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(Stroke. 2008;39:768.)
© 2008 American Heart Association, Inc.

Original Contributions

Social Support and Stroke and Coronary Heart Disease

The JPHC Study Cohorts II

Ai Ikeda, PhD; Hiroyasu Iso, MD; Ichiro Kawachi, MD; Kazumasa Yamagishi, MD; Manami Inoue, MD; Shoichiro Tsugane, MD for the JPHC Study Group

From Public Health (A.I., H.I.,), Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Society, Human Development, and Health (A.I., I.K.), Harvard School of Public Health, Boston, Mass; Department of Public Health Medicine (K.Y.), Doctoral Program in Social and Environmental Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan; Division of Epidemiology and Community Health (K.Y.), School of Public Health, University of Minnesota, Minn; Epidemiology and Prevention Division (M.I., S.T.), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.

Correspondence to Hiroyasu Iso, MD, PhD, MPH, Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University. Suita-shi, Osaka 565-0871, Japan. E-mail fvgh5640{at}mb.infoweb.ne.jp

Background and Purpose— Studies conducted in Western countries have found a robust association between social support and cardiovascular outcomes (eg, prognosis after myocardial infarction and functional recovery after stroke). However, less is known about the influence of social support on the same outcomes among Asian populations. In this prospective cohort study, we sought to examine the impact of social support on the incidence and mortality of coronary heart disease and stroke among the Japanese.

Methods— We examined prospectively the association between social support and risk of coronary heart disease and stroke incidence and mortality within a cohort of 44 152 Japanese men and women aged 40 to 69 years, free of previous diagnosis of cancer and cardiovascular disease. A total of 301 cases of newly diagnosed coronary heart disease, 1057 strokes, 191 coronary heart disease deaths, and 327 stroke deaths occurred between the baseline questionnaire (1993–1994) and the end of follow-up in January 2004.

Results— The multivariate hazard ratios and 95% CI for stroke mortality in the highest social support versus lowest social support group was 1.45 (1.00 to 2.10) overall, 1.59 (1.01 to 2.51) for men, and 1.25 (0.63 to 2.46) for women. Social support was not associated with stroke incidence or coronary heart disease incidence and mortality.

Conclusions— Low social support was associated with higher risk of stroke mortality in men. However, social support was not associated with stroke incidence, suggesting social support may be more important in stroke prognosis than preventing incidence.

Key Words: coronary heart disease • follow-up study • social support • stroke