High-Density Lipoprotein Cholesterol and Risk of Stroke in Japanese Men and Women: The Oyabe Study
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Many reports have indicated that there is no clear relationship between the TG level and cerebrovascular disease.
“Many reports have also indicated that there is no clear relationship between the TG level and cerebrovascular disease856, 862, 863).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [856]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Role of Insulin Resistance in Human Disease
Reaven, G. M. (1988) · Diabetes · doi:10.2337/diab.37.12.1595 · Cited by 12,154 · see citing works
DeFronzo, R. A., & Ferrannini, E. (1991) · Diabetes Care · doi:10.2337/diacare.14.3.173 · Cited by 4,555 · see citing works
Rubins, H. B., Robins, S. J., Collins, D., Fye, C. L., Anderson, J. W., Elam, M. B., Faas, F. H., Linares, E., Schaefer, E. J., Schectman, G., et al. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908053410604 · Cited by 3,439 · see citing works
High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies.
Gordon, D. J., Probstfield, J. L., Garrison, R. J., Neaton, J. D., Castelli, W. P., Knoke, J. D., Jacobs, D. R., Bangdiwala, S., & Tyroler, H. A. (1989) · Circulation · doi:10.1161/01.cir.79.1.8 · Cited by 3,162 · see citing works
High-Density Lipoprotein — The Clinical Implications of Recent Studies
Desforges, J. F., Gordon, D. J., & Rifkind, B. M. (1989) · New England Journal of Medicine · doi:10.1056/nejm198911093211907 · Cited by 1,547 · see citing works
Iso, H., Jacobs, D. R., Wentworth, D. N., Neaton, J. D., & Cohen, J. D. (1989) · New England Journal of Medicine · doi:10.1056/nejm198904063201405 · Cited by 1,130 · see citing works
Prospective Studies Collaboration, & Kromhout, D. (1995) · The Lancet · doi:10.1016/s0140-6736(95)92836-7 · Cited by 851 · see citing works
Stroke risk profile: adjustment for antihypertensive medication. The Framingham Study.
D’Agostino, R. B., Wolf, P. A., Belanger, A. J., & Kannel, W. B. (1994) · Stroke · doi:10.1161/01.str.25.1.40 · Cited by 714 · see citing works
Blood pressure, cholesterol, and stroke in eastern Asia
Xu, Z., Sasaki, R., Wang, S., Ling, Y., Wu, X., Wu, Y., Lam, T., Xie, J., He, Y., Zhou, B., et al. (1998) · The Lancet · doi:10.1016/s0140-6736(98)03454-0 · Cited by 532 · see citing works
Lipoproteins, Cardiovascular Disease, and Death
Gordon, T. (1981) · Archives of Internal Medicine · doi:10.1001/archinte.1981.00340090024008 · Cited by 528 · see citing works
Gorelick, P. B., Sacco, R. L., Smith, D. B., Alberts, M. J., MustoneAlexander, L., Rader, D. J., Ross, J. L., Raps, E. C., Ozer, M. N., Brass, L. M., et al. (1999) · JAMA · doi:10.1001/jama.281.12.1112 · Cited by 493 · see citing works
American Heart Association Prevention Conference IV: Prevention and Rehabilitation of Stroke
Helgason, C. M., & Wolf, P. A. (1997) · Stroke · doi:10.1161/01.str.28.7.1498 · Cited by 440 · see citing works
A Classification and Outline of Cerebrovascular Diseases II
(1975) · Stroke · doi:10.1161/01.str.6.5.564 · Cited by 373 · see citing works
Lindenstrom, E., Boysen, G., & Nyboe, J. (1994) · BMJ · doi:10.1136/bmj.309.6946.11 · Cited by 370 · see citing works
Sacco, R. L., Benson, R. T., Kargman, D. E., Boden-Albala, B., Tuck, C., Lin, I.-F., Cheng, J. F., Paik, M. C., Shea, S., & Berglund, L. (2001) · JAMA · doi:10.1001/jama.285.21.2729 · Cited by 311 · see citing works
Serum cholesterol and hemorrhagic stroke in the Honolulu Heart Program.
