Recent change of Risk factors of Ischemic Cordio-and Cerebrovasular Diseases

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The data from a long-term epidemiologic studies in populations in ibaraki, Akita, Osaka, Kochi, Hiroshima, Nagasaki, Fukuoka was analyzed and the following results were obtained.1) The proportion of cerebral infarction among total stroke increased in each population. According to computer tomography (CT) findings, the proportion was highest in lacunar infarction, and progressively lower in embolic infarction and in thrombotic infarction. The proportion of lacunar infarction was higher in Japanese populations than in Western populations. Incidence of ischemic heart disease has increased in urban male employees, but has not changed in other populations.2) A cohort of 25,811 men and women aged 40-69 was followed 9 to 10 years and 779 stroke and 307 ischemic heart disease incidence cases were obtained. Significant risk factors shown by regression analyzes were hypertension for lacunar infarction, high serum total cholesterol, alcohol intake, left ventricular hypertrophy for thrombotic infa … More rction, and atrial infarction and left ventricular hypertrophy for embolic infarction. Risk factors for ischemic heart disease were high serum total cholesterol, high blood pressure, and cigarette smoking.3) According to a prospective nested case-control study in rural populations, the proportion of serum polyunsaturated fat, in particular n-6 fatty acids was lower in stroke incidence cases, either hemorrhagic or non-hemorrhagic stroke than in controls.In urban populations, the proportion of n-3 fatty acids tended to be lower in ischemic heart disease cases than in controls. Plasma fibrinogen concentrations were higher in patients of ischemic heart disease than in control.4) Related factors for serum fatty acids, plasma fibrinogen and tissue plasminogen activator inhibitor I included cigarette smoking, alcohol intake and fish intake.Pathologic study showed that a probable cause of vascular dementia was nonsymptomatic lacunar infartion in basal ganglia which was acceralated by aging and hypertension. Less