Skip to main content

Advertisement

Log in

The incidence of hemorrhagic stroke in Japan is twice compared with western countries: the Akita stroke registry

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

The purpose of this study is to find out new knowledge about stroke among huge Japanese stroke registry involving complete brain images. The first stroke events from 1995 to 2004 in the Akita stroke registry (28,781 cases) were included in this study. According to brain images, we classified them into three types; cerebral infarction (CI 18,018 cases, 62.6 %), cerebral hemorrhage (CH 7,423 cases, 25.8 %), and subarachnoid hemorrhage (SAH 3,340, 11.6 %). CI and CH were classified according to the lesional areas, respectively. SAH was divided into three types according to arterial sites of ruptured aneurysm. The proportion of hemorrhagic stroke in Japan (37.4 %) was two times higher than in Western countries. Among CI group; lacunar infarction, cortical infarction, and infratentorial infarction occupied 5,437 (30.2 %), 6,121 (34.0 %), and 2,703 (15.0 %) cases, respectively. Among CH group; putamen, thalamus, and subcortex occupied 1,379 (18.6 %), 2,251 (30.3 %), and 1,204 (16.2 %) cases, respectively. According to ruptured cerebral aneurysm site, they were obviously different between men and women, proportion of internal carotid artery was the most (40.8 %) in women and that of anterior communicating artery was the most (46.8 %) in men on the contrary. The incidence of hemorrhagic stroke in Japan is twice as much as in the western countries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Go AS, Mozaffarian D, Roger VL et al (2014) Heart disease and stroke statistics–2014 update: a report from the American heart association. Circulation 129:e28–e292

    Article  PubMed  Google Scholar 

  2. Suzuki K, Sarti C, Tuomilehto J et al (1994) Stroke incidence and case fatality in Finland and in Akita, Japan: a comparative study. Neuroepidemiology 13:236–244

    Article  CAS  PubMed  Google Scholar 

  3. Adams HP Jr, Bendixen BH, Kappelle LJ et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment. Stroke 24:35–41

  4. WHO MONICA Project (1994) Myocardial infarction and coronary deaths in the WHO MONICA Project. Registration Procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 90:583–612

  5. Ueshima H (2007) Explanation for the Japanese paradox: prevention of increase in coronary heart disease and reduction in stroke. J Atheroscler Thromb 14:278–786

    Article  PubMed  Google Scholar 

  6. Kolominsky-Rabas PL, Sarti C, Heuschmann PU et al (1998) A Prospective Community-Based Study of Stroke in Germany-The Erlangen Stroke Project(ESPro) Incidence and Case Fatality at 1, 3, and 12 Months. Stroke 29:2501–2506

    Article  CAS  PubMed  Google Scholar 

  7. Vemmos KN, Bots ML, Tsibouris PK et al (1999) Stroke incidence and case fatality in southern greece the Arcadia stroke registry. Stroke 30:363–370

    Article  CAS  PubMed  Google Scholar 

  8. Thirft AG, Dewey HM, Macdonell RAL, McNeil JJ, Donnan GA (2000) Stroke incidence on the east coast of Australia. The north east Melbourne stroke incidence study (NEMESIS). Stroke 31:2087–2092

    Article  Google Scholar 

  9. Syme P, Byrne AW, Chen R, Devenny R, Forbes JF (2005) Community-based stroke incidence in a Scottish population: the Scottish borders stroke study. Stroke 36:1837–1843

    Article  PubMed  Google Scholar 

  10. Brown RD, Whisnant JP, Sicks JD, O’Fallon WM, Wiebers DO (1996) Stroke incidence, prevalence and survival: secular trends in Rochester, Minnesota, through 1989. Stroke 27:372–380

    Google Scholar 

  11. Suzuki K, Kutsuzawa T, Takita K et al (1987) Clinico-epidemiologic study of stroke in Akita, Japan. Stroke 18:402–406

    Article  CAS  PubMed  Google Scholar 

  12. Feigin VL, Forouzanfar MH, Krishnamurthi R et al (2014) Global and regional burden of stroke during 1990-2010: findings from the global burden of disease study 2010. Lancet 383:245–254

