S-34-5: PERSPECTIVES FROM LONGITUDINAL COHORT STUDY IN NORTHERN JAPAN -HYPERTENSION, METABOLIC DISORDERS AND CARDIOVASCULAR DISEASE-

Abstract

The percentage of obese in the population of middle-aged Japanese has been increasing in recent years. With obese, population of metabolic disorder to be accompanied with diabetes mellitus, IGT increases explosively.The similar tendency is observed in the whole Asian countries. Recently, for the purpose of preventing cardiovascular disease, the conception of metabolic syndrome is proposed. Obesity, hypertension, glucose intolerance and lipid metabolism abnormality are included in this conception. On the basis of data obtained through annual health examinations on about 2,000 residents in the two communities, we performed analysis and are currently reviewing cardiovascular disease and its relevant risk factors in this population. On the basis of the analysis, at this seminar, I will lecture on metabolic syndrome among the Japanese population in terms of frequency and characteristics as well as its impact on the onset of cardiovascular disease. Diagnosis of metabolic syndrome is based on the Japanese Criteria. When the sample consisted of those without a history of cardiovascular disease and not undergoing treatment for hypertension, diabetes, or hyperlipidemia, frequency of the syndrome was 20–25 percent for men and 5–7 percent for women, levels that have remained unchanged over the past 10 years. Those frequencies appeared to be on a level with those observed in other regions around the country. We also conducted a six-year follow-up of the male group. We found as a result that the relative risk of cardiovascular disease development, including coronary heart disease, was 2.3 times higher in syndrome males than in non-syndrome males.These studies suggest that the Japanese population exhibited a certain level of metabolic syndrome incidence due to accumulation of visceral fat, even though the rate of obesity is lower in this population than in the U.S., that metabolic syndrome affected a variety of atherosclerosis-related factors, and that the syndrome could practically serve as a predictive factor for cardiovascular disease. Obesity is a basic factor in the onset of metabolic syndrome, and the BMI average among the Japanese population has increased over time. The significance of coronary heart disease against the backdrop of diabetes and metabolic syndrome will likely increase in the future. It is therefore necessary to develop primary preventive measures against coronary heart disease, tailored for the Japanese population, with a particular focus on improvement of lifestyle.