A. Kagan

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

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.

Epidemiology of serum uric acid among 8000 Japanese-American men in Hawaii

Abstract Distribution of serum uric acid (SUA) levels among 8000 men of Japanese ancestry living in Hawaii and the relationships between SUA and a number of biological, clinical and socio-cultural variables were investigated. Stepwise regression analysis of SUA on fifteen independent variables selected on the basis of univariate analysis revealed that relative weight was by far the most important correlate with SUA. Alcohol intake, serum triglyceride, diabetes (negative association) and diastolic pressure, in order of relative importance, were also significantly associated with SUA.

THE CORONARY PROFILE.

Mounting evidence indicates that in recent decades there h a s been an absolute as well a s a relative increase in the occurrence of coronary heart d i sease in this and in other highly developed countries. Moreover, there h a s been an increasing tendency for the d i sease to occur in younger age groups, a t l ea s t among men.’ With the recent advances in the control of infectious diseases, the cardiovascular-renal d i seases in general and coronary heart d i sease in particular have become th i s country’s most serious health problem. International studies, such as those contrasting the coronary heart d i sease experience of the Japanese in Japan, Hawaii, and in the continental United States,l of rural and urban Guatemalans,3 and the newly arrived and long-resident Yemenite J ews in Israe1,4 have all pointed to the importance of environmental factors in th i s disease. The indication that the “way of life’’ of individuals affects their susceptibility to coronary heart d i sease is a more hopeful concept than one that accepts liability to coronary heart d i sease as an inevitable concomitant of aging. We cannot s tay the course of t i m e , but an unhealthful environment is subject to manipulation, an unhealthful way of life is subject to change. Mortality statistics indicate the outside dimensions of the problem and reports on hospital and autopsy series provide important data on selected portions of the population, but community surveys or epidemiological studies are necessary to round out the picture, to show the pattern of the disease, and to indicate where we may mast profitably attack it. Such an epidemiological study h a s been going on in the town of Framingham, Massachusetts s ince 1949.‘ Two thousand two hundred and eighty-two (2,282) men and 2,846 women initially free of coronary heart d i sease ( T A B L E 1) have been followed primarily by means of biennial examinations, each of which consisted of a history, a physical examination, and a battery of laboratory determinations6 L e s s than one half of one per cent of those initially examined have been completely lost to