Korean Circ J.  2021 Aug;51(8):643-655. 10.4070/kcj.2021.0121.

Modifiable Risk Factors for Cardiovascular Disease in Korea and Japan

Affiliations
  • 1Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
  • 2Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
  • 3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 5Department of Public Health, Faculty of Medicine, Minia University, Minya, Egypt
  • 6Department of Public Health, Yonsei University Graduate School, Seoul, Korea

Abstract

Cardiovascular disease (CVD) is the leading cause of death and a major contributor to disability worldwide. Since the majority of cardiovascular events are preventable, identification of modifiable CVD risk factors and implementation of primordial prevention strategies should be a public health priority. In this aspect, the American Heart Association declared a strategic goal to reduce total CVD mortality in the US by 20% within 10 years via eliminating 7 major CVD risk factors (hypertension, diabetes, dyslipidemia, cigarette smoking, physical inactivity, obesity, and poor-quality diet) in 2010, and their strategy has been achieving. However, the applicability of similar metrics to prevent CVD among East Asians requires an in-depth investigation of the modifiable CVD risk factors based on national and regional evidence-based findings. Herein, this review article aims to discuss several modifiable risk factors for CVDs, using epidemiological evidence from cohort studies and nationally representative data of 2 East Asian countries: Korea and Japan.

Keyword

Risk factor; Modification; Prevention; Cardiovascular disease; Korea; Japan

Figure

  • Figure 1 Prevalence of cardiovascular risk factors in Korea and Japan. (A) Hypertension, (B) diabetes, (C) current smoking, (D) physical inactivity, (E) obesity. Error bars indicate 95% confidence intervals.


