Stroke, Vol 15, 15-23, Copyright © 1984 by American Heart Association
Y Takeya, JS Popper, Y Shimizu, H Kato, GG Rhoads and A Kagan
As part of the Ni-Hon-San Study, stroke incidence was compared in the Japan
and Hawaii cohorts. Stroke cases were classified in two types, intracranial
hemorrhage (ICH) and thrombo-embolic stroke (T-E). For each type the
incidence in Japan was about three times as great as in Hawaii. The ratio
ICH/T-E was 1/2.2 and 1/1.6 in Japan and Hawaii, respectively. Blood
pressure was the most important risk factor, followed by age for total
stroke in both Japan and Hawaii. Proteinuria was also a risk factor in
Hawaii. Conversely, an index of animal food intake was inversely related to
total stroke, significantly in Hawaii, and at a suggestive level for total
and hemorrhagic stroke in Japan. Since the levels of blood pressure do not
differ between Japan and Hawaii, one possible explanation for the large
difference in stroke incidence between the two cohorts may be the fact that
animal protein and saturated fat intake, which is inversely associated with
stroke incidence, is much greater in Hawaii than in Japan. This explanation
would support epidemiologic and experimental studies in Japan which suggest
that dietary animal protein and fat exert an inhibitory effect on the
incidence of stroke.
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Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: incidence of stroke in Japan and Hawaii
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