Published online before print March 13, 2003, doi: 10.1161/01.STR.0000060869.34009.38
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(Stroke. 2003;34:863.)
© 2003 American Heart Association, Inc.
Original Contributions |
High-Density Lipoprotein Cholesterol and Risk of Stroke in Japanese Men and Women
The Oyabe Study
From the Department of Public Health, Kanazawa Medical University, Ishikawa, Japan (Y.S., K.M., Y.M., M.N., Y.N., H.N.), and Departments of Community and Geriatric Nursing (Y. Naruse) and Welfare Promotion and Epidemiology (S.K.), Toyama Medical and Pharmaceutical University, Toyama, Japan.
Reprint requests to Yoshiyuki Soyama, DDS, Department of Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan. E-mail ysoyama{at}kanazawa-med.ac.jp
Background and Purpose— Evidence of an inverse relationship between serum high-density lipoprotein cholesterol (HDL-C) and the risk of stroke is sparse in Asians and in women. The purpose of this investigation was to examine the relationship in a long-term cohort study of Japanese men and women among whom stroke occurrence is higher than in Western countries.
Methods— A prospective cohort study was performed involving 4989 participants (1523 men, 3466 women) 35 to 79 years of age at baseline with 
10 years of follow-up in a rural area of Japan. End points included all stroke incidence and ischemic stroke incidence.
Results— During follow-up, 132 participants developed stroke, including 81 ischemic stroke cases. Age-adjusted incidence rates per 10 000 person-years for all stroke in subjects with low HDL-C (<30 mg/dL [0.78 mmol/L]) were 103.4 in men and 49.3 in women, which were remarkably higher than in subjects with high HDL-C (
60 mg/dL [1.56 mmol/L]) (26.4 in men and 15.5 in women). A similar relationship was observed for ischemic stroke. Multivariate-adjusted relative risks for all stroke incidence and ischemic stroke incidence were 2.89 (95% CI, 1.35 to 6.20) and 2.92 (95% CI, 1.17 to 7.32), respectively, for low versus high HDL-C participants. The relationships were independent of sex, age, body mass index, blood pressure, serum total cholesterol, alcohol consumption, and smoking.
Conclusions— This 10-year follow-up study of Japanese men and women demonstrated that lower HDL-C levels were related significantly and independently to increased risk of all stroke incidence and ischemic stroke incidence.
Key Words: cohort studies • lipoproteins, HDL cholesterol • risk factors • stroke
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