Carotid atherosclerosis and cardiovascular risk factors: a comparison of residents of a rural area of Okinawa with residents of a typical suburban area of Fukuoka, Japan

Atherosclerosis. 2004 Feb;172(2):337-43. doi: 10.1016/j.atherosclerosis.2003.10.007.


Areas of Japan are known worldwide for the longevity of their residents. Okinawa has the highest longevity in Japan and a low rate of death due to cardiovascular disease. We investigated carotid atherosclerotic (CA) risk factors in islands of I city in Okinawa prefecture and compared them with K town, a suburban area of Fukuoka prefecture in Kyushu, to determine the relationship between cardiovascular risk factors and carotid atherosclerosis. We investigated conventional cardiovascular risk factors in 1078 I city residents (375 men, mean age 63.7 and 703 women, mean age 60.0) in 2000 and 2364 K town residents (676 men, mean age 57.1 and 1688 women, mean age 53.0) in 1999. Carotid atherosclerosis was assessed by mean intima-media thickness (IMT) by B-mode ultrasound. The mean IMT was significantly lower in the residents of I city than in those of K town (P < 0.05). Total cholesterol (TC) and low-density-lipoprotein cholesterol (LDL-C) levels and smoking rate were also lower in I city than in K town. Body mass index (BMI) and triglyceride (TG) level were higher in I city than in K town. In I city, multiple regression analysis found independent relationships between carotid atherosclerosis and age, sex (male), hypertension, LDL cholesterol, high-density-lipoprotein cholesterol (HDL-C), and diabetes. The lower mean IMT is probably related to a lower lifetime burden of atherosclerotic risk factors, which may in turn be related to the longevity of Okinawa residents. BMI was not a cardiovascular risk factor, although LDL cholesterol was a common important risk factor.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Cardiovascular Diseases / etiology*
  • Carotid Arteries / diagnostic imaging
  • Carotid Artery Diseases / diagnostic imaging*
  • Cholesterol / blood
  • Cholesterol, LDL / blood
  • Diabetes Complications
  • Female
  • Humans
  • Hypertension / complications
  • Intracranial Arteriosclerosis / diagnostic imaging*
  • Japan / epidemiology
  • Longevity
  • Male
  • Middle Aged
  • Risk Factors
  • Rural Population*
  • Sex Factors
  • Smoking
  • Triglycerides / blood
  • Ultrasonography
  • Urban Population


  • Cholesterol, LDL
  • Triglycerides
  • Cholesterol