title: Body mass index and risk of stroke mortality among a random sample of Japanese adults: 19-year follow-up of NIPPON DATA80.
abstract: BACKGROUND
  The relationship between body mass index (BMI) and stroke mortality remains unclear. The aim of the present study was to elucidate the relationship between BMI and stroke death in a representative cohort of Japanese men and women.
  
  
  METHODS
  We analyzed a database of 9,526 men and women aged 30 years and older who were randomly selected throughout Japan in 1980. These individuals had no history of stroke and were followed for 19 years. Hazard ratios (HR) and their 95% confidence intervals (CI) of deaths due to total stroke, cerebral infarction, and intracerebral hemorrhage were examined using Cox's proportional hazards regression models of BMI levels.
  
  
  RESULTS
  A U-shaped association between BMI and cerebral infarction mortality was observed. Participants with the highest BMI category (BMI > or = 30.0) showed a significantly highest HR for cerebral infarction (HR 2.46, 95% CI 1.01-5.99). The excess risk at the lower extreme of the BMI was confined to men. These associations did not change after excluding deaths occurring in the first 2 years of follow-up.
  
  
  CONCLUSIONS
  In the Japanese general population, a U-shaped association between BMI and cerebral infarction mortality was found and the excess risk at the lower extreme of the BMI was confined to men.
authors.affiliation: Department of Public Health, Jichi Medical University, Tochigi, Japan. i-oki@jichi.ac.jp
authors.forename: Izumi
authors.initials: I
authors.lastname: Oki
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.forename: Takehito
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kita
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D002544:Cerebral Infarction / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012494:Sampling Studies; D017678:Sex Distribution; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D013997:Time Factors