Atherosclerosis in a Defined Japanese Population: A Clinicopathologic Appraisal

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Abstract
During 1 year, 132 men and women, aged 40 to 69, were examined after death in Hiroshima and Nagasaki. The subjects were members of a defined study sample and were representative for age and sex of all who had died in these cities during the period of study. The degree of atherosclerosis of the aorta and of the coronary and cerebral arteries was graded systematically. In general, atherosclerosis increased in severity with age and correlated positively with antecednet hypertension and with a concentration of cholesterol that exceeded 200 mg. per 100 ml. of blood; in particular, the frequency of occurrence of fibrous plaques and complicated atherosclerotic lesions was related to those factors. In the group of Japanese persons studied, the degree of atherosclerosis was relatively greater in the aorta than in the coronary arteries were relatively spared. A myocardial infarct was demonstrated in 10.3%, and was the cause of death in 3.4%. All infarcts were associated with severe coronary atherosclerosis. Cerebrovascular lesions were very common, occurring in 41% of persons; they were the cause of death in 20%. Intracerebral hemorrhage caused death of 10 of the 111 persons (9%). Cerebral hemorrhage, however, did not occur as often as cerebral infarcts. Cerebral aneurysms, often multiple, were frequently encountered in the study sample. The value of a combined study of clinical and pathologic findings in a defined sample, unselected for disease and continuously surveyed, is noted.