C-reactive protein and risk of first-ever ischemic and hemorrhagic stroke in a general Japanese population: The Hisayama study

Yoshiyuki Wakugawa, Yutaka Kiyohara, Yumihiro Tanizaki, Michiaki Kubo, Toshiharu Ninomiya, Jun Hata, Yasufumi Doi, Ken Okubo, Yoshinori Oishi, Kentaro Shikata, Koji Yonemoto, Daisuke Maebuchi, Setsuro Ibayashi, Mitsuo Iida

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Background and Purpose - The role of high-sensitivity C-reactive protein (hsCRP) in the development of stroke is not clearly understood. We investigated the relationship between serum hsCRP levels and stroke occurrence in a general Japanese population. Methods - We followed 2692 subjects ≥40 years of age for 12 years. The relative risks and 95% CIs for ischemic and hemorrhagic stroke occurrence were calculated according to the hsCRP quintiles. Results - During the follow-up, 129 first-ever ischemic and 59 hemorrhagic strokes occurred. In men, the age-adjusted incidence of ischemic stroke significantly increased with elevated serum hsCRP levels; the difference between the first and fifth quintiles was statistically significant (1.4 versus 6.6 per 1000 person-years; P=0.02). This association remained significant even after adjustment for other confounding factors, such as age, systolic blood pressure, ECG abnormalities, diabetes, body mass index, total cholesterol, high-density lipoprotein cholesterol, smoking habits, alcohol intake, and regular exercise (adjusted relative risks, 3.11; 95% CI, 1.04 to 9.32; P=0.04). However, such associations were not observed for ischemic stroke in women or in hemorrhagic stroke in either sex. Among male subjects who were both in the fifth hsCRP level and had hypertension, diabetes, obesity, hypercholesterolemia, or a smoking habit, the risk of ischemic stroke was extremely increased, even after adjustment for other risk factors. Conclusions - Our findings suggest that elevated serum hsCRP levels are an independent risk factor for future ischemic stroke in Japanese men and that the coexistence of a high hsCRP level with another risk factor extremely increases the risk of ischemic stroke.

Original languageEnglish
Pages (from-to)27-32
Number of pages6
JournalStroke
Volume37
Issue number1
DOIs
Publication statusPublished - 01-01-2006

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C-Reactive Protein
Stroke
Population
Habits
Smoking
Serum
Blood Pressure
Hypercholesterolemia
HDL Cholesterol
Electrocardiography
Body Mass Index
Obesity
Cholesterol
Alcohols
Exercise
Hypertension
Incidence

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Wakugawa, Yoshiyuki ; Kiyohara, Yutaka ; Tanizaki, Yumihiro ; Kubo, Michiaki ; Ninomiya, Toshiharu ; Hata, Jun ; Doi, Yasufumi ; Okubo, Ken ; Oishi, Yoshinori ; Shikata, Kentaro ; Yonemoto, Koji ; Maebuchi, Daisuke ; Ibayashi, Setsuro ; Iida, Mitsuo. / C-reactive protein and risk of first-ever ischemic and hemorrhagic stroke in a general Japanese population : The Hisayama study. In: Stroke. 2006 ; Vol. 37, No. 1. pp. 27-32.
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abstract = "Background and Purpose - The role of high-sensitivity C-reactive protein (hsCRP) in the development of stroke is not clearly understood. We investigated the relationship between serum hsCRP levels and stroke occurrence in a general Japanese population. Methods - We followed 2692 subjects ≥40 years of age for 12 years. The relative risks and 95{\%} CIs for ischemic and hemorrhagic stroke occurrence were calculated according to the hsCRP quintiles. Results - During the follow-up, 129 first-ever ischemic and 59 hemorrhagic strokes occurred. In men, the age-adjusted incidence of ischemic stroke significantly increased with elevated serum hsCRP levels; the difference between the first and fifth quintiles was statistically significant (1.4 versus 6.6 per 1000 person-years; P=0.02). This association remained significant even after adjustment for other confounding factors, such as age, systolic blood pressure, ECG abnormalities, diabetes, body mass index, total cholesterol, high-density lipoprotein cholesterol, smoking habits, alcohol intake, and regular exercise (adjusted relative risks, 3.11; 95{\%} CI, 1.04 to 9.32; P=0.04). However, such associations were not observed for ischemic stroke in women or in hemorrhagic stroke in either sex. Among male subjects who were both in the fifth hsCRP level and had hypertension, diabetes, obesity, hypercholesterolemia, or a smoking habit, the risk of ischemic stroke was extremely increased, even after adjustment for other risk factors. Conclusions - Our findings suggest that elevated serum hsCRP levels are an independent risk factor for future ischemic stroke in Japanese men and that the coexistence of a high hsCRP level with another risk factor extremely increases the risk of ischemic stroke.",
author = "Yoshiyuki Wakugawa and Yutaka Kiyohara and Yumihiro Tanizaki and Michiaki Kubo and Toshiharu Ninomiya and Jun Hata and Yasufumi Doi and Ken Okubo and Yoshinori Oishi and Kentaro Shikata and Koji Yonemoto and Daisuke Maebuchi and Setsuro Ibayashi and Mitsuo Iida",
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Wakugawa, Y, Kiyohara, Y, Tanizaki, Y, Kubo, M, Ninomiya, T, Hata, J, Doi, Y, Okubo, K, Oishi, Y, Shikata, K, Yonemoto, K, Maebuchi, D, Ibayashi, S & Iida, M 2006, 'C-reactive protein and risk of first-ever ischemic and hemorrhagic stroke in a general Japanese population: The Hisayama study', Stroke, vol. 37, no. 1, pp. 27-32. https://doi.org/10.1161/01.STR.0000194958.88216.87

