Residual Lifetime Risk of Cardiovascular Diseases in Japan

Abstract

Risk assessment of cardiovascular diseases (CVD) is shifting from the relative risk to an absolute risk approach. The residual lifetime risk (LTR), which provides an absolute risk assessment, is an epidemiologic measure that expresses the probability of someone of a given age and sex developing a disease condition during their remaining lifespan. The LTR estimation is important because it could be more easily comprehended by clinicians and patients. The LTR for CVD was not estimated for the Japanese population until recently, when the LTR of stroke and acute myocardial infarction (AMI) was reported. The reported LTR of stroke and AMI for middle-aged adults is substantial. The observed probabilities illustrated that approximately 1 in 5 men and women of middle age will suffer from a stroke in their remaining lifetime. On the other hand, approximately 1 in 6 men and 1 in 9 women of middle age will suffer from AMI in their remaining lifetime. Aaginst the backdrop of the aging population and worsening risk factor scenario, these estimates re-emphasize that CVD is a public health burden that requires preventive interventions. These estimates provide a means to communicate the absolute risk of CVD to the lay population, policy makers, as well as health service providers in predicting the disease burden of CVD. This easily comprehended knowledge can be used as an important index to assist in public health education and planning. J Atheroscler Thromb, 2011; 18:443-447.

Kidney Function, Albuminuria and Life Expectancy

“…Age-specific mortality rates were calculated with the person-year method [ 12 ]. The abridged life table was used to calculate life expectancies from these age-group specific mortality rates [ 13 , 14 ]. Abridged life tables and associated variances, standard errors, and 95% confidence intervals (CI) were calculated according to Chiang’s method [ 15 ].…”

Lifetime risk of diabetes among First Nations and non–First Nations people

“…However, our reported estimates need to be interpreted in light of the limitations of this type of methodology. 47,52,[54][55][56][57] First, lifetime risk estimates are population based and reflect average individuals in a population. Although they serve as general guidelines, lifetime risk estimates therefore have only restricted prognostic utility at the patient level, where the lifetime risk would be influenced by individual risk factors for diabetes.…”

Predicting lifetime risk for developing atherosclerotic cardiovascular disease in Chinese population: the China-PAR project

“…Dr. Lloyd-Jones first reported lifetime risk estimates of CHD in 1999 and published a series of articles regarding the evaluation of lifetime risk for various cardiovascular outcomes afterwards, using the most recognized risk factors [20,[36][37][38]. Subsequently, investigators from other countries also conducted lifetime risk estimations [21,25]. Although Chinese Multi-provincial Cohort Study (CMCS) has estimated lifetime risk of CVD and stroke, the relatively low follow-up rate (<80%) and inclusion of participants mostly from northern China made the extrapolation of the results limited [24,25].…”

“…In 1999, the lifetime risk of coronary heart disease (CHD) was first reported based on the Framingham Heart Study [20]. Since then, several assessments of lifetime risk for CVD, CHD, and stroke were published [21][22][23]. In addition, lifetime risk estimations of CVD and stroke among Chinese were also conducted using cohorts followed up until 2011 [24,25].…”