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Reference

1. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392:1736–1788. PMID: 30496103.
2. Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. J Am Coll Cardiol. 2020; 76:2982–3021. PMID: 33309175.
3. Lee HH, Cho SMJ, Lee H, et al. Korea heart disease fact sheet 2020: analysis of nationwide data. Korean Circ J. 2021; 51:495–503. PMID: 34085422.
Article
4. Baek J, Lee H, Lee HH, Heo JE, Cho SMJ, Kim HC. Thirty-six year trends in mortality from diseases of circulatory system in Korea. Korean Circ J. 2021; 51:320–332. PMID: 33821581.
Article
5. Hata J, Ninomiya T, Hirakawa Y, et al. Secular trends in cardiovascular disease and its risk factors in Japanese: half-century data from the Hisayama study (1961–2009). Circulation. 2013; 128:1198–1205. PMID: 23902756.
6. Jang IY, Lee HY, Lee E. 50th Anniversary Committee of Korean Geriatrics Society. Geriatrics fact sheet in Korea 2018 from national statistics. Ann Geriatr Med Res. 2019; 23:50–53. PMID: 32743288.
Article
7. Nakatani H. Population aging in Japan: policy transformation, sustainable development goals, universal health coverage, and social determinates of health. Glob Health Med. 2019; 1:3–10. PMID: 33330747.
Article
8. Stewart J, Manmathan G, Wilkinson P. Primary prevention of cardiovascular disease: A review of contemporary guidance and literature. JRSM Cardiovasc Dis. 2017; 6:2048004016687211. PMID: 28286646.
Article
9. Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic Impact Goal through 2020 and beyond. Circulation. 2010; 121:586–613. PMID: 20089546.
10. Mensah GA, Wei GS, Sorlie PD, et al. Decline in cardiovascular mortality: possible causes and implications. Circ Res. 2017; 120:366–380. PMID: 28104770.
11. Lee HY, Shin J, Kim GH, et al. 2018 Korean Society of Hypertension guidelines for the management of hypertension: part II-diagnosis and treatment of hypertension. Clin Hypertens. 2019; 25:20. PMID: 31388453.
Article
12. Umemura S, Arima H, Arima S, et al. The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2019). Hypertens Res. 2019; 42:1235–1481. PMID: 31375757.
13. The World Bank. Data, population, total [Internet]. Washington, D.C.: The World Bank;2020. cited 2021 March 11. Available from: https://data.worldbank.org/indicator/SP.POP.TOTL?.
14. Kim HC, Cho SMJ, Lee H, et al. Korea hypertension fact sheet 2020: analysis of nationwide population-based data. Clin Hypertens. 2021; 27:8. PMID: 33715619.
Article
15. Fuchs FD, Whelton PK. High blood pressure and cardiovascular disease. Hypertension. 2020; 75:285–292. PMID: 31865786.
Article
16. Ueshima H, Sekikawa A, Miura K, et al. Cardiovascular disease and risk factors in Asia: a selected review. Circulation. 2008; 118:2702–2709. PMID: 19106393.
17. Soenarta AA, Buranakitjaroen P, Chia YC, et al. An overview of hypertension and cardiac involvement in Asia: focus on heart failure. J Clin Hypertens (Greenwich). 2020; 22:423–430. PMID: 31955506.
Article
18. Oh HJ, Lee S, Lee EK, et al. Association of blood pressure components with mortality and cardiovascular events in prehypertensive individuals: a nationwide population-based cohort study. Ann Med. 2018; 50:443–452. PMID: 29929398.
Article
19. Lida M, Ueda K, Okayama A, et al. Impact of elevated blood pressure on mortality from all causes, cardiovascular diseases, heart disease and stroke among Japanese: 14 year follow-up of randomly selected population from Japanese -- Nippon data 80. J Hum Hypertens. 2003; 17:851–857. PMID: 14704729.
Article
20. Jung HH. Association of optimal blood pressure with critical cardiorenal events and mortality in high-risk and low-risk patients treated with antihypertension medications. JAMA Netw Open. 2019; 2:e199307. PMID: 31441935.
Article
21. Lee CJ, Ryu J, Kim HC, et al. Clinical benefit of treatment of stage-1, low-risk hypertension. Hypertension. 2018; 72:1285–1293. PMID: 30571236.
Article
22. Ikeda A, Iso H, Yamagishi K, Inoue M, Tsugane S. Blood pressure and the risk of stroke, cardiovascular disease, and all-cause mortality among Japanese: the JPHC study. Am J Hypertens. 2009; 22:273–280. PMID: 19229210.
Article
23. Kim MK, Ko SH, Kim BY, et al. 2019 Clinical practice guidelines for type 2 diabetes mellitus in Korea. Diabetes Metab J. 2019; 43:398–406. PMID: 31441247.
