Intracerebral hemorrhage in a Japanese community, Hisayama: incidence, changing pattern during long-term follow-up, and related factors.

Ueda, Kazuo; Hasuo, Yutaka; Kiyohara, Yutaka; Wada, Junichi; Kawano, Hideo; Kato, Ikunoshin; Fujii, I; Yanai, Toshiro; Omae, Teruo; Fujishima, Masatoshi

doi:10.1161/01.str.19.1.48

Cited by 118 publications

(63 citation statements)

References 24 publications

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“…The proportion of hemorrhagic events of all strokes was greater in Honolulu than in Framingham (25% versus 17%), however, which is consistent with higher rates of hemorrhagic stroke in Japanese populations. 17 Although it is not clear that the observed difference in risk factor profiles between Honolulu and Framingham gave one cohort a risk advantage over the other, adjustment for these factors failed to appreciably diminish the large difference in the risk of thromboembolic stroke (PϽ0.001). Although the Honolulu sample was younger, had lower levels of total cholesterol, had lower body mass index, smoked fewer cigarettes per day, and consumed less alcohol, diabetes in Honolulu was 4 times more prevalent than in Framingham.…”

Section: Discussionmentioning

confidence: 99%

Risk of Hospitalized Stroke in Men Enrolled in the Honolulu Heart Program and the Framingham Study

Rodríguez

D’Agostino

Abbott

et al. 2002

Stroke

158

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Background and Purpose-Risk of death due to stroke in Japan is more than double the risk in the United States. It remains unknown why some ethnic groups are more prone to stroke than others.Our purpose was to compare the 20-year incidence of hospitalized stroke between Japanese-American men in the Honolulu Heart Program and white men in the Framingham Study. Methods-This was a 20-year follow-up study beginning around 1965, a population-based study on the island of Oahu, Hawaii, and in Framingham, Mass. Participants were 7589 men in Honolulu and 1216 men in Framingham without prevalent coronary heart disease and stroke. Subjects were 45 to 68 years old when follow-up began. Main outcome measures were incident thromboembolic and hemorrhagic stroke. Results-Framingham men had a 40% excess of thromboembolic stroke compared with Honolulu men after adjustment for age and other risk factors (62/1000 versus 45/1000, respectively, PϽ0.001), whereas incidence of hemorrhagic stroke was nearly identical (14.8/1000). In both cohorts, each stroke type was consistently elevated in the presence of hypertension and cigarette smoking. Diabetes and body mass index increased the risk of thromboembolic stroke in both samples, and diabetes increased the risk of hemorrhagic events in Framingham. Alcohol intake and low total cholesterol were associated with hemorrhagic events in Honolulu but not in Framingham. Despite occasional differences in risk factor effects, none were significantly different between cohorts. Conclusions-The incidence of thromboembolic stroke requiring hospitalization is markedly less in Honolulu than in Framingham. The difference in stroke incidence rates observed cannot be explained by the traditional risk factors. Further studies are needed to identify factors that protect Japanese-American men in Honolulu from stroke.

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Section: Discussionmentioning

confidence: 99%

Risk of Hospitalized Stroke in Men Enrolled in the Honolulu Heart Program and the Framingham Study

Rodríguez

D’Agostino

Abbott

et al. 2002

Stroke

158

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“…- 28 Ganglionic hemorrhage related to hypertension had the same frequency as in the west, but subarachnoid hemorrhage and lobar intracerebral hemorrhage due to arteriovenous malformations had lower incidences, suggesting that aneurysm and arteriovenous malformations are less common in this ethnic group. 29 Our findings on lacunar infarcts are comparable to those in other studies, which indicate that lacunar syndromes are more common in the elderly, in hypertensive persons, and in males.…”

Section: ^7mentioning

confidence: 93%

Cerebrovascular disease in Saudi Arabia.

Yaqub

Shamena

Kolawole

et al. 1991

Stroke

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We studied the pattern and outcome of strokes in 200 Saudi patients. Cerebral infarction constituted 87% of strokes, subarachnoid hemorrhage 4.5%, cerebral hemorrhage 6.5%, and venous infarction 2%. The vessel most commonly involved was part or all of the middle cerebral artery, constituting 52% (90) of the 174 arterial infarcts. Lacunar infarcts were seen in 21% (37) of the patients with arterial infarcts. Among all 200 patients, 8% died and 8% had secondary generalized seizures. Hypertension occurred in 41% of the 174 patients with arterial infarcts and 62% of the 13 with cerebral hemorrhages. The highest incidence of hypertension as a risk factor was among those with lacunar infarcts (81%), ganglionic cerebral hemorrhages (80%), and infarcts of deep branches of the middle cerebral artery (57%). Embolic infarcts due to rheumatic heart disease constituted 11% of all arterial infarcts. We conclude that our pattern of strokes is similar to that of the west rather than that of the Japanese, but with less frequent arteriovenous malformations and aneurysms. (Stroke 1991^22:1173-1176)

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“…[10][11][12] Cohort studies in Japan also identified hypertension or high blood pressure as an important risk factor for cardiovascular disease. 2,3,[13][14][15] In this paper the current epidemiology of hypertension in China and Japan, which are in different stages of economic development, are presented.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of hypertension in China and Japan

2000

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Hypertension is a major risk factor for cardiovascular disease in Chinese and Japanese with a low to moderate serum cholesterol level. The prevalence of hypertension is diverse in Chinese populations with different geographic region, lifestyles and cultures. The same diversity was observed in Japan in the past, but recently the regional difference has become smaller. The large decline in stroke mortality in Japan was followed by a reduction in the prevalence of hypertension and the lowering level of blood pressure. This is partly explained by various community-based hypertension control programmes. Chinese populations are now showing similar patterns as those observed in Japan. These populations

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Intracerebral hemorrhage in a Japanese community, Hisayama: incidence, changing pattern during long-term follow-up, and related factors.

Cited by 118 publications

References 24 publications

Risk of Hospitalized Stroke in Men Enrolled in the Honolulu Heart Program and the Framingham Study

Risk of Hospitalized Stroke in Men Enrolled in the Honolulu Heart Program and the Framingham Study

Cerebrovascular disease in Saudi Arabia.

Epidemiology of hypertension in China and Japan

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