Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: Demographic, physical, dietary and biochemical characteristics

Abstract

CORONARY heart disease and stroke continue to be the subjects of intensive epidemiologic study in many parts of the world. Particular research interest has been focused on the apparent differences in the prevalence and incidence of coronary heart disease among various racial and geographically separate population groups [l-4]. As a result of these intensive efforts to explain the epidemiology of these diseases and to determine methods of control, pioneering studies have established risk factors for coronary heart disease [.5-lo] and are now establishing such risk factors for cerebrovascular disease as well [l 1, 121. At present, multifactorial causation has been accepted, the strongest evidence being the demonstrated relationship between elevated blood lipid levels, elevated blood pressure levels, and heavy cigarette smoking with coronary atherosclerosis and its clinical manifestations [5-10, 13-161. Studies in many countries have shown that in most populations exhibiting a high serum cholesterol in men, there is also a high prevalence of coronary heart disease [17-191. Usually these people eat a diet high in fat, especially in the form of meat and dairy fat. In most populations with low cholesterol levels and a low prevalence of coronary heart disease, the intake of fat is low and the fat which is ingested is derived primarily from fish and vegetable oils [ 17-201.