Associations of serum total cholesterol, different types of stroke, and stenosis distribution of cerebral arteries. The Akita Pathology Study.

Konishi, Masamitsu; Iso, Hiroyasu; Komachi, Yoshio; Iida, Minoru; Satō, Takashi; Jacobs, David R.; Terao, A; Baba, Shunroku; Sankai, Tomoko; Ito, Mamoru

doi:10.1161/01.str.24.7.954

Cited by 181 publications

(148 citation statements)

References 42 publications

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“…In addition to the effect of high TC on atheroscle rosis, the low TC is reported as a risk factor for intra cerebral hemorrhage, a phenomenon that was first identified in Japan (13). Low serum TC may contribute to the development of a fragile cerebrovascular en dothelium, eventually leading to the development of an gionecrosis and cerebral hemorrhage in the presence of hypertension (24). In the multiple risk factor interven tion trial, mortality from hemorrhage stroke was in-versely correlated with the serum TC level in middle aged American men (25).…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure, Serum Cholesterol Concentration and Their Related Factors in Urban and Rural Elderly of Ho Chi Minh City.

Tran

Komatsu

Nguyen³

et al. 2001

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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SummaryIn Vietnam, information about blood pressure, serum lipids and their factors is limited. To obtain some of this information, a cross sectional nutrition survey was carried out in an urban and rural area of Ho Chi Minh City with 217 participants aged 60-69y (148 females and 69 males). Anthropometry and blood pressure were measured. For three consecutive weekdays, 24h dietary recalls were performed. Single 24h urine was collected for sodium and potassium analysis. A fasting blood sample was taken and biochemical pa rameters were measured. Results indicate a high percentage of hypertension in urban (fe male: 35.5%, male: 43.8%) and rural areas (female: 22.2%, male: 35.1%). Blood pressure was correlated with body mass index (BMI) and 24h urinary sodium-to-potassium (Na/K) ratio. A high prevalence of serum total cholesterol (TC) above 220mg/dL (female: 55.3%, male: 31.3%) and overweight (female: 34.2%, male: 25.0%) were observed in urban resi dents. By contrast, 5.6% and 24.3% of rural females and males respectively had TC below 150mg/dL and both genders had the same prevalence of underweight (32.4%). TC was positively correlated with body weight, BMI, dietary protein and dietary lipids. Overweight might be a major risk factor for hypertension in our urban elderly. A high Na/K intake ratio might be a risk factor for hypertension in both areas. The high prevalence of elevated TC in the urban area might to be related to the high lipid intake, and the high prevalence of low TC in the rural area might to be related to the low lipid intake.

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Section: Discussionmentioning

confidence: 99%

Blood Pressure, Serum Cholesterol Concentration and Their Related Factors in Urban and Rural Elderly of Ho Chi Minh City.

Tran

Komatsu

Nguyen³

et al. 2001

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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“…Although atherosclerosis of large vessels in the brain is caused by hypercholesterolemia 38) , the proportion caused by hypercholesterolemia is quite low in Japan 33) . The most important risk factors for CHD are hypertension, hypercholesterolemia, smoking and diabetes mellitus 21,29) .…”

Section: Risk Factors For Stroke and Chd In Japanmentioning

confidence: 99%

Explanation for the Japanese Paradox: Prevention of Increase in Coronary Heart Disease and Reduction in Stroke

