Low Serum Cholesterol as a Risk Factor for Hemorrhagic Stroke in Men: A Community-Based Mass Screening in Okinawa, Japan
Open accessAbstract
The relation between the level of total serum cholesterol and stroke is controversial. The relation between serum total cholesterol and subtypes of stroke was examined in the participants of a community-based mass screening program in Okinawa, Japan. A total of 38,053 subjects, whose serum level of cholesterol had been determined during a mass screening carried out in 1983, were examined to see whether they had experienced stroke during a 3-year period from 1988 to 1991. Of them, 315 subjects aged 33-93 years (174 men, 141 women) had had a stroke during that period. The types of stroke were cerebral infarction in 164, cerebral hemorrhage in 111, subarachnoid hemorrhage in 19, and others in 21. In men, the odds ratio of cerebral hemorrhage was 0.71 (95% confidence interval, 0.55-0.95), and the odds ratio of cerebral hemorrhage associated with serum level of cholesterol < or =167 mg/dl, 168-191 mg/dl, 192-217mg/dl, and > or =218mg/dl were 1.00 (reference), 0.70 (0.38-1.30), 0.77 (0.55-1.08), 0.73 (0.56-0.96), respectively. Lower serum cholesterol was an independent predictor of cerebral hemorrhage in men.
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Low TC levels are associated with increased risk of hemorrhagic stroke.
“For hemorrhagic strokes, in contrast with the increase in risk of occurrence at low TC levels55–57)”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [56]
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Cites
Experience from a multicentre stroke register: a preliminary report.
Hatano, S. (1976) · PubMed · Cited by 1,522 · see citing works
Cholesterol in the Prediction of Atherosclerotic Disease
Kannel, W. B., Castelli, W. P., & Gordon, T. (1979) · Annals of Internal Medicine · doi:10.7326/0003-4819-90-1-85 · Cited by 1,314 · 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
Trends for coronary heart disease and stroke and their risk factors in Japan.
Shimamoto, T., Komachi, Y., Inada, H., Doi, M., Iso, H., Sato, S., Kitamura, A., Iida, M., Konishi, M., & Nakanishi, N. (1989) · Circulation · doi:10.1161/01.cir.79.3.503 · Cited by 362 · see citing works
Risk of developing end-stage renal disease in a cohort of mass screening
Iseki, K., Iseki, C., Ikemiya, Y., & Fukiyama, K. (1996) · Kidney International · doi:10.1038/ki.1996.111 · Cited by 340 · see citing works
Self-citationRisk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community.
Tanaka, H., Ueda, Y., Hayashi, M., Date, C., Baba, T., Yamashita, H., Shoji, H., Tanaka, Y., Ôwada, K., & Detels, R. (1982) · Stroke · doi:10.1161/01.str.13.1.62 · Cited by 328 · see citing works
Stroke, Statins, and Cholesterol
Blauw, G. J., Lagaay, A. M., Smelt, A. H. M., & Westendorp, R. G. J. (1997) · Stroke · doi:10.1161/01.str.28.5.946 · Cited by 312 · see citing works
Evidence for high risk of cerebral hemorrhage in chronic dialysis patients
Iseki, K., Kinjo, K., Kimura, Y., Osawa, A., & Fukiyama, K. (1993) · Kidney International · doi:10.1038/ki.1993.352 · Cited by 222 · see citing works
Self-citationReductase Inhibitor Monotherapy and Stroke Prevention
Crouse, J. R. (1997) · Archives of Internal Medicine · doi:10.1001/archinte.1997.00440330039004 · Cited by 221 · see citing works
Why are the Japanese living longer?
