A Community-Based Study on the Type of Stroke Determined by CT Scan and Their Risk Factors

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Although mortality and morbidity of stroke have declined in Japan, stroke is a leading cause of physical and metal disability. Because of a wide use of computerized tomography (CT scan), stroke with small hemorrhage is likely to be detected although the incidence of cerebral hemorrhage declined along with hypertension control and improvements of lifestyle. According to clinical reports, the number of cerebral infraction in cortical artery regions, mostly thrombotic infraction, are increasing. However, few community-based study was conducted to clarify the prevalence of the type of stroke and their risk factors in our country. Recent wide use of CT scan enabled us to conduct the community-based study. The survey communities were two rural populations in northeast Japan and a rural population in central japan. Census populations in 1990 were 3,000, 7,000 and 17,000, respectively. Among 203 stroke cases of men and women aged 40 and over in three communities, 142 had the examination of CT scan For 142 stroke cases, the prevalence of the type of stroke was tabulated according to sex and age. Prevalences of cerebral hemorrhage and penetrating artery infraction were higher in Japan than in the U. S. and European countries. The opposite trend was observed in the prevalence of cortical artery infarction. To examine risk factors of the type of stroke, a nested-case control study was conducted. Addition to previous epidemiologic findings, a positive association between hypertension and penetrating artery infraction, and positive associations of atrial fibrillation and serum total cholesterol with cortical artery infraction were found.