Abstract
The recent development of health care system, particularly for control of stroke and cardiovascular disease in Japan was briefly reviewed. Vital statistics in Japan and our own epidemiological study showed that incidence of death due to cerebral hemorrhage was decreased. However, incidence of death due to cerebral infarction in Japan was not substantially reduced, though our epidemiological study showed some reduction. From the etiological view point, cerebral hemorrhage was considered to be caused by hypertensive small vessel disease inside of the brain and cerebral infarction to occur in close association with atherosclerosis in the cerebral arteries or sometimes in the neck arteries. It was clearly shown by our study that atherosclerotic lesions were definitely accentuated by presence of hypertension. Among the possible risk factors for cardiovascular diseases, hypertension was found to be the only factor, which significantly contributed to the development of both types of stroke and was controllable by our hands. The problems of community-based hypertension control program were discussed.
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