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Dietary and other risk factors for stroke in Hawaiian Japanese men
Insights
This longitudinal study identified key risk factors for stroke in Japanese men on Oahu. Elevated blood pressure and smoking increased risks for both thromboembolic and hemorrhagic stroke.
Area of Science:
- Epidemiology
- Cardiovascular Disease Research
- Neurology
Background:
- Stroke remains a significant public health concern, particularly in aging populations.
- Understanding ethnic-specific risk factors is crucial for targeted prevention strategies.
Purpose of the Study:
- To identify independent risk factors for thromboembolic stroke and intracranial hemorrhage.
- To investigate the association between lifestyle and clinical factors and stroke incidence in a Japanese-American male cohort.
Main Methods:
- A longitudinal study followed 7,895 men of Japanese ancestry aged 45-68 on Oahu for 10 years.
- Data collection included re-examinations and surveillance for stroke events.
- Statistical analyses, including univariate and multivariate approaches, were used to determine risk factors.
Main Results:
- Independent risk factors for thromboembolic stroke included elevated blood pressure, glucose intolerance, age, electrocardiographic evidence of left ventricular hypertrophy/strain, smoking, and proteinuria.
- Risk factors for intracranial hemorrhage included age, elevated blood pressure, smoking, serum uric acid, and inversely, serum cholesterol.
- Electrocardiographic findings predicted cerebral hemorrhage but not subarachnoid hemorrhage.
Conclusions:
- Elevated blood pressure and cigarette smoking are significant risk factors for both major stroke subtypes in this cohort.
- Specific risk factor profiles differ between thromboembolic stroke and intracranial hemorrhage.
- Further research into dietary factors and their complex interplay with stroke risk is warranted.
Abstract:
As part of an on-going longitudinal study, 7895 men of Japanese ancestry living on the island of Oahu, aged 45-68 and free of evidence of prior stroke at entry examination, have been followed by re-examinations and surveillance. During ten years of follow-up 154 men developed thromboembolic stroke, 65 developed intracranial hemorrhage, and 19 developed stroke of unknown type. There were 79 deaths attributed to stroke. The independent risk factors for thrombo-embolic stroke were elevated blood pressure, glucose intolerance, age, electrocardiographic evidence of left ventricular hypertrophy or strain, cigarette smoking and proteinuria. Attributes associated with increased risk of intracranial hemorrhage were age, elevated blood pressure, cigarette smoking, serum uric acid and, inversely, serum cholesterol level. Electrocardiographic evidence of left ventricular hypertrophy or strain significantly increased the risk of cerebral hemorrhage, but was not associated with subarachnoid hemorrhage. In univariate analysis, there was an inverse relation between dietary fat intake and thrombo-embolic and total stroke incidence. An inverse relation was also shown between protein intake and total stroke incidence. These dietary relations became statistically not significant in multivariate analysis. No relation was found between salt intake and the incidence of stroke.