FIGURE 9-1 Atherosclerotic heart disease mortality rates for Japanese men aged 55-64 by geographic area, 1950. SOURCE: Gordon, 1957.

maintained to date in japan and Hawaii but not in California. The main objectives of this prospective study were (1) to verify the reported differences among Japanese men in the three geographic locations by comparing prevalence of, incidence of, and mortality from coronary heart disease measured the same way, and (2) to search for the factors that could explain the observed differences. In this report, we review the findings concerning the cultural, lifestyle, and biological differences among the different population and nativity groups, and provide data on the effect of these characteristics on the incidence of cardiovascular disease. We will place special emphasis on the generational subgroups within the Honolulu Heart Program cohort, which has been followed for more than 25 years.

Details of the recruiting methods, population characteristics, and examination procedures for the cohorts have been published elsewhere (Kato et al., 1973; Kagan et al., 1974; Nichaman et al., 1975; Marmot et al., 1975; Worth et al., 1975). A brief summary follows (Table 9-1). In Japan, the target population included approximately 2,400 Japanese men who were born between January 1, 1900, and December 31, 1919, selected from the Adult Health Study population of the Radiation Effects Research Foundation in Hiroshima and Nagasaki. These men have been examined biennially since 1958 to study the late effects of indirect exposure to atomic bomb radiation. Among these men, 2,141 participated in the initial examination of the Ni-Hon-San Study in 1965-1966.