Marmot, M. G., & Smith, G. D. (1989) · BMJ · doi:10.1136/bmj.299.6715.1547 · Cited by 213 · see citing works
Konishi, M., Iso, H., Komachi, Y., Iida, M., Shimamoto, T., Jacobs, D. R., Terao, A., Baba, S., Sankai, T., & Ito, M. (1993) · Stroke · doi:10.1161/01.str.24.7.954 · Cited by 203 · see citing works
Current Status of Risk Factors for Stroke
Wolf, P. A., Kannel, W. B., & Verter, J. I. (1983) · Neurologic Clinics · doi:10.1016/s0733-8619(18)31185-x · Cited by 187 · see citing works
Ueshima, H., Iida, M., Shimamoto, T., Konishi, M., Tsujioka, K., Tanigaki, M., Nakanishi, N., Ozawa, H., Kojima, S., & Komachi, Y. (1980) · Preventive Medicine · doi:10.1016/0091-7435(80)90017-1 · Cited by 143 · see citing works
Iribarren, C., Jacobs, D. R., Sadler, M. C., Claxton, A. J., & Sidney, S. (1996) · Stroke · doi:10.1161/01.str.27.11.1993 · Cited by 136 · see citing works
Review of lipid-lowering clinical trials in relation to observational epidemiologic studies.
Tyroler, H. (1987) · Circulation · doi:10.1161/01.cir.76.3.515 · Cited by 132 · see citing works
Incidence of stroke in Shibata, Japan: 1976-1978.
Tanaka, H., Ueda, Y., Date, C., Baba, T., Yamashita, H., Hayashi, M., Shoji, H., Ôwada, K., Baba, K., Shibuya, M., et al. (1981) · Stroke · doi:10.1161/01.str.12.4.460 · Cited by 130 · see citing works
Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis. A review.
Tell, G. S., Crouse, J. R., & Furberg, C. D. (1988) · Stroke · doi:10.1161/01.str.19.4.423 · Cited by 126 · see citing works
Risk factors of end-stage renal disease and serum creatinine in a community-based mass screening
Iseki, K., Ikemiya, Y., & Fukiyama, K. (1997) · Kidney International · doi:10.1038/ki.1997.119 · Cited by 121 · see citing works
Self-citationAn Overview of Trials of Cholesterol Lowering and Risk of Stroke
Hebert, P. R. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.1995.00430010054007 · Cited by 115 · see citing works
Influence of cholesterol on survival after stroke: retrospective study
Dyker, A. G., Weir, C. J., & Lees, K. R. (1997) · BMJ · doi:10.1136/bmj.314.7094.1584 · Cited by 105 · see citing works
Ooneda, G., Yoshida, Y., Suzuki, K., et al. (2008) · Blood Vessels · doi:10.1159/000158160 · Cited by 79 · see citing works
An Epidemiologic Analysis of End-stage Lupus Nephritis
Iseki, K., Miyasato, F., Oura, T., Uehara, H., Nishime, K., & Fukiyama, K. (1994) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(12)80377-5 · Cited by 78 · see citing works
Self-citationYamori, Y., Nara, Y., Horie, R., et al. (1980) · Clinical and Experimental Hypertension · doi:10.3109/10641968009037158 · Cited by 72 · see citing works
Serum cholesterol, other risk factors, and cardiovascular disease in a Japanese cohort
Szatrowski, T. P., Peterson, A. V., Shimizu, Y., Prentice, R. L., Mason, M. W., Fukunaga, Y., & Kato, H. (1984) · Journal of Chronic Diseases · doi:10.1016/0021-9681(84)90007-9 · Cited by 62 · see citing works
Serum total cholesterol and mortality in a Japanese population
Iso, H., Naito, Y., Kitamura, A., Sato, S., Kiyama, M., Takayama, Y., Iida, M., Shimamoto, T., Sankai, T., & Komachi, Y. (1994) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)90110-4 · Cited by 57 · see citing works
Blood pressure and risk of end-stage renal disease in a screened cohort.
Iseki, K., Ikemiya, Y., & Fukiyama, K. (1996) · PubMed · Cited by 57 · see citing works
Self-citationwakugami, K., Iseki, K., Kimura, Y., Okumura, K., lkemiya, Y., Muratani, H., & Fukiyama, K. (1998) · Japanese Circulation Journal · doi:10.1253/jcj.62.7 · Cited by 51 · see citing works
Self-citationAn Epidemiological Analysis of Cardiovascular Diseases in Okinawa, Japan.