Ueshima

2007

JAT

249

225

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Japan's age-adjusted rate for mortality from stroke increased after the Second World War until 1965 and then showed a significant decline until 1990; however, the age-adjusted rate for mortality from all heart disease and coronary heart disease (CHD) increased until 1970 and then declined slowly. A puzzling question is why the rate of mortality from CHD declined in spite of an increase in serum total cholesterol level following an increase in fat consumption. It was confirmed that CHD incidence was far lower in several Japanese populations compared to Western countries in the "Monitoring Trends and Determinants in Cardiovascular Disease" (MONICA) project; therefore, the lower CHD mortality in Japan stems from the lower CHD incidence. CHD risk factors based on epidemiologic cohort studies in Japan were no different from those of other industrialized countries: hypertension, hypercholesterolemia, smoking and diabetes mellitus (DM). So, how can we explain this phenomenon ? There are three possible explanations. One is the decline in population blood pressure level and the prevalence of hypertension during the years 1965-1990; the second is the decline in smoking rate in men and women; the third is that the serum total cholesterol level for middle-aged and elderly populations remains 5-15 mg/dL lower than that of the US elderly counterpart, although men aged 40-49 in Japan and the US had similar serum total cholesterol levels. It was also noted that elderly people in Japan, as observed in the Seven Countries Study, had far lower serum total cholesterol levels in midlife, i.e., around 160 mg/dL in the 1960s. This was not the case for elderly in the US where a higher serum total cholesterol level was observed in midlife. In conclusion, the lower serum cholesterol level in the past of Japanese middle-aged and elderly people compared to Western counterparts helps to maintain the low CHD incidence and mortality supported by the declining trend in blood pressure level and smoking rate for both men and women. J Atheroscler Thromb, 2007; 14:278-286.

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“…In part, this improved outcome has been attributed to a slowed progression of intracranial (carotid) atherosclerosis (Konishi et al, 1993) consequent to a decrease in hypercholesterolemia (Amarenco and Labreuche, 2009). However, there is also evidence that the beneficial effects of such interventions potentially relate to effects independent of lipid modification.…”

Section: Introductionmentioning

confidence: 99%

Alterations in Nitric Oxide and Endothelin-1 Bioactivity Underlie Cerebrovascular Dysfunction in ApoE-Deficient Mice

Yamashiro

Milsom

Duchêne

et al. 2010

J Cereb Blood Flow Metab

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Hypercholesterolemia is associated with decreased nitric oxide (NO) bioavailability and endothelial dysfunction, a phenomenon thought to have a major role in the altered cerebral blood flow evident in stroke. Therefore, strategies that increase endothelial NO production have potential utility. Vascular reactivity of the middle cerebral artery (MCA) from C57BL/6J wild-type (WT) mice, apolipoprotein-E knockout (ApoE À/À ) mice, and mice treated with the phosphodiesterase inhibitor cilostazol (100 mg/kg) was analyzed using the tension myograph. Contractile responses to endothelin-1 were significantly enhanced in MCA from ApoE À/À mice compared with WT mice (P < 0.01), an effect absent in cilostazol-treated ApoE À/À mice. Acetylcholine-induced relaxation (which is entirely NO-dependent) was significantly impaired in MCA of ApoE À/À mice compared with WT mice (P < 0.05), again an effect prevented by cilostazol treatment. Endothelial NOS phosphorylation at Ser 1179 was decreased in the aorta of ApoE À/À mice compared with WT mice (P < 0.05), an effect normalized by cilostazol. Taken together, our data suggest that the endothelial dysfunction observed in MCA associated with hypercholesterolemia is prevented by cilostazol, an effect likely due to the increase in eNOS phosphorylation and, therefore, activity.

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Associations of serum total cholesterol, different types of stroke, and stenosis distribution of cerebral arteries. The Akita Pathology Study.

Cited by 181 publications

References 42 publications

Blood Pressure, Serum Cholesterol Concentration and Their Related Factors in Urban and Rural Elderly of Ho Chi Minh City.

Blood Pressure, Serum Cholesterol Concentration and Their Related Factors in Urban and Rural Elderly of Ho Chi Minh City.

Explanation for the Japanese Paradox: Prevention of Increase in Coronary Heart Disease and Reduction in Stroke

Alterations in Nitric Oxide and Endothelin-1 Bioactivity Underlie Cerebrovascular Dysfunction in ApoE-Deficient Mice

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