Abstract WP192: Secular Trends in the Incidence, Mortality and Survival Rates of Cardiovascular Disease in a General Japanese Population: the Hisayama Study, 1961-2009

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Jun Hata ◽  
Toshiharu Ninomiya ◽  
Yasufumi Doi ◽  
Yoichiro Hirakawa ◽  
Masayo Fukuhara ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Survival Rates ◽  
The Past ◽  
Past Half Century ◽  
Incidence And Mortality ◽  
Clear Change ◽  
Past Half

Background: Changes in lifestyle and advances in medical technology during the past half century have been likely to affect the incidence and mortality of cardiovascular diseases and the prevalence of their risk factors in Japan. Methods: We established 5 cohorts consisting of residents of the town of Hisayama, Fukuoka, Japan, aged 40 years or older without a history of cardiovascular disease in 1961, 1974, 1983, 1993, and 2002. Each cohort was followed up for 7 years. Results: The age-adjusted incidence and mortality rates of ischemic stroke decreased significantly in men and women over the past half century. These decreasing trends were the greatest in the earlier period (from the 1960s to the 1970s) and slowed down in the recent period (from the 1980s to the 2000s). The incidence and mortality of intracerebral hemorrhage decreased significantly in men but not in women. The incidence and mortality of coronary heart disease decreased in women, but did not show a clear change in men. Five-year survival rates of stroke and acute myocardial infarction increased significantly with time. While the prevalence of hypertension did not show a drastic secular change, the proportion of individuals with antihypertensive treatment increased consistently, and mean systolic and diastolic blood pressures among hypertensive participants significantly decreased over the study period. On the other hand, the prevalence of glucose intolerance, hypercholesterolemia, and obesity increased steeply. Conclusions: The incidence and mortality rates of ischemic stroke in both sexes, intracerebral hemorrhage in men, and coronary heart disease in women decreased significantly, probably owing to better management of hypertension. However, the decreasing trends in ischemic stroke slowed down recently and there was no clear change for coronary heart disease in men, probably because the benefits of hypertension control were negated by increasing prevalence of metabolic risk factors. In addition to strict control of hypertension, urgent management of metabolic disorders is needed for further prevention of cardiovascular disease in Japan.

scholarly journals Tailored Interventions to Improve Medication Adherence for Cardiovascular Diseases

2020 ◽  
Vol 11 ◽  
Author(s):  
Hai-Yan Xu ◽  
Yong-Ju Yu ◽  
Qian-Hui Zhang ◽  
Hou-Yuan Hu ◽  
Min Li
Keyword(s):  
Cardiovascular Disease ◽  
Medication Adherence ◽  
Cardiovascular Diseases ◽  
Healthcare Costs ◽  
Therapeutic Effects ◽  
Improve Medication Adherence ◽  
The Past ◽  
Tailored Interventions ◽  
Past Half Century ◽  
Past Half

Over the past half-century, medical research on cardiovascular disease (CVD) has achieved a great deal; however, medication adherence is unsatisfactory. Nearly 50% of patients do not follow prescriptions when taking medications, which limits the ability to maximize their therapeutic effects and results in adverse clinical outcomes and high healthcare costs. Furthermore, the effects of medication adherence interventions are disappointing, and tailored interventions have been proposed as an appropriate way to improve medication adherence. To rethink and reconstruct methods of improving medication adherence for CVD, the literature on tailored interventions for medication adherence focusing on CVD within the last 5 years is retrieved and reviewed. Focusing on identifying nonadherent patients, detecting barriers to medication adherence, delivering clinical interventions, and constructing theories, this article reviews the present state of tailored interventions for medication adherence in CVD and also rethinks the present difficulties and suggests avenues for future development.

Rheumatic Fever, ed. 2 (vol. II in the series Major Problems in Clinical Pediatrics), by Milton Markowitz, M.D., and Leon Gordis, M.D., Dr.P.H. Philadelphia/London/Toronto: W. B. Saunders, 1972, 309 pp., $11.50

PEDIATRICS ◽  
1973 ◽  
Vol 51 (6) ◽  
pp. 1117-1118
Author(s):  
Benedict F. Massell
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Half Century ◽  
The Past ◽  
Past Half Century ◽  
And Control ◽  
Past Half ◽  
Rheumatic Heart

Although a number of texts devoted to special aspects of rheumatic fever have appeared within the past half century, Milton Markowitz, first in the 1965 edition with Ann Kuttner and now in an updated and amplified edition with Leon Gordis, has provided the first objective and comprehensive monograph on this disease since 1924, when Carey Coombs's Rheumatic Heart Disease was published. In view of the advances in our knowledge of the etiology and control of rheumatic fever that have been made since the days of Carey Coombs, this monograph by Markowitz and Gordis answers a long felt need.

Cardiovascular disease and trace metals

1979 ◽  
Vol 205 (1158) ◽  
pp. 135-143 ◽  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Trace Metals ◽  
Developed Countries ◽  
Environmental Lead ◽  
The Past ◽  
Cadmium And Lead

Cardiovascular disease is a major cause of morbidity and mortality in the U. K. and other developed countries. In the U. K., mortality from coronary heart disease has increased progressively over the past 25 years, particularly in males. This paper examines the possible role of trace metals in the development of cardiovascular disease, with particular reference to the effects of cobalt, cadmium and lead in myocardial disease, atherosclerosis and hypertension. It is concluded that cobalt is an unimportant factor in community levels of cardiovascular disease, that cadmium has striking effects on blood pressure in animals and that there is some evidence for an association between environmental lead and high blood pressure.

