Epidemiologic studies of stroke in Shibata, a Japanese provincial city: preliminary report on risk factors for cerebral infarction.

Tanaka, Heizo; Hayashi, Masayuki; Date, Chigusa; Imai, Kunihiko; Asada, Mitsunori; Shoji, H; Okazaki, Kanako; Yamamoto, Hiroshi; Yoshikawa, Kentaro; Shimada, Takashi

doi:10.1161/01.str.16.5.773

Cited by 86 publications

(32 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[39][40][41][42] However, serum total cholesterol, which is a risk factor for ischaemic heart disease and not for stroke in Japan, [2][3][4][5] was not associated with plasma BNP levels. Since mortality due to ischaemic heart disease in Japan is lower than that in Western populations, 1,6,43 it may be reasonable to assume that the risk factors for latent heart failure are similar to those for stroke in the Japanese population.…”

Section: Discussionmentioning

confidence: 99%

What factors are associated with high plasma B-type natriuretic peptide levels in a general Japanese population?

et al. 2004

View full text Add to dashboard Cite

There are few community-based epidemiologic studies that have dealt with risk factors for heart failure in nonWestern populations. It has been reported that the measurement of plasma B-type natriuretic peptide (BNP) is useful for detecting patients with asymptomatic heart failure. To clarify the determinants of high plasma BNP level, the association of BNP with cardiovascular risk factors in community dwelling residents was examined. The plasma BNP levels were measured in 686 residents aged 35-69 years who received annual health check-up. The relationship of BNP to blood pressure, blood haemoglobin, serum cholesterol (total and high-density lipoprotein cholesterol), plasma glucose, electrocardiographic (ECG) findings, urinary salt excretion, and lifestyle factors (smoking and alcohol consumption) were cross-sectionally analysed. The plasma BNP geometric mean was 13.7 pg/ml. Both linear and logistic regression analyses indicated that the plasma BNP levels were positively associated with age, urinary salt excretion, higher blood pressure, high R-wave voltage in the 12-lead ECG (Minnesota Code 3-1 or 3-3), and female gender. Plasma BNP levels were inversely associated with blood haemoglobin levels. Gender-specific analysis showed similar results. However, plasma BNP did not correlate with other cardiovascular risk factors such as serum lipids.

show abstract

Section: Discussionmentioning

confidence: 99%

What factors are associated with high plasma B-type natriuretic peptide levels in a general Japanese population?

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Using all of the residents aged 40 years and over, 1,182 men and 1,469 women, as the eligible population, a baseline examination was conducted in July 1977. The details of the method have already been described in previous reports (8,9). Of the items examined at entry, an epidemiological analysis was performed on three risk factors for this report: blood pressure, atrial fibrillation on electro cardiogram and serum total cholesterol.…”

Section: Methodsmentioning

confidence: 99%

Dietary Lipids and Incidence of Cerebral Infarction in a Japanese Rural Community.

Seino¹,

Date

Nakayama³

et al. 1997

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

View full text Add to dashboard Cite

SummaryObjective: To assess the relationship between dietary lipids and incidence of cerebral infarction in a Japanese rural population. Design: A cohort study from July 1977 through December 1992. Setting: Akadani-Ijimino (A-I) district, Niigata Prefecture, Japan. Subjects and methods: All the residents, 1,182 men and 1,469 women, aged 40 years and over. Out of these members, 954 men and 1,329 women who were initially free of stroke completed a semiquantitative food frequency ques tionnaire in 1977, and were then subjected to a follow-up for 15.5 years. The occurrence of stroke was determined by the annual follow-up exam ination and registry. Dietary lipid was adjusted for total energy or fat intake by the residual method. Sex and age-stratified and blood pressure and atrial fibrillation-adjusted relative risk for cerebral infarction was estimated by the Cox proportional hazard model. Results: There were 75 new cases of cerebral infarction during the observation period. The relative risk for cerebral infarction was less than one in the highest quartile level of total fat, saturated fatty acids (S), Keys score and west ernized dietary pattern: 0.68-0.94. It ranged between 1.36 and 1.57 in the highest level of polyunsaturated (P), n-3 and n-6 fatty acids, and P/S ratio. Conclusion: This study suggests the possibility that the traditional Japanese diet, very low fat intake, was likely to increase the risk of stroke through the low level of serum cholesterol as an intermediary factor. Key Words dietary lipids, cerebral infarction, cohort study, serum cho lesterol, "diet-stroke" hypothesis According to the "diet-heart" hypothesis (1, 2), a high intake of saturated fatty acids and cholesterol and low intake of polyunsaturated fatty acids increase the 83 84 F. SEINO et al. level of serum cholesterol, and hypercholesterolemia results in the occurrence of coronary heart disease and stroke. In Japan, however, some ecological studies compared stroke incidence rates among several defined populations, and showed that the rates were inversely correlated with mean serum cholesterol and fat intake (3, 4). Afterwards, some cohort studies indicated that the level of serum cholester ol was inversely associated with the risk of stroke; particularly cerebral hemorrhage and cerebral infarction in perforating artery regions after adjustment for some confounding variables such as sex, age and blood pressure (5-7).To date, however, there have been few prospective studies on the relationship between dietary fat and stroke among Japanese in Japan. Using all of the residents aged 40 years and over in Akadani-Ijimino district (hereinafter referred to as A-I district), Shibata City, Niigata Prefecture, Japan, their dietary lipid intakes were assessed by a semiquantitative food frequency questionnaire in July 1977. Those who were initially free of stroke have been subjected to a follow-up ever since. In this report, we deal with the relationship of dietary lipid intake to the subsequent 15.5-year incidence of cerebral infarction which sho...

