1994 Volume 17 Issue SupplementI Pages S11-S21
We reviewed the characteristics of stroke epidemiology in Japan mainly based on the 30-year experience of the Hisayama study which is a prospective and autopsy-based population survey conducted since 1961 in a Japanese subrural area. The most frequent type of cerebral stroke was cerebral infarction, sequentially followed by intracerebral hemorrhage and subarachnoid hemorrhage for men, while subarachnoid hemorrhage was more frequent than intracerebral hemorrhage for women. Among subtypes of cerebral infarction, lacunar infarction was a major type for the Hisayama residents. Hypertension was the most powerful risk factor for both intracerebral hemorrhage and cerebral infarction, and diabetes mellitus contributed to the occurrence of cerebral infarction through conferring an excess risk of hypertension to the ictus. Hypertension and diabetes could play an important role as an accerelating factor for brain small arteriolar lesions. The incidence of both intracerebral hemorrhage and cerebral infarction decreased in the recent Hisayama residents, and this could be related to the decreased prevalence of hypertension. However, the type of cerebral stroke will change into that more related to atherosclerosis in the future, since the prevalence of metabolic disorders such as hypercholesterolemia, obesity or glucose intolerance has much more increased among the recent Hisayama population. (Hypertens Res 1994; 17 Suppl. I: S11-S21)
