Published Online
on November 23, 2005

A more recent version of this article appeared on January 1, 2006

This Article Full Text (PDF) All Versions of this Article: 37/1/27    most recent 01.STR.0000194958.88216.87v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wakugawa, Y. Articles by Iida, M. Search for Related Content PubMed PubMed Citation Articles by Wakugawa, Y. Articles by Iida, M. Related Collections Cerebrovascular disease/stroke Risk Factors Risk Factors for Stroke Epidemiology

Submitted on July 7, 2005
Accepted on July 13, 2005

C-Reactive Protein and Risk of First-Ever Ischemic and Hemorrhagic Stroke in a General Japanese Population. The Hisayama Study

Yoshiyuki Wakugawa MD^*; Yutaka Kiyohara MD, PhD; Yumihiro Tanizaki MD, PhD; Michiaki Kubo MD, PhD; Toshiharu Ninomiya MD, PhD; Jun Hata MD; Yasufumi Doi MD, PhD; Ken Okubo MD; Yoshinori Oishi MD; Kentaro Shikata MD; Koji Yonemoto PhD; Daisuke Maebuchi MD; Setsuro Ibayashi MD, PhD; and Mitsuo Iida MD, PhD

From the Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

^* To whom correspondence should be addressed. E-mail: wakuwaku{at}intmed2.med.kyushu-u.ac.jp.

Background and Purpose--The role of high-sensitivity C-reactive protein (hsCRP) in the development of stroke is not clearly understood. We investigated the relationship between serum hsCRP levels and stroke occurrence in a general Japanese population.

Methods--We followed 2692 subjects 40 years of age for 12 years. The relative risks and 95% CIs for ischemic and hemorrhagic stroke occurrence were calculated according to the hsCRP quintiles.

Results--During the follow-up, 129 first-ever ischemic and 59 hemorrhagic strokes occurred. In men, the age-adjusted incidence of ischemic stroke significantly increased with elevated serum hsCRP levels; the difference between the first and fifth quintiles was statistically significant (1.4 versus 6.6 per 1000 person-years; P=0.02). This association remained significant even after adjustment for other confounding factors, such as age, systolic blood pressure, ECG abnormalities, diabetes, body mass index, total cholesterol, high-density lipoprotein cholesterol, smoking habits, alcohol intake, and regular exercise (adjusted relative risks, 3.11; 95% CI, 1.04 to 9.32; P=0.04). However, such associations were not observed for ischemic stroke in women or in hemorrhagic stroke in either sex. Among male subjects who were both in the fifth hsCRP level and had hypertension, diabetes, obesity, hypercholesterolemia, or a smoking habit, the risk of ischemic stroke was extremely increased, even after adjustment for other risk factors.

Conclusions--Our findings suggest that elevated serum hsCRP levels are an independent risk factor for future ischemic stroke in Japanese men and that the coexistence of a high hsCRP level with another risk factor extremely increases the risk of ischemic stroke.

Key words: C-reactive protein • hemorrhage, brain • ischemic stroke

This article has been cited by other articles:

				H. Arima, M. Kubo, K. Yonemoto, Y. Doi, T. Ninomiya, Y. Tanizaki, J. Hata, K. Matsumura, M. Iida, and Y. Kiyohara High-Sensitivity C-Reactive Protein and Coronary Heart Disease in a General Population of Japanese: The Hisayama Study Arterioscler Thromb Vasc Biol, July 1, 2008; 28(7): 1385 - 1391. [Abstract] [Full Text] [PDF]

				S. C. Larsson, S. Mannisto, M. J. Virtanen, J. Kontto, D. Albanes, and J. Virtamo Coffee and Tea Consumption and Risk of Stroke Subtypes in Male Smokers Stroke, June 1, 2008; 39(6): 1681 - 1687. [Abstract] [Full Text] [PDF]

				Y. Tabara, H. Osawa, R. Kawamoto, R. Tachibana-Iimori, M. Yamamoto, J. Nakura, T. Miki, H. Makino, and K. Kohara Reduced High-Molecular-Weight Adiponectin and Elevated High-Sensitivity C-Reactive Protein Are Synergistic Risk Factors for Metabolic Syndrome in a Large-Scale Middle-Aged to Elderly Population: the Shimanami Health Promoting Program Study J. Clin. Endocrinol. Metab., March 1, 2008; 93(3): 715 - 722. [Abstract] [Full Text] [PDF]

				J. Ajiro, B. Alchi, I. Narita, K. Omori, D. Kondo, M. Sakatsume, J. J. Kazama, K. Akazawa, and F. Gejyo Mortality Predictors after 10 Years of Dialysis: A Prospective Study of Japanese Hemodialysis Patients Clin. J. Am. Soc. Nephrol., July 1, 2007; 2(4): 653 - 660. [Abstract] [Full Text] [PDF]

				J. Ishikawa, Y. Tamura, S. Hoshide, K. Eguchi, S. Ishikawa, K. Shimada, and K. Kario Low-Grade Inflammation Is a Risk Factor for Clinical Stroke Events in Addition to Silent Cerebral Infarcts in Japanese Older Hypertensives: The Jichi Medical School ABPM Study, Wave 1 Stroke, March 1, 2007; 38(3): 911 - 917. [Abstract] [Full Text] [PDF]