Projections of future coronary heart disease and stroke mortality in Japan until 2040: a Bayesian age-period-cohort analysis

Eri Kiyoshige; Soshiro Ogata; Martin O'Flaherty; Simon Capewell; Misa Takegami; Koji Iihara; Chris Kypridemos; Kunihiro Nishimura

doi:10.1016/j.lanwpc.2022.100637

Projections of future coronary heart disease and stroke mortality in Japan until 2040: a Bayesian age-period-cohort analysis

Lancet Reg Health West Pac. 2022 Nov 15:31:100637. doi: 10.1016/j.lanwpc.2022.100637. eCollection 2023 Feb.

Authors

Eri Kiyoshige¹, Soshiro Ogata¹, Martin O'Flaherty², Simon Capewell², Misa Takegami¹, Koji Iihara³, Chris Kypridemos², Kunihiro Nishimura¹

Affiliations

¹ Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Simmachi, Suita, Osaka 564-8565, Japan.
² Department of Public Health, Policy and Systems, University of Liverpool, L69 3GB, Brownlow Street, Liverpool, UK.
³ Director General, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, Japan.

Abstract

Background: We aimed to estimate the future burden of coronary heart disease (CHD) and stroke mortalities by sex and all 47 prefectures of Japan until 2040 while accounting for effects of age, period, and cohort and integrating them to be at the national level to account for regional differences among prefectures.

Methods: We estimated future CHD and stroke mortality projections, developing Bayesian age-period-cohort (BAPC) models in population and the number of CHD and stroke by age, sex, and all 47 prefectures observed from 1995 to 2019; then applying these to official future population estimates until 2040. The present participants were all men and women aged over 30 years and were residents of Japan.

Findings: In the BAPC models, the predicted number of national-level cardiovascular deaths from 2020 to 2040 would decrease (39,600 [95% credible interval: 32,200-47,900] to 36,200 [21,500-58,900] CHD deaths in men, and 27,400 [22,000-34,000] to 23,600 [12,700-43,800] in women; and 50,400 [41,900-60,200] to 40,800 [25,200-67,800] stroke deaths in men, and 52,200 [43,100-62,800] to 47,400 [26,800-87,200] in women).

Interpretation: After adjusting these factors, future CHD and stroke deaths will decline until 2040 at the national level and in most prefectures.

Funding: This research was supported by the Intramural Research Fund of Cardiovascular Diseases of the National Cerebral and Cardiovascular Center (21-1-6, 21-6-8), JSPS KAKENHI Grant Number JP22K17821, and the Ministry of Health, Labour and Welfare Comprehensive Research on Life-Style Related (Diseases Cardiovascular Diseases and Diabetes Mellitus Program), Grant Number 22FA1015.

Keywords: APC, age-period-cohort; BAPC, Bayesian age-period-cohort; Bayesian age-period-cohort; CHD, coronary heart disease; CI, credible intervals; CVD, cardiovascular disease; Coronary heart disease; RMSE, root mean square errors; Stroke; Vital statistics; y.o., years old.