 1974-79. Since 1973 integrated annual health examinations for cardiovascular diseases, tuberculosis, and cancers were also being conducted. 752 males and 1, 223 females participated in health examination more than once during 17 years, 35 males and 100 females of whom were followed completely in 1973, 1979, 1983, and 1988. In 1974 registration of stroke cases aged 40-69 years old was initiated. Age-adjusted mortality rates and incidence rates from stroke have seen a decline in males, while for females no change is seen. The mortality and incidence decline from stroke in males was affected by a steep in stroke due to cerebral hemorrhage largely because of improved control of hypertension. In females, rates were unchanged because of increases in the remaining types of stroke for those aged 80 years and over, although cerebral hemorrhage and cerebral infarction declined. A registration system for stroke for those aged 70 years and over appears to be very important. While integrated annual health examinations had an effect on increases in participation-rates and improved control of hypertension by medication for the prevention of stroke, the need for the establishment of a system in which the health examination is followed by effective primary health care is also apparent.

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[in Japanese]

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