Article
24. Araki E, Goto A, Kondo T, et al. Japanese clinical practice guideline for diabetes 2019. J Diabetes Investig. 2020; 11:1020–1076.
Article
25. International Diabetes Federation. IDF Diabetes Atlas. 9th ed. Brussels: International Diabetes Federation;2019.
26. De Rosa S, Arcidiacono B, Chiefari E, Brunetti A, Indolfi C, Foti DP. Type 2 diabetes mellitus and cardiovascular disease: genetic and epigenetic links. Front Endocrinol (Lausanne). 2018; 9:2. PMID: 29387042.
Article
27. Aambø A, Klemsdal TO. Cardiovascular disease and diabetes in patients with African or Asian background. Tidsskr Nor Laegeforen. 2017; 137.
28. Kim HK, Lee JB, Kim SH, et al. Association of prediabetes, defined by fasting glucose, HbA1c only, or combined criteria, with the risk of cardiovascular disease in Koreans. J Diabetes. 2016; 8:657–666. PMID: 26355268.
Article
29. Bae JC, Cho NH, Suh S, et al. Cardiovascular disease incidence, mortality and case fatality related to diabetes and metabolic syndrome: a community-based prospective study (Ansung-Ansan cohort 2001–12). J Diabetes. 2015; 7:791–799. PMID: 25407754.
Article
30. Hayama-Terada M, Muraki I, Imano H, et al. Diabetes trend and impact on risk of cardiovascular disease in middle-aged Japanese people - the CIRCS study. Circ J. 2016; 80:2343–2348. PMID: 27666757.
31. Saito I, Kokubo Y, Yamagishi K, Iso H, Inoue M, Tsugane S. Diabetes and the risk of coronary heart disease in the general Japanese population: the Japan Public Health Center-based prospective (JPHC) study. Atherosclerosis. 2011; 216:187–191. PMID: 21300356.
Article
32. Cui R, Iso H, Yamagishi K, et al. Diabetes mellitus and risk of stroke and its subtypes among Japanese: the Japan Public Health Center study. Stroke. 2011; 42:2611–2614. PMID: 21836098.
33. Rhee EJ, Kim HC, Kim JH, et al. 2018 Guidelines for the management of dyslipidemia in Korea. J Lipid Atheroscler. 2019; 8:78–131. PMID: 32821702.
Article
34. Kinoshita M, Yokote K, Arai H, et al. Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017. J Atheroscler Thromb. 2018; 25:846–984. PMID: 30135334.
Article
35. Kim HS, Kim JH, Yu SH, et al. Dyslipidemia fact sheets in Korea, 2018 [Internet]. Seoul: Korean Society of Lipid and Atherosclerosis;2018. cited 2021 March 28. Available from: https://www.lipid.or.kr/bbs/index.html?code=fact_sheet&category=&gubun=&page=1&number=896&mode=view&keyfield=&key=.
36. Ministry of Health, Labour and Welfare (JP). National Health and Nutrition Survey in Japan [Internet]. Tokyo: Ministry of Health, Labour and Welfare;2015. cited 2021 March 11. Available from: http://www.mhlw.go.jp/toukei/itiran/gaiyo/k-eisei.html.
37. Stein R, Ferrari F, Scolari F. Genetics, dyslipidemia, and cardiovascular disease: new insights. Curr Cardiol Rep. 2019; 21:68. PMID: 31227920.
Article
38. Lee H, Park JB, Hwang IC, et al. Association of four lipid components with mortality, myocardial infarction, and stroke in statin-naïve young adults: a nationwide cohort study. Eur J Prev Cardiol. 2020; 27:870–881. PMID: 32013600.
Article
39. Okamura T, Tanaka H, Miyamatsu N, et al. The relationship between serum total cholesterol and all-cause or cause-specific mortality in a 17.3-year study of a Japanese cohort. Atherosclerosis. 2007; 190:216–223. PMID: 16529754.
Article
40. World Health Organization. WHO global report on trends in prevalence of tobacco smoking 2000–2025. 2nd ed. Geneva: World Health Organization;2018.
41. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004; 364:937–952. PMID: 15364185.
Article
42. Baba S, Iso H, Mannami T, et al. Cigarette smoking and risk of coronary heart disease incidence among middle-aged Japanese men and women: the JPHC study Cohort I. Eur J Cardiovasc Prev Rehabil. 2006; 13:207–213. PMID: 16575274.
Article
43. Honjo K, Iso H, Tsugane S, et al. The effects of smoking and smoking cessation on mortality from cardiovascular disease among Japanese: pooled analysis of three large-scale cohort studies in Japan. Tob Control. 2010; 19:50–57. PMID: 20008160.
Article
44. World Health Organization. Global recommendations on physical activity for health [Internet]. Geneva: World Health Organization;2010. cited 2021 March 11. Available from: http://whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf?ua=1.
