title: Temporal trends in sudden unexpected death in a general population: the Hisayama study.
abstract: BACKGROUND
  Studies addressing the temporal trends in the prevalence of sudden unexpected death (SUD) and its underlying causes in the general population are limited.
  
  
  METHODS
  Among a total of 1934 residents aged ≥20 years of the town of Hisayama, Japan, who died of endogenous causes of death and underwent autopsy examination (autopsy rate 78.5%) from 1962 to 2009, 204 were determined to be cases of SUD within 24 hours.
  
  
  RESULTS
  The trend in the age- and sex-adjusted prevalence of SUD among all autopsy subjects was stable over four 12-year periods (13.1% in 1962-1973, 13.4% in 1974-1985, 15.0% in 1986-1997, and 14.6% in 1998-2009; P for trend = .80). Regarding causes of death, the prevalence of SUD from stroke significantly declined with time (8.0%, 5.0%, 2.3%, and 2.1%, respectively; P for trend < .001), whereas significant increments were observed in the prevalence of SUD from heart disease (4.0%, 6.2%, 8.6%, and 9.7%; P for trend = .02) and from aortic aneurysm and dissection (0.2%, 1.2%, 2.9%, and 2.8%; P for trend = .01). In particular, the prevalence of ischemic heart disease increased 3-fold from 2.1% in 1962-1973 to 6.6% in 1998-2009 (P = .04). Reflecting the increment of ischemic heart disease, SUD within 1 hour increased significantly from 2.5% to 7.6% during this period (P = .01).
  
  
  CONCLUSIONS
  The trend in the prevalence of SUD was stable across a half century in a general Japanese population. Despite the decrement in the prevalence of SUD from stroke, that from heart disease, especially ischemic heart disease, increased significantly with time.
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nagata
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Jun
authors.initials: J
authors.lastname: Hata
authors.forename: Fumie
authors.initials: F
authors.lastname: Ikeda
authors.forename: Naoko
authors.initials: N
authors.lastname: Mukai
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Oda
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications* / Q000401:mortality; D002423:Cause of Death / Q000639:trends; D003645:Death, Sudden / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D055815:Young Adult