Cigarette Smoking and Risk of Stroke and its Subtypes Among Middle-Aged Japanese Men and Women

Mannami, Toshifumi; Iso, Hiroyasu; Baba, Shunroku; Sasaki, Satoshi; Okada, Katsutoshi; Konishi, Masamitsu; Tsugane, Shoichiro

doi:10.1161/01.str.0000128794.30660.e8

Cited by 131 publications

(102 citation statements)

References 34 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Smoking was not found to be a risk factor for stroke in the past 26,27) ; however, recent large cohort studies in Japan, i.e. NIPPON DATA80, show a clear graded relationship between smoking and stroke [28][29][30] , as has been found in Western countries 31,32) . One explanation is that the magnitude of hypertension as a strong risk factor weakened due to the decline in population blood pressure level [3][4][5] .…”

Section: Risk Factors For Stroke and Chd In Japanmentioning

confidence: 97%

“…Serum total cholesterol is not a risk factor for stroke, either cerebral hemorrhage or cerebral infarction, in Japan 29,[33][34][35][36][37] because most incidents of cerebral infarction in Japan are caused by hypertension and smoking 11,[21][22][23][24][25][26][27][28][29][30]33) . Although atherosclerosis of large vessels in the brain is caused by hypercholesterolemia 38) , the proportion caused by hypercholesterolemia is quite low in Japan 33) .…”

Section: Risk Factors For Stroke and Chd In Japanmentioning

confidence: 99%

See 1 more Smart Citation

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

Ueshima

2007

JAT

250

225

View full text Add to dashboard Cite

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.

show abstract

Section: Risk Factors For Stroke and Chd In Japanmentioning

confidence: 97%

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

250

225

View full text Add to dashboard Cite

show abstract

“…Risk factors are dyslipidemia 10) , hypertension 11) , diabetes mellitus 8,9) , smoking habits 12) , family history 13,14) , male gender, and advanced age [15][16][17] . Arterial stiffness can be evaluated by various methods: stiffness parameter-, pulse wave velocity (PWV) 18) , carotid-femoral pulse wave velocity (cfPWV) 19) , heart-femoral pulse wave velocity (hfPWV) 20) , and brachial-ankle pulse wave velocity (baPWV) 21,22) are used as common noninvasive clinical indices, but these methods are limited because PWV is dependent on blood pressure at the measurement time.…”

Section: Introductionmentioning

confidence: 99%

Values of Cardio-Ankle Vascular Index (CAVI) between Amami Islands and Kagoshima Mainland Among Health Checkup Examinees

Hirasada

Niimura

Kubozono

et al. 2012

JAT

View full text Add to dashboard Cite

Aim:To investigate the prevalence and geographical variation of high arterial stiffness in groups from the Amami islands (Amami) and Kagoshima mainland (mainland), Japan, using the cardio-ankle vascular index (CAVI) as a surrogate marker of arterial stiffness. Methods: We recruited 4,523 health checkup examinees from Amami and 440 examinees from the mainland, with an age range of 40-69 years. The frequency of high arterial stiffness (CAVI ≥ 9.0) was geographically compared between the regions, and both mean CAVI values were compared with those of the healthy Japanese population with less risk factors for coronary artery disease. Clinical, lifestyle, and regional factors for increased CAVI values were estimated by the multiple linear regression model. Results: The frequency of high arterial stiffness on Amami was significantly lower than on the mainland. Mean CAVI values on Amami were similar in males and lower in females than in the healthy Japanese population, but those on the mainland were higher for both sexes. Age, systolic blood pressure, triglycerides, fasting blood glucose, and a history of hypertension and diabetes mellitus were positively related to increased CAVI values on Amami. The regional factor of Amami, compared with the mainland, was negatively related to increased CAVI values in both sexes after adjusting for traditional cardiovascular risk factors. Conclusion: CAVI values in Amami residents were significantly lower than in mainland residents, suggesting that environmental or genetic factors might have improved arterial stiffness in the Amami population.

show abstract

“…An 11-year follow-up of the JPHC Study of 41,282 men and women aged 40 to 59 years 29) showed that the multivariate hazard ratios (95% CIs) for current smokers compared with never-smokers were 1.27 (1.05 to 1.54) for total stroke, 3.60 (1.62 to 8.01) for subarachnoid hemorrhage, and 1.66 (1.25 to 2.20) for ischemic stroke. The corresponding hazard ratios for women were 1.98 (1.42 to 2.77), 2.70 (1.45 to 5.02) and 1.57 (0.86 to 2.87).…”

Section: Smoking and Smoking Cessationmentioning

confidence: 99%

Lifestyle and Cardiovascular Disease in Japan

Iso

2011

JAT

Self Cite

143

108

View full text Add to dashboard Cite

The aim was to give on overview of the profile of cardiovascular disease, vascular pathology and the relationships between lifestyle and cardiovascular disease in Japanese. Compared with the United States and Europe, the higher mortality from stroke and lower mortality from coronary heart disease constitute a unique cardiovascular profile for Japan.A selective review of population-based pathology, trend and prospective cohort studies was performed to clarify the characteristics of cardiovascular disease and vascular pathology, trends in the incidence and mortality of cardiovascular disease, and the relationships between lifestyle and cardiovascular disease among Japanese adults. Since the 1970s, mortality from coronary heart disease as well as stroke has declined substantially in Japan, probably due to a major decline in blood pressure levels and for men a more recent decline in smoking, in spite of an increase in body mass index and total cholesterol levels. However, the decline in mortality was smaller and plateaued in middle-aged men aged 30-49 in the metropolitan cities of Tokyo and Osaka. The incidence of coronary heart disease has increased among middle-aged men residing in the suburbs of Osaka. As for the associations between lifestyle and cardiovascular disease, higher sodium, lower calcium and lower animal protein content in the diet and for men higher alcohol consumption may account for the higher prevalence of hypertension and higher risk of stroke for Japanese than for western populations. On the other hand, lower saturated fat (meat) and higher n3 polyunsaturated fat (fish) in the Japanese diet may contribute to the lower prevalence of hypercholesterolemia and lower risk of coronary heart disease among Japanese.Japan is unique among developed countries in that coronary heart disease mortality has been low and has continued to decline, while stroke mortality has declined substantially. However, a recent trend for coronary heart disease incidence to increase among urban men is a cause for concern as a potential source of future problems for public health and clinical practice in Japan.J Atheroscler Thromb, 2011; 18:83-88.

show abstract

Cigarette Smoking and Risk of Stroke and its Subtypes Among Middle-Aged Japanese Men and Women

Cited by 131 publications

References 34 publications

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

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

Values of Cardio-Ankle Vascular Index (CAVI) between Amami Islands and Kagoshima Mainland Among Health Checkup Examinees

Lifestyle and Cardiovascular Disease in Japan

Contact Info

Product

Resources

About