High BP, tobacco smoking considered biggest risk factors for mortality in Japan

Ikeda N. PLoS Med. 2012;doi:10.1371/journal.pmed.1001160.

Issue: March 2012

Tobacco smoking and high BP are the top two risk factors for noncommunicable diseases and injuries in Japan, according to recent study results.

Through data obtained on risk factor exposure from the National Health and Nutrition Examination Survey and epidemiological studies in Japan, researchers found in 2007 that tobacco smoking accounted for 129,000 deaths (95% CI, 115,000-154,000) and high BP accounted for 104,000 deaths (95% CI, 86,000-119,000). Death attributable to high BP occurred most often in those aged at least 70 years and were caused by stroke (47,000 deaths; 95% CI, 38,000-56,000) or ischemic heart disease (28,000 deaths; 95% CI, 15,000-39,000). However, in recent decades, stroke mortality caused by high BP has declined while cancer mortality caused by tobacco smoking has increased.

According to study results, after tobacco smoke and high BP, the next highest risks for death included physical inactivity (52,000 deaths; 95% CI, 47,000-58,000), high blood glucose (34,000 deaths; 95% CI, 26,000-43,000), high dietary salt intake (34,000 deaths; 95% CI, 22,000-43,000) and alcohol use (31,000 deaths; 95% CI, 27,000-35,000).

When looking at disease subtypes among both sexes, researchers found the leading risks for death were lung cancer (42,000 deaths; 95% CI, 39,000-45,000), ischemic heart disease (27,000 deaths; 95% CI, 19,000-42,000) and chronic obstructive pulmonary disease (13,000 deaths; 95% CI, 9,000-16,000). If exposure to multiple CV risk factors had been reduced, life expectancy in 2007 at age 40 years would have been extended by 1.4 years for both men and women (95% CI, 1.3-1.6 for men; 95% CI, 1.2-1.7 for women).

These results prompted researchers to recommend additional efforts to decrease adult mortality from chronic disease and injuries, such as promoting effective programs for smoking cessation and establishing a monitoring system for high BP management.

“Measuring the quality of care that is actually delivered by interventions will be of paramount importance in the assessment of current policies and programs for the treatment of multiple CV risks including hypertension,” the researchers concluded. “These concerted actions in research, public health, clinical practice and policymaking will be the key for maintaining good population health in the aging society.”

Disclosure: The researchers report no relevant financial disclosures.

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