Why Japanese Men Have Far Less Heart Disease

Coronary artery disease, the type that causes heart attacks and is generally known as heart disease, is the leading killer in the U.S., and men have much higher rates of it than women. Things are different elsewhere, such as in Japan; this article will tell you why Japanese men have far less heart disease than Americans.

Virtually every man is taught to fear heart disease, with good reason, and wants to do everything to prevent it.

Heart disease rates are much higher in the U.S. and the UK than many other places, such as Japan. Dr. Malcolm Kendrick posted the following stats, taken from the article “Cardiovascular Disease and Risk Factors in Asia”.1

In Japan, the percentage of men who smoke is 35.4%, more than double the rate of 17.2% in the U.S.

Their average systolic blood pressure is 130.5, compared to 123.3 in the U.S.

The cholesterol level averages 201 mg/dl (5.2 mmol/L) vs 197 mg/dl (5.1 mmol/L) in the U.S.

The rate of diabetes in Japan is 7.2%, vs 12.6% in the U.S.

Yet the rate of coronary heart disease among Japanese men is less than one third that of the U.S. at 45.8 (per 100,000/year), while American men have a rate of 150.7.

Dr. Kendrick wished to make a point about cholesterol, namely that it cannot be a risk factor.

The point I wish to make is: can we learn from the Japanese experience and keep our heart disease risk low?

Japanese men smoke cigarettes at twice the rate of American men, have higher cholesterol and higher blood pressure, yet they have about 30% the rate of heart disease as in the U.S.

Note that their rate of diabetes is about 60% that of the U.S.; that’s important.

Here are some candidates for the lower male Japanese heart disease rate, along with what I believe are the best answers.


Maybe the Japanese have some kind of genetic protection against heart disease.

Unfortunately for that thesis, Japanese men who move to the U.S. have much higher rates of heart disease than Japanese men in Japan.2

The incidence rate was lowest in Japan where it was half that observed in Hawaii. The youngest men in the sample in Japan were at particularly low risk. The incidence among Japanese men in California was nearly 50 percent greater than that of Japanese in Hawaii. A striking increase in the incidence of myocardial infarction appears to have occurred in the Japanese who migrated to the United States; this increase is more pronounced in California than in Hawaii.

No, Japanese genes do not offer protection.

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