Epidemiology of cardiovascular disease in Japan: An overview study

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. (c) 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.