Changes in incidence and mortality of stroke and risk factors in a Japanese general population: the Hisayama study

Abstract

Stroke is the third leading cause of death in Japan, but it is more common than coronary heart disease in Japanese. Our autopsy-based, long-term prospective cohort study, the Hisayama study, demonstrated that stroke incidence and mortality markedly decreased from the 1960s to 1970s mainly due to treatment of hypertension. Thereafter, the reduction of stroke incidence became smaller and almost ceased in 1980 to 1990s in Japan. Stroke risk factors other than hypertension, such as obesity, hypercholesterolemia and diabetes, have been increasing in recent years probably due to the westernization of lifestyle. They become more important risk factors for ischemic stroke and seem to be responsible for the recent decline in the reduction of stroke incidence.