Kinjo, K., Kimura, Y., Shinzato, Y., Tomori, M., Komine, Y., Kawazoe, N., Takishita, S., Fukiyama, K., & COSMO Group (1992) · Hypertension Research · doi:10.1291/hypres.15.111 · Cited by 50 · see citing works
Self-citationHypertension and cerebrovascular disease - the Japanese experience
Omae, T., & Ueda, K. (1988) · Journal of Hypertension · doi:10.1097/00004872-198805000-00002 · Cited by 43 · see citing works
The ongoing natural experiment of cardiovascular diseases in Japan.
Blackburn, H., & Jacobs, D. R. (1989) · Circulation · doi:10.1161/01.cir.79.3.718 · Cited by 23 · see citing works
Serum cholesterol and risk of end-stage renal disease in a cohort of mass screening
Iseki, K., Ikemiya, Y., & Fukiyama, K. (1998) · Clinical and Experimental Nephrology · doi:10.1007/bf02480619 · Cited by 12 · see citing works
Self-citation(2) The 15 Year Follow-Up Population Survey on Cerebrovascular Disease in Rural Kyushu, Japan
Kimura, N., Nakayama, Y., & Tashiro, H. (1977) · Japanese Journal of Medicine · doi:10.2169/internalmedicine1962.16.142 · Cited by 11 · see citing works
Flagged first, then by citations
Research works printed but not linked: 6
- Kinjo K, Kimura Y, Shinzato Y Tomori M, Komine Y, Kawazoe N, et al, and COSMO Group: An epidemiological analysis of cardiovas- cular disease in Okinawa Japan. Hypertens Res 1992; 15: 111 -119
- Hatano S: Experience from a multicenter stroke register: a prelimi- nary report. Bull WHO 1976; 54: 541 -553
- Tazaki Y: Topics of cerebrovascular disturbance. Medicina 1984; 21: 1897 -1899 (in Japanese)
- SAS/STAT: User's guide, Release 6.03 Edition. Cary, NC: SAS Institute Inc, 1988
- Yamori Y, Horie R, Ikeda K, Nara Y, Lovenberg W: Prophylactic effect of dietary protein on stroke and its mechanism. In: Yamori Y, Lovenberg W, Reis ED, editors. Prophylactic approach to hyperten- sive disease. New York: Raven Press 1979: 497 -504
- Kimura N, Toshima H, Nakayama Y, Takayama K, Tashiro H, Takagi M: Fifteen-year follow-up population survey on stroke: multivariate analysis of the risk of stroke in farmers of Tanushimaru and fisherman of Ushibuka. In: Katz AAM, editor. Perspectives in cardiovascular research, Vol. 4. Yamori Y, Lovenberg W, Frei ED, editors. Prophylactic approach to hypertensive disease. New York: Raven Press, 1979; 505 -510
Cited by
Sorted by citations
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
Noda, H., Iso, H., Irie, F., Sairenchi, T., Ohtaka, E., Doi, M., Izumi, Y., & Ohta, H. (2009) · Circulation · doi:10.1161/circulationaha.108.795666 · Cited by 150 · see citing works
- Authors
- Okumura, K., Iseki, K., Wakugami, K., Kimura, Y., Muratani, H., Ikemiya, Y., & Fukiyama, K.
- Affiliations
- University of the Ryukyus (JP)
- Third Department of Internal Medicine
- The Okinawa General Health Maintenance Association
- ORCID
- Iseki, Kunitoshi
- Venue
- Japanese Circulation Journal
- Publisher
- Japanese Circulation Society
- Published
- 1999
- Volume
- 63
- Issue
- 1
- Pages
- 53-58
- ISSN
- 0047-1828 (ISSN-L)
- 1347-4839
- OpenAlex
- W1591457700
- Cited by
- 69
- References
- 33
- Citations by year
- 2025: 1 · 2023: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 2 · 2013: 3 · 2012: 1
- FWCI
- 4.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Japanese Circulation Journal-english Edition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- serum cholesterol, hemorrhagic stroke, cerebral hemorrhage, stroke risk factors, men, subarachnoid hemorrhage, cerebral infarction, Okinawa, mass screening
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cerebral Hemorrhage, Cerebrovascular Disorders, Cholesterol, Female, Humans, Japan, Male, Mass Screening, Middle Aged, Risk Factors, Biomarkers
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