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Ohira T, Eguchi E, Hayashi F, Kinuta M, Imano H. Epidemiology of cardiovascular disease in Japan: An overview study. J Cardiol 2024; 83:191-200. [PMID: 37591340 DOI: 10.1016/j.jjcc.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/20/2023] [Accepted: 08/10/2023] [Indexed: 08/19/2023]
Abstract
Cardiovascular diseases (CVDs), such as heart disease and stroke, have a significant impact on life expectancy, healthy life expectancy, and medical costs in Japan. Each prefecture is currently promoting measures in accordance with the Japanese National Plan for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease, which was established by the government. In recent years, the crude mortality rate of heart disease in Japan has been increasing year by year with the aging population. Meanwhile, the age-adjusted mortality rate has leveled off or shown a downward trend. In addition, the proportion of acute myocardial infarction has decreased, whereas the proportion of heart failure has increased. By contrast, both the crude and age-adjusted mortality rates of stroke have a declining trend. Nevertheless, considering the potential variations in death certificates issued for patients with myocardial infarction across different prefectures, it is crucial to determine the incidence of CVD in each prefecture for the accurate assessment of CVD trends. However, as for the incidence of CVD, not many prefectures have yet implemented registration programs. The age-adjusted incidence rate of acute myocardial infarction has been increasing in some areas and decreasing in others since 1990. The age-adjusted incidence rate of stroke has consistently declined since the 1960s. Nevertheless, the possible increase in the incidence rate of cerebral embolism and thrombotic cerebral infarction among patients with different stroke subtypes is a cause of concern. The impact of heart failure on the incidence of heart disease has increased. Therefore, relevant academic societies and prefectures must collaborate in registering the incidence of heart failure as well as myocardial infarction and implementing countermeasures.
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Affiliation(s)
- Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Eri Eguchi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Fumikazu Hayashi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Minako Kinuta
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hironori Imano
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
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Moon J, Seo Y, Lee HH, Lee H, Kaneko F, Shin S, Kim E, Yum KS, Kim YD, Baek JH, Kim HC. Incidence and case fatality of stroke in Korea, 2011-2020. Epidemiol Health 2023; 46:e2024003. [PMID: 38186243 PMCID: PMC10928468 DOI: 10.4178/epih.e2024003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
OBJECTIVES Stroke remains the second leading cause of death in Korea. This study was designed to estimate the crude, age-adjusted and age-specific incidence rates, as well as the case fatality rate of stroke, in Korea from 2011 to 2020. METHODS We utilized data from the National Health Insurance Services from January 1, 2002 to December 31, 2020, to calculate incidence rates and 30-day and 1-year case fatality rates of stroke. Additionally, we determined sex and age-specific incidence rates and computed age-standardized incidence rates by direct standardization to the 2005 population. RESULTS The crude incidence rate of stroke hovered around 200 (per 100,000 person-years) from 2011 to 2015, then surged to 218.4 in 2019, before marginally declining to 208.0 in 2020. Conversely, the age-standardized incidence rate consistently decreased by 25% between 2011 and 2020. When stratified by sex, the crude incidence rate increased between 2011 and 2019 for both sexes, followed by a decrease in 2020. Age-standardized incidence rates displayed a downward trend throughout the study period for both sexes. Across all age groups, the 30-day and 1-year case fatality rates of stroke consistently decreased from 2011 to 2019, only to increase in 2020. CONCLUSIONS Despite a decrease in the age-standardized incidence rate, the total number of stroke events in Korea continues to rise due to the rapidly aging population. Moreover, 2020 witnessed a decrease in incidence but an increase in case fatality rates.