    Article  PubMed Central  PubMed  Google Scholar 

  13. Daniel T, Lackland TD, Roccella EJ, Deutsch AF et al (2014) Factors influencing the decline in stroke mortality a statement from the American Heart Association/American Stroke Association. Stroke 45:315–353

  14. Suzuki K, Izumi M, Sakamoto T, Hayashi M (2011) Blood pressure and total cholesterol level are critical risks especially for hemorrhagic stroke in Akita, Japan. Cerebrovasc Dis 31:100–106

    Article  CAS  PubMed  Google Scholar 

  15. Ueshima H, Iida M, Shimamoto et al (1980) Multivariate analysis of risk factors for stroke. Eight-year follow-up study of farming villages in Akita, Japan. Prev Med 9:722–740

  16. Tanaka H, Ueda Y, Hayashi M et al (1982) Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community. Stroke 13:62–73

    Article  CAS  PubMed  Google Scholar 

  17. Yano K (1989) M Dwayne, MacLean CJ. Serum cholesterol and hemorrhagic stroke in the Honolulu heart program. Stroke 20:1460–1465

    Article  CAS  PubMed  Google Scholar 

  18. Iso H, Jacobs DR, Wentworth D, Neaton JD, Cohen JD (1989) Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the Multiple Risk Factor Intervention Trial. N Eng J Med 320:904–910

    Article  CAS  Google Scholar 

  19. Lindenstrom, Boysen G, Nyboe J (1994) Influence of total cholesterol, high density lipoprotein cholesterol, and triglycerides on risk of cerebrovascular disease: the Copenhagen City heart study. BMJ 309:11–5

  20. White HD, Smith RJ, Anderson NE et al (2000) Pravastation therapy and the risk of stroke. N Eng J Med 343:317–326

    Article  CAS  Google Scholar 

  21. Amarenco P, Bogousslavsky J, Callahan A 3rd et al (2006) High-dose atorvastatin after stroke or transient ischemic attack. N Eng J Med. 355:549–559

    Article  CAS  Google Scholar 

  22. Suzuki K, Izumi M (2013) Alcohol is a risk factor not for thalamic but for putaminal hemorrhage: the Akita stroke registry. J Stroke Cerebrovasc Dis 22:1064–1069

    Article  PubMed  Google Scholar 

  23. Choudhury SR, Okayama A, Kita Y et al (1995) The associations between alcohol drinking and dietary habits and blood pressure in Japanese men. J Hypertens 13:587–593

    Article  CAS  PubMed  Google Scholar 

  24. Konishi M, Iso H, Iida M et al (1993) Association of serum total cholesterol, different types of stroke, and stenosis distribution of cerebral arteries. The Akita pathology study. Stroke. 24:954–964

    Article  CAS  PubMed  Google Scholar 

  25. Masuda J, Tanaka K, Omae T, Ueda K, Sadoshima S (1983) Cerebrovascular diseases and their underlying vascular lesions in Hisayama, Japan. A pathological study of autopsy cases. Stroke 14:934–940

    Article  CAS  PubMed  Google Scholar 

  26. Inoue H, Fujiki A, Origasa H et al (2009) Prevalence of atrial fibrillation in the general population of Japan. Int J Cardiol 137:102–107

    Article  PubMed  Google Scholar 

  27. Longstreth WT, Koepsell TD, Yerby MS, Belle G (1985) Risk factor for subarachnoid hemorrhage. Stroke 16:377–385

    Article  PubMed  Google Scholar 

  28. Ghods AJ, Lopes D, Chen M (2012) Gender differences in cerebral aneurysm location. Front Neurol 3:78

  29. Inagawa T (2010) Site of ruptured intracranial saccular aneurysms in patients in Izumo City. Japan. Cerebrovasc Dis. 30:72–84

    Article  PubMed  Google Scholar 

  30. Takao H, Murayama Y, Otsuka S et al (2012) Hemodynamic differences between unruptured and ruptured intracranial aneurysms during observation. Stroke 43:1436–1439

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

We have no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Manabu Izumi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suzuki, K., Izumi, M. The incidence of hemorrhagic stroke in Japan is twice compared with western countries: the Akita stroke registry. Neurol Sci 36, 155–160 (2015). https://doi.org/10.1007/s10072-014-1917-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-014-1917-z

Keywords

Navigation