show abstract

“…However, a previous epidemiologic study found that the incidence of embolism among Japanese patients with NAVF did not differ from that among Caucasian patients with NVAF. 25 Third, the present data were collected from tertiary university hospitals, and might not represent nationwide trends of warfarin use in Japan. Finally, the mean age of the patients in the present study was 66.6 years, which was lower than in previous studies 4,5,15 and could affect the proportion of warfarin use.…”

Section: Study Limitationsmentioning

confidence: 99%

Attitudes of Japanese Cardiologists Toward Anticoagulation for Nonvalvular Atrial Fibrillation and Reasons for Its Underuse

Inoue

Nozawa

Okumura

et al. 2004

Circ J

View full text Add to dashboard Cite

andomized clinical trials clearly show that adjusted dosage of warfarin decreases embolic episodes by two-thirds in patients with nonvalvular atrial fibrillation (NVAF), and that aspirin only does so to a modest extent. 1 Together with progressive accumulation of data supporting the efficacy of warfarin, its use has increased gradually, 2-7 but was still less than 50% even among patients with NVAF who were complicated with risk factors for embolism. 3,5,8 Previous clinical studies indicated that 50-60% of patients with NVAF did not have contraindications to warfarin use, 4 and a recent guideline recommended appropriate antithrombotic therapy and intensities of anticoagulation with warfarin according to the age and other clinical characteristics of patients with NVAF. 9 There are clear ethnic differences in the perceptions of atrial fibrillation (AF) and anticoagulation therapy among patients living in England, 10 and possible ethnic differences in the incidence of stroke. 11 Therefore, there could be difCirculation Journal Vol.68, May 2004 ferences between Japan and the USA in cardiologists' attitude toward antithrombotic therapy in patients with NVAF. In the early 90 s Japanese cardiologists used warfarin in less than 20% of patients with AF, 12,13 so the aim of the present study was to determine current attitudes toward warfarin use, the proportion of adherence to the guideline for antithrombotic therapy and reasons for non-use of warfarin in patients with NVAF. Methods Study SubjectsWe started a prospective, cooperative study from 1999 to determine the clinical efficacy of measuring hemostatic markers to identify patients with NVAF who would be at increased risk for embolic complication. 14 The design of the study was approved by the ethics committee of each university hospital. Patients with NVAF treated in 1999 at 5 tertiary, university hospitals were subjects of the present study. A total of 509 patients (66.6±10.3 years old, 330 men and 179 women) with NVAF were enrolled in the study after giving informed consent. 14 Baseline clinical characteristics, including diabetes mellitus, hypertension, New York Heart Association functional status, prior cerebral infarction (CI) or transient ischemic attack (TIA), status of antithrombotic therapy, and type of AF, were determined. The selection of antithrombotic drugs was left to the treating cardiologist's decision. Intensity of anticoagulation with warfarin expressed as the international normalized ratio (INR) of prothrombin time was determined at the time

show abstract

Epidemiologic studies of stroke in Shibata, a Japanese provincial city: preliminary report on risk factors for cerebral infarction.

Cited by 86 publications

References 20 publications

What factors are associated with high plasma B-type natriuretic peptide levels in a general Japanese population?

What factors are associated with high plasma B-type natriuretic peptide levels in a general Japanese population?

Dietary Lipids and Incidence of Cerebral Infarction in a Japanese Rural Community.

Attitudes of Japanese Cardiologists Toward Anticoagulation for Nonvalvular Atrial Fibrillation and Reasons for Its Underuse

Contact Info

Product

Resources

About