The recent trend of death rates from heart diseases, respectively at farm villages, fishing hamlets, and large towns in Japan, was examined in the variety of existing vital statistics.
The chief conclusions are as follows.
The trend of crude death rate from heart diseases, for the past ten years, has been year by year rather increasing. Now, examining the death rate by age groups, we find that, at the advanced age over eighty, it has by bits increased, but, at the age below that, it has rather decreased. As for the type of diseases, ischemic heart disease has increased a little at the advanced age, but below the middle age, it has rather decreased, and chronic rheumatic and hypertensive heart diseases have also decreased. On the other hand, heart failure and other heart diseases have rather increased.
Examining the trend of death rates from heart diseases for the past 25 years, classified, by using the proportion of industrial inhabitants, into the prefecture of farming, that of fishing, and large cities, we find that the death rate from ischemic heart diseases has been high as to the advanced age in large cities, and the death rate from heart failure and other heart diseases has been high as to the advanced and middle ages in the prefecture of farming.
From the above, it has become clear that the chief cause of the increases of heart diseases of recent years is the increase of heart failure and other heart diseases, and that it is chiefly discernible at farming villages.
Next, we investigated the death rate. from heart diseases separately of villeges which may intimately be related to our lives, in respect of the three villages and towns in the West Izu. The result is that the death rate is high in the towns, and then in the district of farming, and is the lowest in that of fishing. This kind of examination is expected to be done widely in Japan, and the universal conclusion to be got.
In addition to the above, we investigated the trend of death rate from heart diseases, from the “ Special Report of Vital Statistics: Occupational and Industrial Aspect”, and we clarified and reported that the death rate of agriculture, forestry and fishing workers, as well as urban occupation, was high in degree, and that, from the investigation separately of the cities, towns and villages of Chiba Prefecture, there was a statistically significant relation between the ratio of agricultural population and the death rate from heart diseases.

A cohort study on risk factors for all strokes and heart diseases was conducted among residents of 30-69years old in Kamo, a farming and fishing village, Shizuoka Prefecture. A study cohort (588 men and 938 women) was assembled in 1965 and followed up to 1985, for about 20 years. All dropouts by deaths from all strokes and heart diseases were checked by death certificates during these periods. The mortality rate and relative risks of death from all strokes and heart diseases were calculated, especially of those aged 50-69. The major results obtained were as the followings.
1: The death rates of all strokes and heart diseases were higher in the advanced age (from 50 to 69 years) than in the middle age (from 30 to 49 years). Sex differences were not observable in statistically.
2: The analysis of the significant risk factors revealed that systolic and diastolic hypertension, hypertensive and sclerotic changes indicated by fundscopic findings, auricular fibrillations on e. c. g, . fatness, ex-smoker, ex-drinker and having no-occupation were important for all strokes.
For the death of heart diseases, systolic hypertension, alubuminuria, Q-waves, ST-T changes on e. c. g. and smoking less than 19 cigaretts daily were regarded as significant risk factors.

To elucidate the correlation between personal behavior patterns (PBPs) and depression, we made a survey of middle-ages and elderly residents in a certain town for mental health promotion and prevention of depression. We performed not only a univariate analysis but also a multivariate analysis to compare the strength of correlation between PBPs and depression by controlling the confounding factors of age and gender.
1) Univariate analysis
Univariate analysis revealed that the PBPs that were positively related to depression (i. e., in which odds ratio was significantly greater than 1) were sleeping insufficient hours (≤6 hours), taking poorly balanced diet, and skipping breakfast.
In males, the PBPs positively related to depression were having poorly balanced diet and sleeping insufficient hours, while in females they were insufficient sleeping hours, poorly balanced diet, and no breakfast.
2) Multivariate analysis
Multivariate analysis, used to control confounding factors, revealed that the PBPs positively related to depression (for which relative risk was singnificantly greater than 1) were insufficient sleeping hours and poorly balanced diet.
In males, poorly balanced diet was positively related to depression, while in females both insuffisient sleeping hours and poorly balanced diet were related to depression.

We studied the correlations between lifestyle (a set of health-related practices sleeping hours, working hours, breakfast, eating between meals, salt, smoking, drinking, exercise, balance in diet) and the sense of well-being using by Neugarten's Life Satisfaction Index (LSI). For this purpose, a survey was made of middle aged and elderly residents in a town.
Multivariate analysis to control the confounding factors of sex and gender revealed that the practices significantly related to the sense of well-being were diet, exercise and salt in take and that the health practices promoting LSI were balanced diet, regular exercise, restriction of salt and excessive drinking, but having poorly unbalanced diet and skipping breakfast deteriorated LSI.
In males the practices promoting LSI were regular exercise, balanced diet, working long, restriction of salt, intake and working long. Lack of sleep and skipping breakfast deteriorated LSI.
In females the practices promoting LSI were balanced diet, regular execise, restriction of salt, intake and drinking. But nutritionaly imbalanced diet and not eating between meals deteriorated LSI.
Better lifestyle was correlated with high LSI irrespective of sex and gender. These results reveal that healthy lifestyle promotes subjective well-being and suggest that the health practiced deter the age-associated decline in health and the deterioration of bodily functions that typically accompany aging.