45. An KY. Physical activity level in Korean adults: the Korea National Health and Nutrition Examination Survey 2017. Epidemiol Health. 2019; 41:e2019047. PMID: 31801321.
Article
46. Chen T, Kishimoto H, Honda T, et al. Patterns and levels of sedentary behavior and physical activity in a general Japanese population: the Hisayama study. J Epidemiol. 2018; 28:260–265. PMID: 29176275.
Article
47. Li J, Siegrist J. Physical activity and risk of cardiovascular disease--a meta-analysis of prospective cohort studies. Int J Environ Res Public Health. 2012; 9:391–407. PMID: 22470299.
Article
48. Jeong SW, Kim SH, Kang SH, et al. Mortality reduction with physical activity in patients with and without cardiovascular disease. Eur Heart J. 2019; 40:3547–3555. PMID: 31504416.
Article
49. Kubota Y, Iso H, Yamagishi K, Sawada N, Tsugane S. JPHC Study Group (Japan Public Health Center). Daily total physical activity and incident cardiovascular disease in Japanese men and women: Japan Public Health Center-based prospective study. Circulation. 2017; 135:1471–1473. PMID: 28396381.
50. Noda H, Iso H, Toyoshima H, et al. Walking and sports participation and mortality from coronary heart disease and stroke. J Am Coll Cardiol. 2005; 46:1761–1767. PMID: 16256882.
Article
51. World Health Organization. Obesity and overweight [Internet]. Geneva: World Health Organization;2020. cited 2021 March 11. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
52. Seo MH, Lee WY, Kim SS, et al. 2018 Korean Society for the study of obesity guideline for the management of obesity in Korea. J Obes Metab Syndr. 2019; 28:40–45. PMID: 31089578.
Article
53. Examination Committee of Criteria for 'Obesity Disease' in Japan. Japan Society for the Study of Obesity. New criteria for ‘obesity disease’ in Japan. Circ J. 2002; 66:987–992. PMID: 12419927.
54. Seo MH, Kim YH, Han K, et al. Prevalence of obesity and incidence of obesity-related comorbidities in Koreans based on National Health Insurance Service Health Checkup data 2006–2015. J Obes Metab Syndr. 2018; 27:46–52. PMID: 31089540.
55. Yoshiike N, Miyoshi M. Epidemiological aspects of overweight and obesity in Japan--international comparisons. Nihon Rinsho. 2013; 71:207–216. PMID: 23631195.
56. Cercato C, Fonseca FA. Cardiovascular risk and obesity. Diabetol Metab Syndr. 2019; 11:74. PMID: 31467596.
Article
57. Shin J, Ham D, Shin S, Choi SK, Paik HY, Joung H. Effects of lifestyle-related factors on ischemic heart disease according to body mass index and fasting blood glucose levels in Korean adults. PLoS One. 2019; 14:e0216534. PMID: 31091295.
Article
58. Choi S, Kim K, Kim SM, et al. Association of obesity or weight change with coronary heart disease among young adults in South Korea. JAMA Intern Med. 2018; 178:1060–1068. PMID: 29913019.
Article
59. Li Y, Yatsuya H, Iso H, et al. Body mass index and risks of incident ischemic stroke subtypes: the Japan Public Health Center-based prospective (JPHC) study. J Epidemiol. 2019; 29:325–333. PMID: 30555115.
Article
60. Zheng W, McLerran DF, Rolland B, et al. Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med. 2011; 364:719–729. PMID: 21345101.
61. Hozawa A, Okamura T, Oki I, et al. Relationship between BMI and all-cause mortality in Japan: NIPPON DATA80. Obesity (Silver Spring). 2008; 16:1714–1717. PMID: 18421264.
Article
62. Saito I, Konishi M, Iso H, Inoue M, Tsugane S. Impact of weight change on specific-cause mortality among middle-aged Japanese individuals. J Epidemiol Community Health. 2009; 63:447–454. PMID: 19221112.
Article
63. Anand SS, Hawkes C, de Souza RJ, et al. Food consumption and its impact on cardiovascular disease: importance of solutions focused on the globalized food system: a report from the workshop convened by the World Heart Federation. J Am Coll Cardiol. 2015; 66:1590–1614. PMID: 26429085.
64. Koyama T, Yoshita K, Okuda N, et al. Overall nutrient and total fat intake among Japanese people: the INTERLIPID study Japan. Asia Pac J Clin Nutr. 2017; 26:837–848. PMID: 28802293.
65. Raatz SK, Silverstein JT, Jahns L, Picklo MJ Sr. Issues of fish consumption for cardiovascular disease risk reduction. Nutrients. 2013; 5:1081–1097. PMID: 23538940.