Yano, K., REED, D. M., & MacLean, C. J. (1989) · Stroke · doi:10.1161/01.str.20.11.1460 · Cited by 310 · see citing works
Mackness, M., Abbott, C. A., Arrol, S., & Durrington, P. N. (1993) · Biochemical Journal · doi:10.1042/bj2940829 · Cited by 304 · see citing works
HDL Cholesterol Predicts Coronary Heart Disease Mortality in Older Persons
Corti, M.-C. (1995) · JAMA · doi:10.1001/jama.1995.03530070037026 · Cited by 284 · see citing works
Exercise and Risk of Stroke in Male Physicians
Lee, I.-M. M., Hennekens, C. H., Berger, K., Buring, J. E., & Manson, J. E. (1999) · Stroke · doi:10.1161/01.str.30.1.1 · Cited by 272 · see citing works
Risk Factors for Ischemic Stroke
Simons, L. A., McCallum, J. C., Friedlander, Y., & Simons, J. (1998) · Stroke · doi:10.1161/01.str.29.7.1341 · Cited by 256 · see citing works
Criqui, M. H., Wallace, R. B., HEISS, G. M., Mishkel, M. A., Schonfeld, G., & Gt, J. (1980) · PubMed · Cited by 232 · see citing works
HDL-Cholesterol, Total Cholesterol, and the Risk of Stroke in Middle-Aged British Men
Wannamethee, S. G., Shaper, A. G., & Ebrahim, S. (2000) · Stroke · doi:10.1161/01.str.31.8.1882 · Cited by 220 · see citing works
High-density lipoprotein cholesterol and premature coronary heart disease in urban Japanese men.
Kitamura, A., Iso, H., Naito, Y., Iida, M., Konishi, M., Folsom, A. R., Sato, S., Kiyama, M., Nakamura, M., & Sankai, T. (1994) · Circulation · doi:10.1161/01.cir.89.6.2533 · Cited by 212 · see citing works
A 15.5-Year Follow-up Study of Stroke in a Japanese Provincial City
Nakayama, T., Date, C., Yokoyama, A., Yoshiike, N., Yamaguchi, M., & Tanaka, H. (1997) · Stroke · doi:10.1161/01.str.28.1.45 · Cited by 203 · see citing works
Risk factors for stroke in middle aged British men.
Shaper, A. G., Phillips, A. N., Pocock, S., Walker, M., & Macfarlane, P. W. (1991) · BMJ · doi:10.1136/bmj.302.6785.1111 · Cited by 200 · see citing works
Molecular mechanisms of reverse cholesterol transport
Barter, P. J., & Rye, K. (1996) · Current Opinion in Lipidology · doi:10.1097/00041433-199604000-00006 · Cited by 183 · see citing works
Effects of high-density lipoprotein on acetylcholine-induced coronary vasoreactivity
Kuhn, F. E., Mohler, E. R., Satler, L. F., Reagan, K., Lu, D. Y., & Rackley, C. E. (1991) · The American Journal of Cardiology · doi:10.1016/0002-9149(91)90274-o · Cited by 165 · see citing works
Tanne, D., Koren-Morag, N., Graff, E., & Goldbourt, U. (2001) · Circulation · doi:10.1161/hc4901.100384 · Cited by 158 · see citing works
Modeling of Risk Factors for Ischemic Stroke
Whisnant, J. P. (1997) · Stroke · doi:10.1161/01.str.28.9.1840 · Cited by 157 · see citing works
High-Density Lipoprotein Cholesterol and Risk of Ischemic Stroke Mortality
Tanné, D., Yaari, S., & Goldbourt, U. (1997) · Stroke · doi:10.1161/01.str.28.1.83 · Cited by 148 · see citing works
Glueck, C. J., Hl, T., Jacobs, D. R., Morrison, J. A., Beaglehole, R., & Williams, O. D. (1980) · PubMed · Cited by 132 · see citing works
RBenfante, KYano, JHwang, L., DCurb, J., AKagan, & WRoss (1994) · Stroke · Cited by 132 · see citing works
Cohn, J. S., McNamara, J. R., & Schaefer, E. J. (1988) · Clinical Chemistry · doi:10.1093/clinchem/34.12.2456 · Cited by 127 · see citing works
Dyken, M. L. (1991) · Springer eBooks · doi:10.1007/978-1-4757-4226-8_6 · Cited by 113 · see citing works
Trends in Stroke Incidence and Acute Case Fatality in a Japanese Rural Area
Morikawa, Y., Nakagawa, H., Naruse, Y., Nishijo, M., Miura, K., Tabata, M., Hirokawa, W., Kagamimori, S., Honda, M., Yoshita, K., et al. (2000) · Stroke · doi:10.1161/01.str.31.7.1583 · Cited by 107 · see citing works
Self-citationGorelick, P. B. (1995) · Archives of Neurology · doi:10.1001/archneur.1995.00540280029015 · Cited by 104 · see citing works
Haskell, W. L., Taylor, H., Wood, P. D., Schrott, H. G., & HEISS, G. M. (1980) · PubMed · Cited by 92 · see citing works
Lipids Are Risk Factors for Ischaemic Stroke: Overview and Review
Qizilbash, N., Duffy, S. W., Warlow, C. P., et al. (1992) · Cerebrovascular Diseases · doi:10.1159/000109004 · Cited by 58 · see citing works
A CLASSIFICATION and outline of cerebrovascular diseases.
