Epidemiological Studies on Cerebrovascular Diseases in Hisayama, Kyushu Island, Japan : Part I. With Particular Reference to Cardiovascular Status

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Epidemiological studies particularly concerned with cardiovascular diseases have been carried out in a selected community of Kyushu Island, Japan, called Hisayama. Of total of 1, 841 residents in this community aged over 40, 1, 658 (90.1 per cent) were examined in blood pressure, electrocardiogram, ocular fundi, total cholesterol in the serum, urinalysis for protein and sugar, and in physical and neurological status. Since November, 1961 when the cross-sectional study was completed, they have been followed as completely as possible in order to confirm their outcomes.This preliminary report deals with the results obtained up to the present time.(1) The means of systolic and diastolic blood pressure in males were 128.6/75.5, 137.5/80.5, 151.8/85.1, 158.4/82.3 and 161.0/81.9mm.Hg, in the 4th, 5th, 6th, 7th and the 8th decade, respectively. In females, they were 127.0/73.8, 136.5/78.0, 151.6/83.4 and 169.8/84.6mm. Hg. They were somewhat lower than those reported in the northern parts of Japan and more similar to those in the populations reported in England and in the U.S.A. The prevalence of hypertension according to WHO criteria was 27.4 per cent in males and 24.9 per cent in females.(2) When electrocardiographic findings were classified according to the Minnesota Code, 436 out of 719 males (60.6 per cent) and 496 of 934 females, (53.2 per cent) had reportable findings. Axis deviation (Code II, 1) and high R wave (Code III, 1) were more common in males than in females but S-T depression (Code IV, 1, 2, 3) and T wave changes (Code V, 1, 2, 3) were more frequently found in females. Q and QS items (Code I, 1, 2, 3), axis deviation, high R wave, and T wave changes were more frequent in hypertensives than in non-hypertensives. The prevalence of Q and QS items were nearly the same between the populations of Yugoslavia and Hisayama, but it was about 3.5 times as much as higher in U.S.A. than in the 2 other populations. On the other hand, no remarkable difference was found in the prevalence of S-T depression and of T wave changes in these populations.(3) The mean value of serum total cholesterol in 1, 484 subjects was 156.5mg./100ml. and the standard deviation 30.1mg./100ml. It was slightly higher in female (161.1mg./100ml.) than in male (150.5mg./100ml.). Serum cholesterol was significantly increased with blood pressure only in females aged between the 6th and 7th decade.(4) Retinopathy became progressed as blood pressure increased. In hypertensives, Grade I was found in 141 (36.7 per cent), Grade II in 120 (31.5 per cent), Grade III in 19 (5.0 per cent) and Grade IV in one (0.3 per cent).(5) Proteinuria was more frequently found in hypertensives than in non-hypertensives. Prevalence of proteinuria in hypertensive females was 19.9 per cent which was significantly higher than that in males (10.0 per cent).Glycosuria was found in 81 cases (4.1 per cent) among which 58 were proved to be diabetic.(6) Neurological examinations at the time of cross-sectional study revealed 26 cases with hemiplegia or hemiparesis attributable to CVD (11 in males and 15 in females). The prevalence was approximately 400 per 100, 000 population. There were 5 cases with old myocardial infarction based upon electrocardiographic findings and the histories (3 in males and 2 in females). The prevalence was approximately 77 per 100, 000 population.(7) In the follow-up study for 18 months starting November 1961 to April 1963, 63 out of 1, 658 subjects (3.2 per cent) moved out of the town and 56 (3.0 per cent) died. Three (0.2 per cent) were not known of their outcomes. Among 56 death cases, 17 (30.4 per cent) underwent postmortem examinations.
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Epidemiological Studies on Cerebrovascular Diseases in Hisayama, Kyushu Island, Japan : Part I. With Particular Reference to Cardiovascular Status

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