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The Japanese experience in hemorrhagic stroke
Summary
Japanese stroke mortality has significantly decreased, particularly for hemorrhagic stroke, due to lifestyle changes and better hypertension control. This shift indicates a trend towards less severe brain hemorrhage cases in recent years.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Hemorrhagic stroke presents unique challenges in Japan.
- Recent years have seen notable shifts in stroke incidence and severity.
Purpose of the Study:
- To review current challenges associated with hemorrhagic stroke in Japan.
- To investigate potential reasons for changes in hemorrhagic stroke incidence and severity.
Main Methods:
- Analysis of mortality statistics.
- Review of community-based stroke registries.
- Examination of hospital records.
Main Results:
- Age-adjusted stroke mortality in Japan declined by approximately 75% over 20 years.
- Hemorrhagic stroke saw a more significant reduction than ischemic stroke.
- The incidence ratio of brain infarction to brain hemorrhage in Japan is lower than in Western populations.
- Subarachnoid hemorrhage accounts for 7-12% of total strokes in Japan.
- Mild to moderate brain hemorrhage cases are now more frequent than severe cases.
Conclusions:
- Antihypertensive treatment and lifestyle modifications (including nutrition) are likely drivers of observed stroke figure changes.
- The declining trend in stroke mortality and the shift in severity suggest successful public health interventions.