(1958) · PubMed · Cited by 58 · see citing works
Ernst, N. D., Fisher, M., Smith, W. G., et al. (1980) · PubMed · Cited by 57 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Okinaka S. Epidemiological study of stroke: three-year follow-up study of 17 districts in Japan [in Japanese]. Jpn Med J. 1966;2221:19 -28.
Cited by
Sorted by citations
Kernan, W. N., Ovbiagele, B., Black, H. R., Bravata, D. M., Chimowitz, M. I., Ezekowitz, M. D., Fang, M. C., Fisher, M., Furie, K. L., Heck, D. V., et al. (2014) · Stroke · doi:10.1161/str.0000000000000024 · Cited by 5,170 · see citing works
Meschia, J. F., Bushnell, C., Boden-Albala, B., Braun, L. T., Bravata, D. M., Chaturvedi, S., Creager, M. A., Eckel, R. H., Elkind, M. S. V., Fornage, M., et al. (2014) · Stroke · doi:10.1161/str.0000000000000046 · Cited by 2,650 · see citing works
Stroke risk factors, genetics, and prevention
Boehme, A. K., Esenwa, C., & Elkind, M. S. V. (2017) · Circulation Research · doi:10.1161/circresaha.116.308398 · Cited by 1,952 · see citing works
Sacco, R. L., Adams, R., Albers, G., Alberts, M. J., Benavente, O., Furie, K., Goldstein, L. B., Gorelick, P., Halperin, J., Harbaugh, R., et al. (2006) · Stroke · doi:10.1161/01.str.0000199147.30016.74 · Cited by 1,873 · see citing works
Goldstein, L. B., Bushnell, C. D., Adams, R. J., Appel, L. J., Braun, L. T., Chaturvedi, S., Creager, M. A., Culebras, A., Eckel, R. H., Hart, R. G., et al. (2011) · Stroke · doi:10.1161/str.0b013e3181fcb238 · Cited by 1,306 · see citing works
Kinoshita, M., Yokote, K., Arai, H., Iida, M., Ishigaki, Y., Ishibashi, S., Umemoto, S., Egusa, G., Ohmura, H., Okamura, T., et al. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.gl2017 · Cited by 813 · see citing works
Imamura, T., Doi, Y., Arima, H., Yonemoto, K., Hata, J., Kubo, M., Tanizaki, Y., Ibayashi, S., Iida, M., & Kiyohara, Y. (2009) · Stroke · doi:10.1161/strokeaha.108.529537 · Cited by 235 · see citing works
Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies
Zhang, C., Qin, Y.-Y., Chen, Q., Jiang, H., Chen, X.-Z., Xu, C.-L., Mao, P.-J., He, J., & Zhou, Y.-H. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2014.04.225 · Cited by 203 · see citing works
Yokokawa, H., Yasumura, S., Tanno, K., Ohsawa, M., Onoda, T., Itai, K., Sakata, K., Kawamura, K., Tanaka, F., Yoshida, Y., et al. (2011) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.5215 · Cited by 83 · see citing works
for the Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) Research Group, Hirata, T., Sugiyama, D., Nagasawa, S.-Y., Murakami, Y., Saitoh, S., Okayama, A., Iso, H., Irie, F., Sairenchi, T., et al. (2017) · European Journal of Epidemiology · doi:10.1007/s10654-016-0203-1 · Cited by 23 · see citing works
Self-citation
- Authors
- Soyama, Y., Miura, K., Morikawa, Y., Nishijo, M., Nakanishi, Y., Naruse, Y., Kagamimori, S., & Nakagawa, H.
- Affiliations
- Kanazawa Medical University (JP)
- Venue
- Stroke
- Published
- 2003-04
- Volume
- 34
- Issue
- 4
- Pages
- 863-868
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2006375443
- Cited by
- 128
- References
- 40
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 1 · 2021: 6 · 2020: 5 · 2019: 1 · 2018: 6 · 2017: 9 · 2016: 6 · 2015: 3 · 2014: 7 · 2013: 14 · 2012: 8
- FWCI
- 5.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- HDL cholesterol, stroke risk, ischemic stroke, stroke incidence, sex differences, Japanese population, lipid metabolism, cardiovascular risk factors
- MeSH terms
- Adult, Aged, Brain Ischemia, Cholesterol, Female, Humans, Japan, Cholesterol, HDL, Male, Middle Aged, Prospective Studies, Risk Factors, Cohort Studies, Incidence, Stroke
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review