Epidemiology of acute coronary syndrome

We reviewed epidemiological findings of acute coronary syndrome (ACS) in Japan. Japan has the lowest mortality and morbidity of ACS in the world. However, the crude mortality of acute myocardial infarction in 2003 increased approximately as twice as that in 1970, most likely due to an aging of population. More importantly, several Japanese prospective studies have failed to demonstrate the decline of the age-adjusted incidence of ACS despite the obvious reduction of ACS incidence caused by the intervention to the risk factors. Particularly, one study implied the increase of ACS patients aged more than 80. Given that the prevalence of dyslipidemia, diabetes, and obesity has increased in Japan, we should endeavor to modify these risk factors, especially in the elderly.