Less subclinical atherosclerosis in Japanese men in Japan than in White men in the United States in the post-World War II birth cohort

Am J Epidemiol. 2007 Mar 15;165(6):617-24. doi: 10.1093/aje/kwk053. Epub 2007 Jan 22.


Coronary heart disease incidence and mortality remain very low in Japan despite major dietary changes and increases in risk factors that should have resulted in a substantial increase in coronary heart disease rates (Japanese paradox). Primary genetic effects are unlikely, given the substantial increase in coronary heart disease in Japanese migrating to the United States. For men aged 40-49 years, levels of total cholesterol and blood pressure have been similar in Japan and the United States throughout their lifetimes. The authors tested the hypothesis that levels of subclinical atherosclerosis, coronary artery calcification, and intima-media thickness of the carotid artery in men aged 40-49 years are similar in Japan and the United States. They conducted a population-based study of 493 randomly selected men: 250 in Kusatsu City, Shiga, Japan, and 243 White men in Allegheny County, Pennsylvania, in 2002-2005. Compared with the Whites, the Japanese had a less favorable profile regarding many risk factors. The prevalence ratio for the presence of a coronary calcium score of > or =10 for the Japanese compared with the Whites was 0.52 (95% confidence interval: 0.35, 0.76). Mean intima-media thickness was significantly lower in the Japanese (0.616 mm (standard error, 0.005) vs. 0.672 (standard error, 0.005) mm, p < 0.01). Both associations remained significant after adjusting for risk factors. The findings warrant further investigations.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asian Continental Ancestry Group / ethnology
  • Asian Continental Ancestry Group / genetics
  • Asian Continental Ancestry Group / statistics & numerical data*
  • Atherosclerosis / diagnosis
  • Atherosclerosis / epidemiology*
  • Atherosclerosis / etiology
  • Calcinosis / complications
  • Calcinosis / diagnosis
  • Cohort Studies
  • Coronary Disease / complications
  • Coronary Disease / diagnosis
  • Cross-Cultural Comparison
  • European Continental Ancestry Group / ethnology
  • European Continental Ancestry Group / genetics
  • European Continental Ancestry Group / statistics & numerical data*
  • Feeding Behavior
  • Humans
  • Incidence
  • Japan / epidemiology
  • Linear Models
  • Male
  • Middle Aged
  • Pennsylvania / epidemiology
  • Population Surveillance
  • Risk Factors
  • Surveys and Questionnaires
  • World War II