title: Similarities and differences between coronary heart disease and stroke in the associations with cardiovascular risk factors: The Japan Collaborative Cohort Study.
abstract: Coronary heart disease (CHD) and stroke have common risk factors, but some of these differ in the magnitude or direction of associations between CHD and stroke. We assessed whether the impact of each risk factor differed between CHD and stroke mortality in Asians.
  
  
  
  In total, 104 910 subjects aged 40-79 years without histories of cancer, CHD and stroke at baseline were followed between 1988 and 2009. Competing-risks analysis was used to test for differences in the associations of each risk factor with two endpoints (CHD and stroke). Population attributable fractions (PAFs) were also calculated for these endpoints to estimate the population impact of each risk factor.
  
  
  
  During a median 19.1-year follow-up, 1554 died from CHD and 3163 from stroke. The association of hypertension with CHD was similar to that with stroke in terms of the magnitude and direction (multivariable-adjusted hazard ratio for CHD: 1.63 vs. stroke: 1.73 in men and 1.70 vs. 1.66 in women). Conversely, the magnitude of these associations differed for smoking (CHD: 1.95 vs. stroke: 1.23 in men and 2.45 vs. 1.35 in women) and diabetes (1.49 vs. 1.09 in men and 2.08 vs. 1.39 in women). The highest PAF for CHD was caused by smoking in men and by hypertension in women; that for stroke was caused by hypertension in both sexes.
  
  
  
  Hypertension associations and PAFs were consistent between CHD and stroke, but not for other risk factors. These findings may be useful to optimize public health intervention strategies.
authors.affiliation: Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Matsunaga
authors.affiliation: Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan. Electronic address: yatsuya@fujita-hu.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsuya
authors.affiliation: Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.affiliation: Department of Cardiology, National Hospital Organization Nagoya Medical Center, Aichi, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: Yuanying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Yamagishi
authors.affiliation: Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Tanabe
authors.affiliation: Faculty of Nutrition, University of Kochi, Kochi, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Wada
authors.affiliation: Department of Public Health, Aichi Medical University School of Medicine, Aichi, Japan.
authors.forename: Chaochen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Ota
authors.affiliation: Department of Nursing, Nagoya University School of Health Science, Nagoya, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tamakoshi
authors.affiliation: Department of Public Health, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D015897:Comorbidity; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012959:Socioeconomic Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D013997:Time Factors
keywords: Cardiovascular disease; Coronary heart disease; Epidemiology; Mortality; Risk factors; Stroke