This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ueshima, H. Articles by Okamura, T. Search for Related Content PubMed Articles by Ueshima, H. Articles by Okamura, T. Related Collections Cerebrovascular disease/stroke Risk Factors Acute myocardial infarction Epidemiology

(Circulation. 2008;118:2702-2709.)
© 2008 American Heart Association, Inc.

Heart Disease in Asia

Cardiovascular Disease and Risk Factors in Asia

A Selected Review

Hirotsugu Ueshima, MD; Akira Sekikawa, MD; Katsuyuki Miura, MD; Tanvir Chowdhury Turin, MBBS; Naoyuki Takashima, MD; Yoshikuni Kita, PhD; Makoto Watanabe, MD; Aya Kadota, MD; Nagako Okuda, MD; Takashi Kadowaki, MD; Yasuyuki Nakamura, MD; Tomonori Okamura, MD

From the Department of Health Science (H.U., A.S., K.M., T.C.T., N.T., Y.K., M.W., A.K., N.O., T.K., Y.N., T.O.), Shiga University of Medical Science, Tsukinowa-cho Seta, Otsu, Shiga, Japan; Department of Epidemiology (A.S.), Graduate School of Pubic Health, University of Pittsburgh, Pittsburgh, Pa; Department of Preventive Cardiology (M.W., T.O.), National Cardiovascular Center, Suita, Osaka, Japan; and Cardiovascular Epidemiology (Y.N.), Kyoto Women’s University, Kyoto, Japan.

Correspondence to Hirotsugu Ueshima, MD, Department of Health Science, Shiga University of Medical Science, Tsukinowa-cho Seta, Otsu, Japan 520-2192. E-mail hueshima@belle.shiga-med.ac.jp

Key Words: myocardial infarction • epidemiology • cerebrovascular disorders • stroke • risk factors

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Cardiovascular disease (CVD) prevention in Asia is an important issue for world health, because half of the world’s population lives in Asia. Asian countries and regions such as Japan, the Republic of Korea, the People’s Republic of China, Hong Kong, Taiwan, and the Kingdom of Thailand have greater mortality and morbidity from stroke than from coronary heart disease (CHD), whereas the opposite is true in Western countries.¹ The reasons why this specific situation is observed in countries with rapid and early-phase westernization, such as Japan and South Korea, are very interesting.

The Seven Countries Study conducted by Keys et al² in 1957 found that Japanese populations had lower fat intake, lower serum total cholesterol, and lower CHD than populations in the United States and Scandinavia, in spite of higher smoking rates. The serum total cholesterol level in Japan has increased rapidly since World War II in accordance with an increase in dietary fat intake from 10% of total energy intake per capita per day to 25%.^1,2 Despite this increase, the specific characteristic of lower CHD incidence and mortality than that in Western countries has persisted.^3,4 Whether Japanese people and certain other Asian populations have different risk factors for CHD than Western populations has been a subject of discussion for quite some time.

In this article, we discuss the existence of higher stroke rates and lower CHD rates in Asian countries than in Western countries and the respective risk factors for this on the basis of extensive reviews of cohort studies. . . . [Full Text of this Article]

This article has been cited by other articles:

				M. Watanabe, T. Okamura, Y. Kokubo, A. Higashiyama, and A. Okayama Elevated serum creatine kinase predicts first-ever myocardial infarction: a 12-year population-based cohort study in Japan, the Suita study Int. J. Epidemiol., December 1, 2009; 38(6): 1571 - 1579. [Abstract] [Full Text] [PDF]