SUMMARY A 6.5-year prospective study of cerebral infarction among residents 40 years and older was conducted at the Akadani-Ijimino district in Shibata City, Niigata Prefecture, Japan. The response rate for the initial examination was 85% of 1,182 males and 93% of 1,469 females. Nine hundred and sixty males and 1,339 females who were initially free of stroke were followed up from July 1977 through December 1983. Statistically significant risk factors for cerebral infarction appeared to be age, elevated blood pressure, high R, ST-T changes and atrial fibrillation on ECG, and albuminuria. The ECG abnormalities and albuminuria were due to the high blood pressure persisted over a long period of time. The strength of association of blood pressure with cerebral infarction got weak in comparison with other factors, and funduscopic changes which had been regarded as a risk factor for stroke in 1965-1974 did not reach statistical significance because of the spread of the community-based hypertension control. Even in 1977-1983 when Japanese dietary habits were westernized, neither hyperlipidemia nor obesity appeared to be related to the development of cerebral infarction.LIFE STYLE appears to be related to the development of stroke. Life style, mainly the dietary habit of the Japanese, has rapidly been westernized since the end of the World War II, while retaining the traditional style. Particularly, changes for 10 years from 1965 to 1974 were most conspicuous.12 From 1975 downward, the changes have leveled off, and life style is in the so-called stable period. The community-based control of hypertension started around .1965 and spread throughout the country in the first half of the 1970s. It is possible that the risk factors for stroke and the strength of the association between stroke and each factor after 1975 have changed from those before 1975. In Japan, the measures for prevention of stroke based on epidemiologic studies of risk factors performed during the period from 1965 to 1974 are taken even at present. Therefore, obtaining information on the risk factors for stroke after 1975 has become an urgent matter.An epidemiologic study was conducted in City, Niigata Prefecture, for the purpose of evaluating the risk factors for stroke after the second half of the 1970s. This city is divided into nine administrative districts. Of them, the Akadani-Ijimino district (hereinafter referred to as A-I district) was selected randomly. A baseline examination was carried out in 1977 when the consent of the residents, medical association and administrative organs was obtained. Nine hundred and sixty men and 1,339 women who were initially free of stroke have been followed up ever since. In this preliminary report, we deal with results of the 6.5-year observation for occurrence of cerebral infarction which shows the highest incidence among the subtypes of stroke. Standardized person-year incidence ratio for cerebral infarction has been determined among subgroups stratified according to risk factors present at the time of the baselin...