Cardiovascular Diseases Clinical Trial
Official title:
Epidemiology of Coronary Heart Disease in Men Aged 40 and Over
To examine whether the prevalence of subclinical coronary and aortic atherosclerotic disease is different among Japanese in Japan, Japanese in Hawaii, and black and white Americans.
BACKGROUND:
Substantial change toward a more Westernized lifestyle has taken place among younger
individuals who were born after World War II (WWII) in non-Western countries including
Japan. Data from national sample surveys in Japan clearly demonstrate that risk factor
profiles for coronary heart disease (CHD) are very similar to those in the United States
(US) in this post WWII cohort. Men in Japan do have a considerably higher prevalence of
cigarette smoking and men in the US have a higher prevalence of obesity. CHD mortality among
men in Japan is, however, still less than a half of that in the US. Careful review of
mortality statistics confirms this. This difference remains unique among industrialized
countries.
DESIGN NARRATIVE:
The study is a collaboration between Dr. Akira Sekikawa at the University of Pittsburgh and
Dr. J. David Curb of the Pacific Health Research Institute in Honolulu, Hawaii. The study
tests the null hypothesis that there are no differences in the extent of atherosclerosis
among Japanese men in Japan, Japanese American men in Hawaii, and US white and black men in
this post WWII birth cohort. The project is based on recent and ongoing successful Japan/US
collaborations in the INTERMAP, INTERLIPID and Honolulu Heart Program studies including
development of the first standardized US/Japan diet tables. The investigators will examine
300 white men and 100 black men aged 40-49, randomly selected from Allegheny County, PA, 300
Japanese American men aged 40-49 from the population-based sample recruited from the
offspring of the members of the Honolulu Heart Program cohort, and 300 Japanese men aged
40-49, randomly selected from Kusatsu City, Japan. The Japanese recruitment and examination
has already been supported in Japan. The extent of atherosclerosis and risk factor profiles
for CHD will be evaluated and compared, as well as the relationship of specific risk factors
to the measures of atherosclerosis. The measures of subclinical disease proposed include
calcium scores of coronary artery and aorta measured by electron beam computed tomography
(EBCT) and carotid intima thickness measured by ultrasound. Other proposed measures include
dietary intake by food frequency questionnaire, total cholesterol, LDLc, HDLc, lipids by NMR
spectroscopy, blood pressure, cigarette smoking, thiocyanate, omega-3 fatty acid, alcohol
consumption, body mass index (BMI), intra-abdominal fat, and others.
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Observational Model: Cohort, Time Perspective: Cross-Sectional
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