Evidence map›Paper›PMID 26182938›Full record

ArticleInternational journal of epidemiology2015

Continuous decline in mortality from coronary heart disease in Japan despite a continuous and marked rise in total cholesterol: Japanese experience after the Seven Countries Study.

Akira Sekikawa, Yoshihiro Miyamoto, Katsuyuki Miura, Kunihiro Nishimura, Bradley J Willcox, Kamal H Masaki, Beatriz Rodriguez, Russell P Tracy, Tomonori Okamura, Lewis H Kuller

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of epidemiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Observational
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Akira SekikawaDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA, akira@pitt.edu.
Yoshihiro MiyamotoNational Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Katsuyuki MiuraDepartment of Health Science, Shiga University of Medical Science, Otsu, Shiga, Japan.
Kunihiro NishimuraNational Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Bradley J WillcoxDepartment of Geriatric Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Kamal H MasakiDepartment of Geriatric Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Beatriz RodriguezDepartment of Geriatric Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Russell P TracyDepartment of Pathology, University of Vermont, Burlington, VT, USA and.
Tomonori OkamuraDepartment of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.
Lewis H KullerDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.

Funding

Foreign CohortR01HL068200 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SEKIKAWA, AKIRA · 2003 to 2012
$5.6M
NHLBI NIH HHS R01 HL068200NHLBI NIH HHS R01 HL68200
6 · The paper itself

Abstract

backgroundThe Seven Countries Study in the 1960s showed very low mortality from coronary heart disease (CHD) in Japan, which was attributed to very low levels of total cholesterol. Studies of migrant Japanese to the USA in the 1970s documented increase in CHD rates, thus CHD mortality in Japan was expected to increase as their lifestyle became Westernized, yet CHD mortality has continued to decline since 1970. This study describes trends in CHD mortality and its risk factors since 1980 in Japan, contrasting those in other selected developed countries.

methodsWe selected Australia, Canada, France, Japan, Spain, Sweden, the UK and the USA. CHD mortality between 1980 and 2007 was obtained from WHO Statistical Information System. National data on traditional risk factors during the same period were obtained from literature and national surveys.

resultsAge-adjusted CHD mortality continuously declined between 1980 and 2007 in all these countries. The decline was accompanied by a constant fall in total cholesterol except Japan where total cholesterol continuously rose. In the birth cohort of individuals currently aged 50-69 years, levels of total cholesterol have been higher in Japan than in the USA, yet CHD mortality in Japan remained the lowest: >67% lower in men and > 75% lower in women compared with the USA. The direction and magnitude of changes in other risk factors were generally similar between Japan and the other countries.

conclusionsDecline in CHD mortality despite a continuous rise in total cholesterol is unique. The observation may suggest some protective factors unique to Japanese.

Indexed as

AdultAgedAsian PeopleAustraliaBlood PressureBody Mass IndexCanadaCholesterolCoronary DiseaseDatabases, FactualDiabetes MellitusFemaleFranceHumansJapanLife StyleCholesterolCoronary heart diseaseinternational trendJapanrisk factorstotal cholesterolWestern countries

Identifiers

PMID26182938
PMCPMC6086557

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.