Japanese National Plan for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease
Authors: Masanari Kuwabara, Megumu Mori, Shigekazu Komoto
Journal: Circulation (2021)

Cerebrovascular disease, including stroke, and cardiovascular disease are the leading causes of death in Japan, which together account for 23.2% of the total number of deaths in 2018.The major causes of the need for long-term care in Japan are also cerebrovascular disease (16.1%) and cardiovascular disease (4.5%), which together account for more than one-fifth of the total.Medical expenses for both cerebrovascular and cardiovascular disease account for ≈20% of the total, which is the highest by injury/illness classification.The Cerebrovascular and Cardiovascular Disease Control Act, of Japanese national law, was promulgated by a legislative act on December 14, 2018, and enacted on December 1, 2019. 1 On the basis of the Cerebrovascular and Cardiovascular Disease Control Act, the Ministry of Health, Labour and Welfare, Japan, published the Japanese National Plan for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease (Japanese National Plan) on October 27, 2020. 2 This national plan was developed through 5 meetings of the Council for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease, 4 parliamentary associated meetings, and public comments.The Council is composed of patients with cerebrovascular or cardiovascular disease; those engaged in emergency services and health, medical, or welfare services; and those with academic experience.The Japanese National Plan reflects the opinions of not only medical professionals but also patients and other stakeholders.It has indicated both problems in the current situation and individual measures to address the problems.The 2 main goals of the Japanese National Plan are to extend healthy life expectancy by 3 years by 2040 compared with 2016 and to decrease age-adjusted mortality of cerebrovascular and cardiovascular disease.The average life expectancy and healthy life expectancy for both men and women increased by 0.67 to 1.72 years from 2010 to 2016 in Japan.In 2016, the unhealthy period which is defined as differences between healthy life expectancy (men, 72.14 years; women, 74.49years) and average life expectancy (men, 80.98 years; women, 87.14 years) was large: ≈8.8 years for men and ≈12.4 years for women.Therefore, extending healthy life expectancy is a primary goal of the Japanese National Plan.These goals are similar to those of the 2030 Impact Goal by the American Heart Association, which strives to equitably increase healthy life expectancy from 66 years to at least 68 years across the United States and from 64 years to at least 67 years worldwide by 2030. 3 However, healthy life expectancy in Japan is much longer than that in the United States.The Japanese National Plan includes 3 major measures: spreading awareness of prevention measures and accurate information on cerebrovascular and cardiovascular disease; enhancing service provision systems related to health, medical care, and welfare services; and promoting research on cerebrovascular and cardiovascular disease.The measures are important for all patients, and all the promotions are needed to achieve the plan's goals.