The purspose of this study was to clarify the relationships between life events and acute stresses felt by rural inhabitants of middle and advanced age. For this purpose, we made a survey of 1, 528 residents aged 40-69 in a farming village, Chiba Prefecture, and inquired of them about 27 stress-producing life events over the past one year. The correlations were sought by multivariate analysis.
A logistic regression analysis using gender and age as covariates found that significant risk variables for acute stress were trouble with relative, trouble with boss, change in number of arguments with spouse, loan, injury/illness, change in social activities, death of spouse and change in health or behavior of family member among the sources of distress, and retirement, outstanding personal achievement and change in living conditions among the source of eustress.
In males, significant variables for acute stress were loan, injury/illness and trouble with boss as distresses, and homecoming and outstanding personal achievement as etistresses. In females, trouble with relatives, change in number of arguments with spouse, change in social activities, injury/illness, change in health or behavior of family member as distresses and change in living conditions as an eustress.
The present study suggested that risk variables fostering distress are trouble with other people and health problems of the subject or family member. But there were slight differences between men and women.

For the purpose of elucidating the life events which aggravate lifestyle as a totality of healthrelated factors we made a survey of lives of residents in a rural district, and analyzed the correlation between life events and lifestyle.
The results obtained by multivariate analysis were as follows.
1) The life events significantly related to lifestyle were husband-and-wife fight, separation, debts, homecoming, death of one's best friends, inconstancy, decrease in income and insolvency.
The life events that conduce to improved lifestyle were inconstancy, discharge from employment, home coming and so on, while separation, husband-and-wife fight and in solvency were among the life events that aggregate lifestyle.
2) In males, the life events significantly related to lifestyle were homecoming, decrease in income, husband-and-wife fight, marriage, death of one's best friends, inconstancy, discharge and pregnancy.
The life events that conduce to improved lifestyle were discharge, homecoming, inconstancy and pregnancy of his wife, while the life events that deteriorate lifestyle were separation and husband-and-wife fight.
In females, marriage and personal success were significantly related to lifestyle.
The life events that conduce to improved lifestyle were personal success, divorce and retirement, while the life events that adversely influence lifestyle were insolvency, death of spouse and husband-and-wife fight.

Fundscopically identified risk factors for cerebrovascular disease (CVD) and heart disease (HD) were prospectively studied in 2, 112 men and women aged 30-59 who initially had no history of either disease and who lived in the Nishi-izu district of Shizuoka Prefecture.
Baseline medical examinations of the retinal arteries were made in a sample of 2, 112 residents in Nishi-izu Machi and Kamo Mura in 1964-1966 who were followed up until 1985. During the follow-up period, 93 died from CVD and 64 from HD.
Using a case-control study in a cohort study design, fundoscopically identified risk variables (hypertensive or arteriosclerotic changes in ocular fundus: fundoscopic classification by Scheie) were compared between the 157 cases (93 CVD cases and 64 HD cases) at the last health examination before death and 314 control survivors matched for gender, age (±2 years), and residential district. Using the same design, the progression of risk variables for 5±1 years prior to the last examination was followed to identify factors associated with circulatory disease.
From conditional logistic regression analyses using findings of the retinal arteries at the last health examination, significant risk variables for CVD were found to be the narrowing of retinal arteries and increases in reflex, whereas risk variables for HD were arteriovenous crossing (concealment) and increase in reflex.
From the same multivariate analyses using the progression of findings, significant risk variables for CVD were the ingravescence of the narrowing of retinal arteries and progressive increases in reflex, whereas for HD the only risk variables was progressive increases in reflex.
The present study suggested that, in addition to the cross-sectional findings of retinal arteries on a given occasion, the progression of findings through serial health examinations yields useful information for controlling the health of residents.

Cerebral stroke in rural areas is a very important disease both from medical and social aspects. Among strokes, infarction which occurs most frequently in elderly persons is liable to result from atherosclerosis. And for the development of atherosclerosis, essential hypertension is the most important predisposing factor. Other than hypertension, aging, diabetes mellitus, hyperlipemia, esp. low HDL/Tch ratio, increased hematocrit values, coronary insufficiency, cardiac failure, arythmia, esp. atrial fibrillation, are also accepted important risk factors. Affirmative of such findings, the authors are convinced of the fact that atrial fibrillation which is increasing recently is closely related to both cerebral thrombosis and embolism.
But, in regard to cerebral infarction no signifying or trigger factor, similar to very high blood pressure, that trigger cerebral hemorrhage, is clarified as yet. It is made clear in this connection that cardiac failure predisposed by hypertensive heart disease in old age, assisted by pathophysiological and other environmental conditions, is the important factor. The authors also studied the clinical predisposing parameters and preventive measures about strokes.

Cerebrovascular disease is still considered a serious health problem in Japanese rural areas. The rate of death from the disease is very high. Many clinical and epidemiological studies have been conducted so far. However, they have failed to come up with answers effective for prediction and prevention of the scourge.
As part of the agricultural coop commissioned research project entitled “Study of Cerebral Apoplexy: Its Prediction and Prevention, ” we took a questionnaire survey in 1985-86, to obtain data as regards patients' subjective symptoms, electrocardiographic observations, hematological findings and many others before the onset of cerebral apoplexy. Five medical research institutes affiliated with the national welfare federation of agricultural cooperatives responded to our questionnaire.
As a result, the subjective symptoms that showed stochastically significant increases from one year to three months before the onset of the disease as a whole were fatigue, forgetfulness and insomnia. When it comes to cerebrovascular infarction, shortness of breath, angina, forgetfulness, and nocturia were particularly notable.
All these symptoms are not peculiar to cerebral apoplexy, but it should be noted that these are the warning signals of the killer disease.