Key result
UK mortality rates remain higher than Japan, driven mainly by differences in heart disease.
Observational
Yes
The widening gap in life expectancy between the UK and Japan from 1970 to 1997 is largely attributable to higher heart disease mortality in the UK, highlighting the need for improved primary prevention.
May inform UK cardiovascular prevention priorities; leaves open whether recent advances have reduced international disparities.
BACKGROUND: Compared with other developed countries, the United Kingdom has exhibited less of an increase in life expectancy over the past 30 years. METHODS: We compared the chronological changes in the age-adjusted mortality rates (AMRs) from all causes or major causes, and in life expectancy in the United Kingdom and Japan between 1970 and 1997. RESULTS: In both 1970 and 1997 the AMRs for most major causes were higher in the United Kingdom than in Japan; the difference in the AMR between countries was smaller in 1970 than in 1997. The difference in the AMR from all causes between the United Kingdom and Japan in 1997 was mainly due to differences in the AMR for heart diseases. The trend for an increasing difference over time between the United Kingdom and Japan in the AMR from all causes was due to the decreased rate of AMR from heart diseases from 1970 to 1997 in the United Kingdom being lower than those from cerebrovascular diseases in same period in Japan. CONCLUSIONS: These data suggest that mortality rates could be reduced by a change in focus of the National Health Service toward an emphasis on primary rather than secondary prevention and associated clinical interventions. The greatest priority should be placed on reducing the incidence of heart disease by aggressively improving primary prevention.
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Nakaji et al. (2003) conducted an observational in Mortality. Residence in the United Kingdom vs. Residence in Japan was evaluated on Age-adjusted mortality rates from all causes or major causes, and life expectancy. Age-adjusted mortality rates for most major causes were higher in the United Kingdom than in Japan in 1970 and 1997, with the increasing gap mainly driven by differences in heart disease mortality.