title: High-density lipoprotein cholesterol and risk of stroke in Japanese men and women: the Oyabe Study.
abstract: OBJECTIVE
  Evidence of an inverse relationship between serum high-density lipoprotein cholesterol (HDL-C) and the risk of stroke is sparse in Asians and in women. The purpose of this investigation was to examine the relationship in a long-term cohort study of Japanese men and women among whom stroke occurrence is higher than in Western countries.
  
  
  METHODS
  A prospective cohort study was performed involving 4989 participants (1523 men, 3466 women) 35 to 79 years of age at baseline with approximately 10 years of follow-up in a rural area of Japan. End points included all stroke incidence and ischemic stroke incidence.
  
  
  RESULTS
  During follow-up, 132 participants developed stroke, including 81 ischemic stroke cases. Age-adjusted incidence rates per 10,000 person-years for all stroke in subjects with low HDL-C (<30 mg/dL [0.78 mmol/L]) were 103.4 in men and 49.3 in women, which were remarkably higher than in subjects with high HDL-C (>or=60 mg/dL [1.56 mmol/L]) (26.4 in men and 15.5 in women). A similar relationship was observed for ischemic stroke. Multivariate-adjusted relative risks for all stroke incidence and ischemic stroke incidence were 2.89 (95% CI, 1.35 to 6.20) and 2.92 (95% CI, 1.17 to 7.32), respectively, for low versus high HDL-C participants. The relationships were independent of sex, age, body mass index, blood pressure, serum total cholesterol, alcohol consumption, and smoking.
  
  
  CONCLUSIONS
  This 10-year follow-up study of Japanese men and women demonstrated that lower HDL-C levels were related significantly and independently to increased risk of all stroke incidence and ischemic stroke incidence.
authors.affiliation: Department of Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan. ysoyama@kanazawa-med.ac.jp
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Soyama
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.forename: Yuko
authors.initials: Y
authors.lastname: Morikawa
authors.forename: Muneko
authors.initials: M
authors.lastname: Nishijo
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Yuchi
authors.initials: Y
authors.lastname: Naruse
authors.forename: Sadanobu
authors.initials: S
authors.lastname: Kagamimori
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*
chemical_list: D008076:Cholesterol, HDL; D002784:Cholesterol