Published online before print May 26, 2005, doi: 10.1161/01.STR.0000169925.57251.4e
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(Stroke. 2005;36:1377.)
© 2005 American Heart Association, Inc.
Original Contributions |
Body Mass Index and Mortality From Cardiovascular Disease Among Japanese Men and Women
The JACC Study
From the Department of Public Health Medicine, Doctoral program in Social and Environmental Medicine (R.C., H.I.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan; the Department of Public Health/Health Information Dynamics (H.T., T.K.), Fields of Science, Program of Health and Community Medicine, Nagoya University Graduate School of Medicine, Japan; the Department of Food Science and Nutrition (C.D.), School of Human Environmental Science, Mukogawa Women’s University, Hyogo, Japan; Infectious Disease Surveillance Cancer (A.Y.), Infectious Disease Research Division, Hyogo Prefectural Institute of Public Health and Environmental Science, Japan; the Department of Public Health (S.K.), Aichi Medical University, Wakayama, Japan; the Department of Social Medicine and Cultural Sciences (Y. Watanabe), Research Institute for Neurological Diseases and Geriatrics, Kyoto Prefectural University of Medicine, Japan; the Department of Health and Environmental Sciences (A.K.), Graduate School of Medicine, Kyoto University, Japan; the Department of Hygiene (Y. Wada), Hyogo College of Medicine, Japan; Juntendo University School of Medicine (Y.I.), Tokyo, Japan; the Department of Preventive Medicine/Biostatistics and Medical Decision Making (A.T.), Field of Social Science, Program in Health and Community Medicine, Nagoya University Graduate School of Medicine, Japan.
Reprint requests to Professor Hiroyasu Iso, MD, Department of Public Health Medicine, Doctoral program in Social and Environmental Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennodai, Tuskuba, Ibaraki 305-8575 Japan. E-mail fvgh5640{at}mb.infoweb.ne.jp
Background and Purpose— Although overweight is an important risk factor for cardiovascular disease in Western countries, the impact of overweight has not been well elucidated in Japan, where its prevalence is low.
Methods— A total of 104 928 Japanese (43 889 men and 61 039 women) aged 40 to 79 years, free of stroke, coronary heart disease, and cancer at entry participated in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study) between 1988 and 1990. Systematic surveillance was completed until the end of 1999, with 1 042 835 person years of follow-up, and the underlying causes of death were determined based on the International Classification of Diseases.
Results— There were 765 total strokes (191 intraparenchymal hemorrhages), 379 coronary heart diseases, and 1707 total cardiovascular diseases for men; and for women, there were 685 (145), 256, and 1432, respectively. Compared with persons with body mass index (BMI) 23.0 to 24.9, those with BMI 
27.0 kg/m2 had a higher risk of coronary heart disease; for men and women, the respective multivariate relative risk (95% CI) was 2.05 (1.35 to 3.13) and 1.58 (0.95 to 2.62). Persons with BMI <18.5 kg/m2 had higher risk of total stroke and intraparenchymal hemorrhage, for men and women, the respective multivariate relative risk was 1.29 (1.01 to 1.49) and 1.92 (1.49 to 2.47) for total stroke and 1.96 (1.16 to 3.31) and 2.32 (1.36 to 3.97) for intraparenchymal hemorrhage. These excess risks did not alter materially when deaths within 5 years were excluded or when smoking status was taken into account.
Conclusions— For Japanese men and women, high BMI was associated with increased risk of coronary heart disease, whereas low BMI was associated with intraparenchymal hemorrhage.
Key Words: body mass index • coronary heart disease • follow-up studies • mortality • stroke
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