DOI QR코드

DOI QR Code

Age-period-cohort Analysis of Cardiovascular Disease Mortality in Japan, 1995-2018

  • Okui, Tasuku (Medical Information Center, Kyusyu University Hospital)
  • Received : 2020.02.10
  • Accepted : 2020.03.26
  • Published : 2020.05.29

Abstract

Objectives: This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis. Methods: We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases' mortality rates into age, period, and cohort effects. Results: The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later. Conclusions: The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.

References

  1. Ministry of Health, Labour and Welfare of Japan. Overview of annual total monthly report of the vital statistics 2018 [cited 2020 Feb 10]. Available from: https://www.mhlw.go.jp/toukei/saikin/hw/jinkou/geppo/nengai18/index.html (Japanese).
  2. Ma E, Iso H, Takahashi H, Yamagishi K, Tanigawa T. Age-period-cohort analysis of mortality due to ischemic heart disease in Japan, 1955 to 2000. Circ J 2008;72(6):966-972. https://doi.org/10.1253/circj.72.966
  3. Lee HA, Park H. Trends in ischemic heart disease mortality in Korea, 1985-2009: an age-period-cohort analysis. J Prev Med Public Health 2012;45(5):323-328. https://doi.org/10.3961/jpmph.2012.45.5.323
  4. Ocana-Riola R, Mayoral-Cortes JM, Fernandez-Ajuria A, Sanchez-Cantalejo C, Martin-Olmedo P, Blanco-Reina E. Age, period, and cohort effects on mortality from ischemic heart disease in southern Spain. Rev Esp Cardiol (Engl Ed) 2015;68(5): 373-381. https://doi.org/10.1016/j.recesp.2014.07.025
  5. Gero K, Eshak ES, Ma E, Takahashi H, Noda H, Iso H. Health disparities in ischaemic heart disease mortality in Hungary from 1970 to 2010: an age-period-cohort analysis. J Epidemiol 2015; 25(6):399-406. https://doi.org/10.2188/jea.JE20140122
  6. Ministry of Health, Labour and Welfare of Japan. Annual report on health, labor and welfare 2018 [cited 2020 Feb 10]. Available from: https://www.mhlw.go.jp/stf/wp/hakusyo/kousei/18/index.html (Japanese).
  7. Ogata S, Nishimura K, Guzman-Castillo M, Sumita Y, Nakai M, Nakao YM, et al. Explaining the decline in coronary heart disease mortality rates in Japan: contributions of changes in risk factors and evidence-based treatments between 1980 and 2012. Int J Cardiol 2019;291:183-188. https://doi.org/10.1016/j.ijcard.2019.02.022
  8. Hisamatsu T, Miura K. Trends of mortality rate and incidence rate of cardiovascular disease in Japan. Jpn J Cardiovasc Dis Prev 2018;53(1):1-8 (Japanese).
  9. Smith TR, Wakefield J. A review and comparison of age-period-cohort models for cancer incidence. Stat Sci 2016;31(4): 591-610. https://doi.org/10.1214/16-STS580
  10. Ma E, Takahashi H, Mizuno A, Okada M, Yamagishi K, Iso H. Stratified age-period-cohort analysis of stroke mortality in Japan, 1960 to 2000. J Stroke Cerebrovasc Dis 2007;16(3):91-102. https://doi.org/10.1016/j.jstrokecerebrovasdis.2006.11.006
  11. Ocana-Riola R, Blanco-Reina E, Navarro-Moreno E, Mayoral-Cortes JM. Age-period-cohort effects on mortality from cerebrovascular disease in southern Spain. J Stroke Cerebrovasc Dis 2014;23(9):2274-2282. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.015
  12. Wang Z, Hu S, Sang S, Luo L, Yu C. Age-period-cohort analysis of stroke mortality in China: data from the global burden of disease study 2013. Stroke 2017;48(2):271-275. https://doi.org/10.1161/STROKEAHA.116.015031
  13. Maruo S, Iso H. Trends in cohort effects of cardiovascular disease mortality in Japan, 1950-2010. Nihon Koshu Eisei Zasshi 2015;62(2):57-65 (Japanese).
  14. Ministry of Health, Labour and Welfare of Japan. The vital statistics: e-Stat General counter of government statistics [cited 2020 Feb 10]. Available from: https://www.e-stat.go.jp/stat-search/files?page=1&layout=datalist&toukei=00450011&tstat=000001028897&cycle=7&tclass1=000001053058&tclass2=000001053061&tclass3=000001053072 (Japanese).
  15. Ministry of Health, Labour and Welfare of Japan. Overview of the vital statistics survey [cited 2020 Feb 27]. Available from: https://www.mhlw.go.jp/toukei/list/81-1b.html (Japanese).
  16. Saito I, Aono H, Ikebe T, Ozawa H, Yamashita T. Change in the mortality statistics for heart disease in Japan: an influence of the 10th revision of the International Classification of Diseases. Jpn J Cardiovasc Dis Prev 1998;33(4):257-265 (Japanese).
  17. Naing NN. Easy way to learn standardization: direct and indirect methods. Malays J Med Sci 2000;7(1):10-15.
  18. Tsutsui H, Isobe M, Ito H, Ito H, Okumura K, Ono M, et al. Guidelines for diagnosis and treatment of acute and chronic heart failure (JCS 2017/JHFS 2017) [cited 2020 Feb 10]. Available from: http://www.j-circ.or.jp/guideline/pdf/JCS2017_tsutsui_h.pdf (Japanese).
  19. Yamakita M, Uchida H, Kawamura K, Homma T, Odagiri Y. Effects of age, period, and cohort on the trends in obesity rate and energy intake ratio from fat in Japanese adults. Nihon Koshu Eisei Zasshi 2014;61(8):371-384. (Japanese).
  20. Mieno MN, Tanaka N, Arai T, Kawahara T, Kuchiba A, Ishikawa S, et al. Accuracy of death certificates and assessment of factors for misclassification of underlying cause of death. J Epidemiol 2016;26(4):191-198. https://doi.org/10.2188/jea.JE20150010