A retrospective, cross-sectional study of real-world values of cardiovascular risk factors using a healthcare database in Japan

BMC Cardiovascular Disorders

Yoko Fujimoto⁴  Yumiko Ikeda¹  Satoshi Nagayasu²  Yuji Yamamoto²  Yoichi Ii³  Daisuke Shima⁴ 

[1] Medical Writing, Pfizer Japan Inc., 3-22-7 Yoyogi, Shibuya-ku, Tokyo 151-8589, Japan;MinaCare Co. Ltd., Japan, 1-23 Kandanishiki-cho, Chiyoda-ku, Tokyo 101-0054, Japan;Clinical Statistics, Pfizer Japan Inc., 3-22-7 Yoyogi, Shibuya-ku, Tokyo 151-8589, Japan;Medical Affairs, Pfizer Japan Inc., 3-22-7 Yoyogi, Shibuya-ku, Tokyo 151-8589, Japan

关键词: Hemoglobin A1c;    Low-density lipoprotein cholesterol;    Blood pressure;    Japanese epidemiology;    Noncommunicable disease;    MinaCare database;    Specific health checkups and specific health guidance;    National Health and Nutrition Survey;   

Others  :  1088452
DOI  :  10.1186/1471-2261-14-120

 received in 2014-02-19, accepted in 2014-09-09,  发布年份 2014

【 摘 要 】

Background

Data collected by the Japanese Ministry of Health, Labour and Welfare (MHLW), namely data from the Specific Health Checkups and Specific Health Guidance (MHLW-SH) and the National Health and Nutrition Survey (MHLW-H&N) allow assessment of blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c) in Japan. Recently, a large database of employment-based health insurance has been developed by MinaCare Co. Ltd.

Methods

A retrospective, cross-sectional study using the Japanese healthcare checkup database developed by MinaCare Co. Ltd. was designed to investigate the distribution of real-world values of BP, LDL-C, and HbA1c in Japan. Data in the MinaCare database were also compared with those in the two national data sources to assess the extent to which the health status in Japan is reflected in each data source.

Results

Of the healthcare checkup results of 232515 subjects in the 2011 MinaCare database, 49.9% were male and 50.1% were female. The age of the subjects ranged from <20 to >70 years. The proportion of subjects with systolic BP (SBP) ≥140 mmHg, LDL-C ≥140 mg/dL, and HbA1c ≥6.1% generally increased with increasing age. If one focused on the upper-end age group representing the majority of the MinaCare study population (i.e. age range, 55–59 years), the proportions of subjects with SBP ≥140 mmHg, LDL–C ≥140 mg/dL, and HbA1c ≥6.1% were 19.0%/12.2% (males/females), 27.2%/42.7%, and 13.5%/5.4%, respectively. The MinaCare database was mostly comparable with the two national data sources; however, some notable differences in BP and lipid parameters were found between MHLW-H&N and the other two data sources.

Conclusions

Analysis of the MinaCare database indicated that a substantial proportion of subjects did not achieve the target BP, LDL-C, and HbA1c levels to reduce the risk of future cardiovascular and cerebrovascular disease events. The results were generally consistent with those of the national data sources. Considering its characteristics of low selection bias, large sample size, wide age distribution, and high flexibility in analysis of subject-level data, the MinaCare database is highly valuable for studying the health status of the population covered by employment-based health insurance.

【 授权许可】

   
2014 Shima et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]National Ministry of Health, Labour and Welfare Database [http://www.e-stat.go.jp/SG1/estat/NewList.do?tid=000001031167 webcite] (in Japanese)
• [2]WHO statistical information system on causes of death, mortality and health status http://www.who.int/research/en/ webcite
• [3]Okamura T, Kadowaki T, Hayakawa T, Kita Y, Okayama A, Ueshima H, Nippon Data80 Research Group: What cause of mortality can we predict by cholesterol screening in the Japanese general population? J Intern Med 2003, 253:169-180.
• [4]Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, Imai Y, Imaizumi T, Ito S, Iwao H, Kario K, Kawano Y, Kim-Mitsuyama S, Kimura G, Matsubara H, Matsuura H, Naruse M, Saito I, Shimada K, Shimamoto K, Suzuki H, Takishita S, Tanahashi N, Tsuchihashi T, Uchiyama M, Ueda S, Ueshima H, Umemura S, Ishimitsu T, Rakugi H, et al.: The Japanese Society of hypertension guidelines for the management of hypertension (JSH 2009). Hypertens Res 2009, 32:3-107.
• [5]The Japan Atherosclerosis Society: Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases. Tokyo; 2012. (in Japanese)
• [6]The Japan Diabetes Society (JDS): Evidence-based Practice Guideline for the Treatment of Diabetes in Japan. 2013. [http://www.jds.or.jp/modules/en/index.php?content_id=44 webcite]
• [7]Data Source of the National Health and Nutrition Survey [http://www.mhlw.go.jp/bunya/kenkou/kenkou_eiyou_chousa.html webcite] (in Japanese)
• [8]Data Source of the Specific Health Checkups and Specific Health Guidance [http://www.mhlw.go.jp/bunya/shakaihosho/iryouseido01/info02a-2.html webcite] (in Japanese)
• [9]Specific Health Checkups and Specific Health Guidance http://www.mhlw.go.jp/english/wp/wp-hw3/dl/2-007.pdf webcite
• [10]Sasaki S: The value of the National Health and nutrition survey in Japan. Lancet 2011, 378:1205-1206.
• [11]Ministry of Education, Culture, Sports, Science and Technology, Ministry of Health, Labour and Welfare: Ethical Guidelines for Epidemiological Research. 2008. [http://www.niph.go.jp/wadai/ekigakurinri/guidelines.pdf webcite]
• [12]Kashiwagi A: Development of the HbA1c international standardization of HbA1c measurement in Japan Diabetes Society. Rinsho Byori 2013, 61:585-593. (in Japanese)
• [13]Nguyen HN, Fujiyoshi A, Abbott RD, Miura K: Epidemiology of cardiovascular risk factors in asian countries. Circ J 2013, 77:2851-2859.
• [14]Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN, Farzadfar F, Riley LM, Ezzati M, Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index): National, regional, and global trends in body-mass index since 1980: Systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 2011, 377:557-567.
• [15]Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang YH, Stevens GA, Rao M, Ali MK, Riley LM, Robinson CA, Ezzati M, Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose): National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet 2011, 378:31-40.
• [16]WHO: Global Atlas on cardiovascular disease prevention and control. 2013. http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf webcite
• [17]Tokudome S, Nishi N, Tanaka H: Towards a better National Health and Nutrition Survey in Japan. Lancet 2012, 379:e44.