Abstract
BackgroundSeveral studies have described an association between hemoglobin concentration and stroke; however, the influence of hemoglobin on stroke incidence has not been fully revealed. Our objective was to elucidate the association between hemoglobin concentration and stroke incidence in Japanese community residents.MethodsIn the present study, we collected the data of 12,490 subjects who were enrolled between April 1992 and July 1995 in the Jichi Medical School (JMS) Cohort Study. We excluded the subjects with a history of stroke. Hemoglobin concentrations were grouped in quartiles, and quartile 2 (Q2) was used as the reference category. A Cox proportional-hazards model was used to examine hazard ratios (HRs) and the stroke incidence rates with 95% confidence intervals (CIs).ResultsDuring 10.8 years of follow-up, 409 participants (212 men and 197 women) experienced a new stroke, including 97 intracerebral hemorrhages, 259 cerebral infarctions, and 52 subarachnoid hemorrhages (SAH). In sex-specific hemoglobin quartiles, the multivariate-adjusted HR was statistically significantly higher in Q1 than in Q2, and a relationship similar to a J shape was observed between all strokes (HR in Q2 vs Q1, 1.36; 95% CI, 1.02–1.83; Q3, 1.20; 95% CI, 0.87–1.64; and Q4, 1.16; 95% CI, 0.84–1.60). Furthermore, the analysis of stroke subtypes showed a statistically significantly higher multivariate-adjusted HR in Q1 than in Q2 for SAH (HR 2.61; 95% CI, 1.08–6.27).ConclusionsA low hemoglobin concentration was associated with an increased risk of stroke, which was strongly influenced by the incidence of SAH.
Highlights
Stroke brings many deaths and long-term disability, which is an important issue for the world
Baseline hemoglobin positively correlated with Body mass index (BMI), total cholesterol (TC), and TG in both sexes
Baseline hemoglobin positively correlated with current drinking and negatively correlated with high-density lipoprotein cholesterol (HDL-C), fibrinogen, and high-sensitivity C-reactive protein (hsCRP)
Summary
Stroke brings many deaths and long-term disability, which is an important issue for the world. In 2016, over 5 million deaths occurred and over 100 million disability-adjusted life-years were reported lost owing to stroke.[1] it becomes imperative to identify predictors for the effective prevention of stroke. Previous studies showed a relationship between hematocrit or hemoglobin concentration and increased stroke onset.[2,3,4,5,6,7,8,9,10] Wood et al described that increased hematocrit was associated with increased blood viscosity and peripheral resistance, which reduced cerebral circulation.[11] the results of the previous studies were inconsistent regarding gender differences and degree of influence of hemoglobin on stroke onset. Several studies have described an association between hemoglobin concentration and stroke; the influence of hemoglobin on stroke incidence has not been fully revealed. Our objective was to elucidate the association between hemoglobin concentration and stroke incidence in Japanese community residents
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