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Affiliation(s)
- Jenny Moon
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Yeeun Seo
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | - Fumie Kaneko
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Sojung Shin
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Eunji Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu Sun Yum
- Department of Neurology, Chungbuk National University Hospital, Cheongju, Korea
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jang-Hyun Baek
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
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Filchenko I, Mürner N, Dekkers MPJ, Baillieul S, Duss SB, Brill AK, Horvath T, Heldner MR, Rexhaj E, Bernasconi C, Bassetti CLA, Schmidt MH. Blood pressure variability, nocturnal heart rate variability and endothelial function predict recurrent cerebro-cardiovascular events following ischemic stroke. Front Cardiovasc Med 2023; 10:1288109. [PMID: 38034378 PMCID: PMC10687449 DOI: 10.3389/fcvm.2023.1288109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/13/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Cardiovascular parameters characterizing blood pressure (BP), heart rate (HR), endothelial function and arterial stiffness predict cerebro-cardiovascular events (CCVE) in the general population. Considering the paucity of data in stroke patients, we assessed these parameters as potential predictors of recurrent CCVE at acute stroke stroke. Patients and methods This is a secondary outcome analysis of a prospective observational longitudinal Sleep Deficiency & Stroke Outcome Study (ClinicalTrials.gov Identifier: NCT02559739). The study consecutively recruited acute ischemic stroke patients. Cardiovascular parameters (blood pressure variability [BPV], heart rate variability [HRV], endothelial function, and arterial stiffness) were assessed within the first week post-stroke. Future CCVE were recorded over a 3-year follow-up. Multivariate Cox regression analysis was used to investigate the prognostic value of 48 cardiovascular parameters regarding CCVE risk. Results Out of 447 recruited patients, 359 were included in this analysis. 20% of patients developed a future CCVE. A high variability of systolic BP (n = 333) and nocturnal HR (non-linear parameters; n = 187) at acute stroke predicted CCVE risk after adjustment for demographic parameters, cardiovascular risk factors and mean BP or HR, respectively. Endothelial dysfunction (n = 105) at acute stroke predicted CCVE risk after adjustment for age and sex, but not after adjustment for cardiovascular risk factors. Diurnal HR and arterial stiffness at acute stroke were not associated with CCVE risk. Conclusion High blood pressure variability, high nocturnal HRV and endothelial function contribute to the risk for future CCVE after stroke.
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Affiliation(s)
- Irina Filchenko
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Nicolas Mürner
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martijn P. J. Dekkers
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sebastien Baillieul
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Univ. Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Simone B. Duss
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anne-Kathrin Brill
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Horvath
- Stroke Unit, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mirjam R. Heldner
- Stroke Unit, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Emrush Rexhaj
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Corrado Bernasconi
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudio L. A. Bassetti
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus H. Schmidt
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Ohio Sleep Medicine Institute, Dublin, OH, United States
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Wada S, Yoshimura S, Miwa K, Iwanaga Y, Koga M, Toyoda K. Current status and future aspects in the Japan Stroke Data Bank. Front Neurol 2023; 14:1090136. [PMID: 37034094 PMCID: PMC10075325 DOI: 10.3389/fneur.2023.1090136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/07/2023] [Indexed: 04/11/2023] Open
Abstract
The Japanese National Plan for the Promotion of Measures Against Cerebrovascular and Cardiovascular Diseases was formulated on October 27, 2020. One purpose of this plan was to promote research on cerebrovascular and cardiovascular diseases. Therefore, it is necessary to clarify the actual status of stroke treatment in Japan and operate a national stroke database with high public interest completely and accurately. The Japan Stroke Data Bank (JSDB; https://strokedatabank.ncvc.go.jp/en/) was established by the Ministry of Health, Labor and Welfare Scientific Research in Shimane University (Shimane, Japan) in 1999 and was transferred to the National Cerebral and Cardiovascular Center (Osaka, Japan) as a part of the Cardiovascular Disease Registry in 2015. More than 200,000 of stroke cases have been registered using individual forms from more than 100 nationwide stroke centers over ~20 years. Since there are few large-scale stroke registries with nationwide coverage in Asia, including Japan, compared with those in Europe and North America, the role of the JSDB in the plan will be important in the future. To construct a high-quality stroke registry, we aimed to (1) collect detailed data through individual questionnaires for each participating stroke center, (2) link to external databases (e.g., insurance claims and public death registries), (3) improve the quality of treatment at participating hospitals through benchmarking, and (4) obtain stable funding through sustained support from government and academic societies. We also describe the history of the JSDB and changes in the trend of real-world stroke treatment in Japan based on the results of analysis of data in the JSDB.
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Affiliation(s)
- Shinichi Wada
- Department of Information and Health, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
- *Correspondence: Shinichi Wada
| | - Sohei Yoshimura
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kaori Miwa
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshitaka Iwanaga
- Department of Information and Health, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Takashima N. Importance of Continuous Monitoring of Stroke Recurrence in the General Population. J Atheroscler Thromb 2022; 29:1699-1700. [PMID: 35598984 PMCID: PMC9881472 DOI: 10.5551/jat.ed202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Naoyuki Takashima
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
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