C-reactive protein and risk of first-ever ischemic and hemorrhagic stroke in a general Japanese population : The Hisayama study. / Wakugawa, Yoshiyuki; Kiyohara, Yutaka; Tanizaki, Yumihiro; Kubo, Michiaki; Ninomiya, Toshiharu; Hata, Jun; Doi, Yasufumi; Okubo, Ken; Oishi, Yoshinori; Shikata, Kentaro; Yonemoto, Koji; Maebuchi, Daisuke; Ibayashi, Setsuro; Iida, Mitsuo.

In: Stroke, Vol. 37, No. 1, 01.01.2006, p. 27-32.

Research output: Contribution to journalArticle

TY - JOUR

T1 - C-reactive protein and risk of first-ever ischemic and hemorrhagic stroke in a general Japanese population

T2 - The Hisayama study

AU - Wakugawa, Yoshiyuki

AU - Kiyohara, Yutaka

AU - Tanizaki, Yumihiro

AU - Kubo, Michiaki

AU - Ninomiya, Toshiharu

AU - Hata, Jun

AU - Doi, Yasufumi

AU - Okubo, Ken

AU - Oishi, Yoshinori

AU - Shikata, Kentaro

AU - Yonemoto, Koji

AU - Maebuchi, Daisuke

AU - Ibayashi, Setsuro

AU - Iida, Mitsuo

PY - 2006/1/1

Y1 - 2006/1/1

N2 - Background and Purpose - The role of high-sensitivity C-reactive protein (hsCRP) in the development of stroke is not clearly understood. We investigated the relationship between serum hsCRP levels and stroke occurrence in a general Japanese population. Methods - We followed 2692 subjects ≥40 years of age for 12 years. The relative risks and 95% CIs for ischemic and hemorrhagic stroke occurrence were calculated according to the hsCRP quintiles. Results - During the follow-up, 129 first-ever ischemic and 59 hemorrhagic strokes occurred. In men, the age-adjusted incidence of ischemic stroke significantly increased with elevated serum hsCRP levels; the difference between the first and fifth quintiles was statistically significant (1.4 versus 6.6 per 1000 person-years; P=0.02). This association remained significant even after adjustment for other confounding factors, such as age, systolic blood pressure, ECG abnormalities, diabetes, body mass index, total cholesterol, high-density lipoprotein cholesterol, smoking habits, alcohol intake, and regular exercise (adjusted relative risks, 3.11; 95% CI, 1.04 to 9.32; P=0.04). However, such associations were not observed for ischemic stroke in women or in hemorrhagic stroke in either sex. Among male subjects who were both in the fifth hsCRP level and had hypertension, diabetes, obesity, hypercholesterolemia, or a smoking habit, the risk of ischemic stroke was extremely increased, even after adjustment for other risk factors. Conclusions - Our findings suggest that elevated serum hsCRP levels are an independent risk factor for future ischemic stroke in Japanese men and that the coexistence of a high hsCRP level with another risk factor extremely increases the risk of ischemic stroke.

AB - Background and Purpose - The role of high-sensitivity C-reactive protein (hsCRP) in the development of stroke is not clearly understood. We investigated the relationship between serum hsCRP levels and stroke occurrence in a general Japanese population. Methods - We followed 2692 subjects ≥40 years of age for 12 years. The relative risks and 95% CIs for ischemic and hemorrhagic stroke occurrence were calculated according to the hsCRP quintiles. Results - During the follow-up, 129 first-ever ischemic and 59 hemorrhagic strokes occurred. In men, the age-adjusted incidence of ischemic stroke significantly increased with elevated serum hsCRP levels; the difference between the first and fifth quintiles was statistically significant (1.4 versus 6.6 per 1000 person-years; P=0.02). This association remained significant even after adjustment for other confounding factors, such as age, systolic blood pressure, ECG abnormalities, diabetes, body mass index, total cholesterol, high-density lipoprotein cholesterol, smoking habits, alcohol intake, and regular exercise (adjusted relative risks, 3.11; 95% CI, 1.04 to 9.32; P=0.04). However, such associations were not observed for ischemic stroke in women or in hemorrhagic stroke in either sex. Among male subjects who were both in the fifth hsCRP level and had hypertension, diabetes, obesity, hypercholesterolemia, or a smoking habit, the risk of ischemic stroke was extremely increased, even after adjustment for other risk factors. Conclusions - Our findings suggest that elevated serum hsCRP levels are an independent risk factor for future ischemic stroke in Japanese men and that the coexistence of a high hsCRP level with another risk factor extremely increases the risk of ischemic stroke.

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