Prevention of noncommunicable diseases is an urgent public health issue worldwide because over two thirds of deaths are caused by ischemic heart disease (IHD) and stroke. The present findings may be useful for scientific communities and policymakers to construct cardiovascular disease preventive strategies and clinical practice guidelines not only in Japan but also other countries or populations where the prevalence of obesity is not largely common. Compared with the supernormal group, nonobese/overweight individuals with risk factors had similar hazard ratios and population attributable fractions as individuals with metabolic syndrome.īecause of the much lower prevalence of obesity/overweight in Japan compared with other high‐ and middle‐income countries, a significant proportion of the population at high cardiovascular disease risk may be missed under the current program framework.
The population attributable fractions in men and women aged 40 to 64 years receiving an intensive support intervention were 17.7% and 6.6%, respectively, while that in women aged 65 to 74 years receiving a motivation‐support intervention was 9.4%. The adjusted CVD risk was 60% to 70% higher in men and women aged 40 to 64 years receiving an intensive support intervention, and 30% higher in women aged 65 to 74 years receiving a motivation‐support intervention, compared with nonobese/overweight individuals. We documented 1023 incident CVD cases (565 men and 458 women). Since the reference category included those with risk factors, we set a supernormal group (nonobese/overweight with no risk factor) as another reference. Sex‐ and age‐specific hazard ratios and population attributable fractions of CVD, which were also further adjusted to consider non–high density lipoprotein cholesterol levels, were estimated with reference to nonobese/overweight individuals, using Cox proportional hazard regression. The risk categories for lifestyle intervention were information supply only, motivation‐support intervention, and intensive support intervention. Metabolic syndrome was defined as the presence of high abdominal obesity and/or overweight plus risk factors such as high blood pressure, high triglyceride or low high‐density lipoprotein cholesterol levels, and high blood glucose levels. Individual‐level data of 29 288 Japanese individuals aged 40 to 74 years without a history of CVD from 10 prospective cohort studies were used. Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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