66. Wang YJ, Yeh TL, Shih MC, Tu YK, Chien KL. Dietary sodium intake and risk of cardiovascular disease: a systematic review and dose-response meta-analysis. Nutrients. 2020; 12:12.
Article
67. Son J, Lee Y, Park K. Effects of processed red meat consumption on the risk of type 2 diabetes and cardiovascular diseases among Korean adults: the Korean Genome and Epidemiology Study. Eur J Nutr. 2019; 58:2477–2484. PMID: 30069618.
Article
68. Nagao M, Iso H, Yamagishi K, Date C, Tamakoshi A. Meat consumption in relation to mortality from cardiovascular disease among Japanese men and women. Eur J Clin Nutr. 2012; 66:687–693. PMID: 22333876.
Article
69. Eshak ES, Iso H, Date C, et al. Rice intake is associated with reduced risk of mortality from cardiovascular disease in Japanese men but not women. J Nutr. 2011; 141:595–602. PMID: 21346103.
70. Eshak ES, Iso H, Yamagishi K, et al. Rice consumption is not associated with risk of cardiovascular disease morbidity or mortality in Japanese men and women: a large population-based, prospective cohort study. Am J Clin Nutr. 2014; 100:199–207. PMID: 24740204.
Article
71. Park JE, Ryu Y, Cho SI. The effect of reference group classification and change in alcohol consumption on the association between alcohol consumption and cardiovascular disease. Alcohol Clin Exp Res. 2017; 41:379–387. PMID: 28098956.
Article
72. Lin Y, Kikuchi S, Tamakoshi A, et al. Alcohol consumption and mortality among middle-aged and elderly Japanese men and women. Ann Epidemiol. 2005; 15:590–597. PMID: 16118003.
Article
73. Iso H, Kobayashi M, Ishihara J, et al. Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-based (JPHC) study cohort I. Circulation. 2006; 113:195–202. PMID: 16401768.
74. Yamagishi K, Iso H, Date C, et al. Fish, omega-3 polyunsaturated fatty acids, and mortality from cardiovascular diseases in a nationwide community-based cohort of Japanese men and women the JACC (Japan Collaborative Cohort Study for Evaluation of Cancer Risk) study. J Am Coll Cardiol. 2008; 52:988–996. PMID: 18786479.
75. Park Y, Park S, Yi H, et al. Low level of n-3 polyunsaturated fatty acids in erythrocytes is a risk factor for both acute ischemic and hemorrhagic stroke in Koreans. Nutr Res. 2009; 29:825–830. PMID: 19963154.
Article
76. Choi-Kwon S, Kim JS. Lifestyle factors and risk of stroke in Seoul, south Korea. J Stroke Cerebrovasc Dis. 1998; 7:414–420. PMID: 17895120.
Article
77. Lim H, Choue R. Dietary pattern, nutritional density, and dietary quality were low in patients with cerebral infarction in Korea. Nutr Res. 2011; 31:601–607. PMID: 21925345.
Article
78. Takachi R, Inoue M, Shimazu T, et al. Consumption of sodium and salted foods in relation to cancer and cardiovascular disease: the Japan Public Health Center-based prospective study. Am J Clin Nutr. 2010; 91:456–464. PMID: 20016010.
79. Nakamura Y, Ueshima H, Okamura T, et al. A Japanese diet and 19-year mortality: national integrated project for prospective observation of non-communicable diseases and its trends in the aged, 1980. Br J Nutr. 2009; 101:1696–1705. PMID: 19021919.
Article
80. Shima A, Miyamatsu N, Miura K, et al. Relationship of household salt intake level with long-term all-cause and cardiovascular disease mortality in Japan: NIPPON DATA80. Hypertens Res. 2020; 43:132–139. PMID: 31748704.
Article
81. Umesawa M, Iso H, Date C, et al. Relations between dietary sodium and potassium intakes and mortality from cardiovascular disease: the Japan Collaborative Cohort Study for Evaluation of Cancer Risks. Am J Clin Nutr. 2008; 88:195–202. PMID: 18614741.
Article
82. Ikehara S, Iso H, Date C, et al. Salt preference and mortality from stroke and coronary heart disease for Japanese men and women: the JACC study. Prev Med. 2012; 54:32–37. PMID: 22057056.
Article
83. Kweon S, Kim Y, Jang MJ, et al. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol. 2014; 43:69–77. PMID: 24585853.
Article
84. Ikeda N, Takimoto H, Imai S, Miyachi M, Nishi N. Data resource profile: the Japan National Health and Nutrition Survey (NHNS). Int J Epidemiol. 2015; 44:1842–1849. PMID: 26239276.
Article
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