Risk of coronary heart disease and ischemic stroke in thyroid cancer patients taking levothyroxine.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 105-105 ◽  
Author(s):  
Dong Wook Shin ◽  
Beomseok Suh ◽  
Jae Moon Yoon ◽  
Youngmin Park
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Thyroid Cancer ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Cancer Patients ◽  
Cox Proportional Hazards ◽  
Health Insurance Data ◽  
Tsh Suppression

105 Background: Many thyroid cancer patients are exposed to long-term TSH suppression, in many cases as lifetime treatment, and are consequently subjected to risk for cardiovascular disease. We investigated incidence of CHD and ischemic stroke among thyroid cancer patients and explored possible pathophysiological mechanisms involved. Methods: A total of 182,419 subjects who received thyroidectomy for thyroid cancer during 2004-2012 were selected from the Korean National Health Insurance data, which covers approximately 97% of the entire Korean population. Propensity score matching was used to select non-cancer controls. Cox proportional hazards regression analysis was used to determine relative risk of coronary heart disease (CHD), and ischemic stroke. Mean follow-up was 4.32 years. Results: Thyroid cancer patients had elevated risk for CHD and ischemic stroke with HR 1.15 (95% CI 1.10-1.22), and 1.15 (1.09-1.22), respectively. This risk was marked in those who received total thyroidectomy and in those who took higher dosage of levothyroxine (HR 1.47, 95% CI 1.34-1.60 for CHD and HR 1.56, 95% CI 1.42-1.72 for ischemic stroke among those who took ≥ 170mcg/d). Atrial fibrillation risk was dose-dependently associated with levothyroxine dosage; however, once patients developed atrial fibrillation, ischemic stroke risk was not significantly greater in those who took higher dosage. Conclusions: The risk for CHD and ischemic stroke was higher in thyroid cancer patients who received thyroidectomy, and the dosage of levothyroxine administered appears to play a major role. More caution is suggested for the choice of thyroidectomy and TSH suppression therapy, as well as proper management for cardiovascular disease prevention.

scholarly journals Increased cardiovascular risk in thyroid cancer patients taking levothyroxine: a nationwide cohort study in Korea

2019 ◽  
Vol 180 (1) ◽  
pp. 11-20 ◽  
Author(s):  
Beomseok Suh ◽  
Dong Wook Shin ◽  
Youngmin Park ◽  
Hyunsun Lim ◽  
Jae Moon Yun ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Cohort Study ◽  
Thyroid Cancer ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Cancer Patients ◽  
Cox Proportional Hazards ◽  
Stroke Incidence ◽  
Tsh Suppression

Objective Many thyroid cancer patients are exposed to long-term thyroid-stimulating hormone (TSH) suppression, often as lifetime treatment, and are consequently at risk for cardiovascular disease. We investigated the incidence of coronary heart disease (CHD) and ischemic stroke among thyroid cancer patients compared with matched control subjects. Design Retrospective cohort study. Methods A total of 182 419 subjects who received thyroidectomy for thyroid cancer during 2004–2012 were selected from the Korean National Health Insurance data, which cover approximately 97% of the entire Korean population. Propensity score matching was used to select non-cancer controls. Cox proportional hazards regression analysis was used to determine relative risk of coronary heart disease and ischemic stroke. Mean follow-up was 4.32 years. Results Thyroid cancer patients had elevated risk for CHD and ischemic stroke with hazard ratio (HR) of 1.15 (95% confidence interval (CI): 1.10–1.22) and 1.15 (1.09–1.22), respectively. This risk was increased in those who took a higher dosage of levothyroxine (HR: 1.47, 95% CI: 1.34–1.60 for CHD and HR: 1.56, 95% CI: 1.42–1.72 for ischemic stroke among those who took ≥170 μg/day levothyroxine). Although risk of atrial fibrillation was dose-dependently associated with levothyroxine dosage, it represents only a small proportion of ischemic stroke incidence (4.4%, 128/2914). Conclusions The risk for CHD and ischemic stroke was higher in thyroid cancer patients who received thyroidectomy, and the dosage of levothyroxine administered appears to play a major role. Greater caution is suggested for the screening and treatment of thyroid cancer and subsequent TSH suppression therapy, as well as proper management for cardiovascular disease prevention.

EDITORIAL: Migration and competitiveness: Japan and the United States

2013 ◽  
Vol 10 (2) ◽  
pp. 115-124
Author(s):  
Philip L. Martin
Keyword(s):  
United States ◽  
The United States ◽  
Variable Cost ◽  
Fixed Cost ◽  
Special Issue ◽  
Science And Engineering ◽  
The Past ◽  
Past Half Century ◽  
Key Sectors ◽  
Past Half

Japan and the United States, the world’s largest economies for most of the past half century, have very different immigration policies. Japan is the G7 economy most closed to immigrants, while the United States is the large economy most open to immigrants. Both Japan and the United States are debating how immigrants are and can con-tribute to the competitiveness of their economies in the 21st centuries. The papers in this special issue review the employment of and impacts of immigrants in some of the key sectors of the Japanese and US economies, including agriculture, health care, science and engineering, and construction and manufacturing. For example, in Japanese agriculture migrant trainees are a fixed cost to farmers during the three years they are in Japan, while US farmers who hire mostly unauthorized migrants hire and lay off workers as needed, making labour a variable cost.

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