title: Association between mortality and incidence rates of coronary heart disease and stroke: The Japan Public Health Center-based prospective (JPHC) study.
abstract: BACKGROUND
  It is essential to have information on incidence rates to estimate the burden of cardiovascular diseases (CVD); however, it is not clear whether mortality measurements are eligible for incidence estimations.
  
  
  METHODS
  We performed eight cohort studies from 1990 to 2010 in Japan, which consisted of total 94,657 residents aged 40-59years who were followed-up for a median of 18.5years. Incidence and mortality rates for coronary heart disease (CHD) and stroke events were ascertained. Sex-specified incidence rates were regressed to the mortality rates, adjusting for differences in community and age group. Further, incidence-to-mortality rate ratios were estimated using the Poisson regression with random intercepts.
  
  
  RESULTS
  CHD or stroke mortality rates were highly associated with incidence rates in communities. Incidence-to-mortality rate ratios were 2.06 (95% confidence interval, 1.56-2.73) in men and 1.41 (1.01-1.95) in women for CHD; and 3.99 (3.32-4.80) in men and 4.44 (3.73-5.29) in women for stroke. There were no significant geographical variations in the ratio among the 8 areas.
  
  
  CONCLUSIONS
  We determined that it is possible to estimate CHD and stroke occurrences in the population from their mortality rates reported in vital statistics. Accordingly, we should pay attention to the communities in which mortality rates due to CHD or stroke reported in vital statistics are higher, and promote CVD prevention positively.
authors: Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Toon, Japan. Electronic address: saitoi@m.ehime-u.ac.jp.
authors: Isao
authors: I
authors: Saito
authors: Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors: Kazumasa
authors: K
authors: Yamagishi
authors: Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
authors: Yoshihiro
authors: Y
authors: Kokubo
authors: Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan.
authors: Hiroshi
authors: H
authors: Yatsuya
authors: Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.
authors: Hiroyasu
authors: H
authors: Iso
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors: Norie
authors: N
authors: Sawada
authors: AXA Department of Health and Human Security, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Manami
authors: M
authors: Inoue
authors: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors: Shoichiro
authors: S
authors: Tsugane
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011446:Prospective Studies; D011634:Public Health / Q000639:trends*; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality*
keywords: Coronary heart disease; Ecological study; Epidemiology; Stroke