冠状動脈疾患に関する研究(第1報) : 冠状動脈疾患に関する集団検診とその予後について

Abstract

The mass survey on coronary artery disease (CAD) was perfomed during the period of 1956 to 1958 in Tokyo. This study was concerned with the incidence and grade of CAD in four male populations aged above 40, and the methods of laboratory examination and the criteria of clinical diagnosis of CAD were also discussed.Inquiry of detailed medical history and physical examination including blood pressure measurement were carried out by physician. In addition, height and Weight were measured, and ECG and chest X-ray film were examined.Total number studied at initial examination was 1122 cases which were classified into four populations, namely, officers, clerks, professors and medical practitioners.Of these cases, 487 were reexamined in 1 to 2 years follow-up period.The classification of CAD was based upon the criteaia shown below : GROUR I : Infarction.GROUP A : 1) Coronary T 2) Positive exercise test 3) Abnormal S-T deviation (over 0.05 mV.) with B. P. under 179/99 mmHg.GROUP B : Abnormal ST-T deviation and/or significant cardiac enlargement with B. P. over 180/100 mmHg.GROUP C : 1) Low voltage 2) Prolongation of PQ interval (over 0.20") 3) Bundle-branch block 4) Prolongation of QRS complex (over 0.01") 5) Abnormal ST-T deviation (under 0.05 mV.) with B. P. under 179/99mmHg. 6) Significant cardiac enlargement with B. P. under 179/99 mmHg. 7) Arrhythmia beginning after middle age.GROUP D* : Hypertension (over 160/90 mmHg.) without electrocardiographic. and roentgenologic abnormalities GROUP E* : No abnormalities.(*Group D and E are not CAD.)1) In 32.8 per cent of all cases, hypertension over 160/90 mmHg. was found, and prevalence rate of hypertension showed a positive correlation with age and relative weight. But there were no differences in prevalence of hypertension between four populations.2) There were no cases with myocardial infarction, but group A was found in 2 to 3 per cent, group B in 9.3 per cent and group C in 24.8 per cent of apparently healthy indiviauals.3) Diagnosis of group A was made in 1.0 per cent of cases aged 40 to 49 years, in 3.8 per cent of 50 to 59, in 7.7 per cent of above 60. The prevalence rate of CAD was increased with age.4) The prevalence of CAD was higher in cases with high levels of blood pressure and/or relative weight than those with normal or low levels.5) Significant relationship of CAD to diet, smoking and alcohol intake was not demonstrated.6) The incidence of myocardial infarction or sudden death among 487 cases, which were reexamined at 1 to 2 years' follow-up survey, was 0.4 per cent (2 cases) and that of group A was 1.0 per cent (5 cases). All these cases showed some abnormal findings at the initial examination.7) In 1 to 2 years' follow-up period, no incidence of myocardial infarction or angina pectoris was seen in the group which was diagnosed as group A, suggesting the necessity of health control by mass survey.