title: History of blood transfusion before 1990 is a risk factor for stroke and cardiovascular diseases: the Japan collaborative cohort study (JACC study).
abstract: BACKGROUND
  We have previously shown novel evidence that history of blood transfusion is a risk factor for mortality from subarachnoid hemorrhage. This study was conducted to assess history of transfusion as a risk factor for other hemorrhagic stroke or ischemic stroke and cardiovascular diseases.
  
  
  METHODS
  A total of 88,312 Japanese participants (36,823 men and 51,489 women), aged 40-79 years, without history of stroke, heart disease or cancer, completed a questionnaire including history of transfusion under the JACC Study from 1988 to 1990. Participants were followed up annually until deceased, or when they moved away from the surveyed community, or at the end of 1999. The underlying causes of death were determined according to the International Classification of Diseases, 10th revision (ICD-10).
  
  
  RESULTS
  Total follow-up person-years were 871,437 (males 359,437, females 512,000). During this 10-year period, 309 died from intracerebral hemorrhage, 587 from ischemic stroke and 472 from coronary heart disease. The multivariate relative risks of a transfusion history were 2.16 (95% CI 1.42-3.27, p < 0.001) for intracerebral hemorrhage, 1.63 (95% CI 1.18-2.27, p = 0.004) for ischemic stroke and 1.66 (95% CI 1.17-2.36, p = 0.005) for coronary heart disease, after adjustment for conventional cardiovascular risk factors.
  
  
  CONCLUSIONS
  A transfusion history was associated with increased mortality from stroke and coronary heart disease.
authors.affiliation: Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Konoe-cho, Yoshida, Sakyo-ku, Kyoto, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamada
authors.forename: Akio
authors.initials: A
authors.lastname: Koizumi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Wada
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Chigusa
authors.initials: C
authors.lastname: Date
authors.forename: Akio
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Shogo
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Inaba
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kondo
authors.forename: Hideaki
authors.initials: H
authors.lastname: Toyoshima
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000401:mortality*; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D065227:Transfusion Reaction