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(Stroke. 2006;37:1374.)
© 2006 American Heart Association, Inc.

Original Contributions

Proportions of Stroke Subtypes Among Men and Women 40 Years of Age in an Urban Japanese City in 1992, 1997, and 2002

Akihiko Kitamura, MD; Yuko Nakagawa, MD; Minoru Sato, MD; Hiroyasu Iso, MD; Shinichi Sato, MD; Hironori Imano, MD; Masahiko Kiyama, MD; Takeo Okada, MD; Hiroshi Okada, MD; Minoru Iida, MD Takashi Shimamoto, MD

From the Osaka Medical Center for Health Science and Promotion (A.K., S.S., H. Imano, M.K., T.O., M.I., T.S.), Japan; Neyagawa Public Health Center (Y.N.), Japan; Yao Medical Association (M.S., H.O.), Japan; and Department of Public Health Medicine (H. Iso), University of Osaka, Japan.

Correspondence to Dr Akihiko Kitamura, Osaka Medical Center for Health Science and Promotion, 1-3-2 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan. E-mail xkita{at}kenkoukagaku.jp

Background and Purpose— Higher proportions of hemorrhagic stroke and lacunar infarction were reported in rural Japan compared with those in Western countries. We examined the relative proportions of stroke subtypes in an urban Japanese city where westernized lifestyles are more common than in rural areas.

Methods— Stroke registration was performed in 1992, 1997, and 2002 for residents 40 years of age who were admitted with acute strokes to all of the 10 hospitals with 90 beds in Yao City, Osaka, Japan. Strokes were classified as intraparenchymal hemorrhage, subarachnoid hemorrhage, or ischemic strokes (embolic infarction, large-artery occlusive infarction, lacunar infarction, and unclassified thrombotic infarction) by criteria using computed tomography or MRI.

Results— A total of 650 first-ever strokes were registered. The age-adjusted proportion of each stroke subtype was not significantly different among the 3 study periods in both men and women. Throughout the 3 periods, intraparenchymal hemorrhage, subarachnoid hemorrhage, and ischemic stroke accounted for 26%, 7%, and 65% in men, respectively. In women, the respective proportions were 29%, 21%, and 44%. The proportion of each subtype for total ischemic strokes was as follows: 51% to 61% lacunar infarction, 25% to 26% large-artery occlusive infarction, and 11% to 17% embolic infarction.

Conclusions— Our study showed that hemorrhagic stroke represented a large proportion of all strokes, especially among women, and lacunar infarction was the most common subtype of ischemic stroke among both men and women in Yao City, which differed from findings in Western countries.

Key Words: brain infarction • epidemiology • intracranial hemorrhages • stroke classification

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