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

对茨城、秋田、大阪、高知、广岛、长崎、福冈等地人群的长期流行病学调查资料进行了分析，结果表明：1)各人群脑梗塞占总卒中的比例增加。根据CT表现，腔隙性脑梗塞的比例最高，栓塞性脑梗塞和血栓性脑梗塞的比例逐渐降低。腔隙性脑梗塞在日本人群中的比例高于西方人群。2)对25,811名年龄在40-69岁的男性和女性进行了9-10年的跟踪调查，获得了779例中风和307例缺血性心脏病的发病率。回归分析显示有意义的危险因素是腔隙性脑梗塞的高血压、高血清总胆固醇、饮酒、血栓…的左心室肥厚。血栓梗死多为房梗、左室肥厚。3)根据一项农村人群的前瞻性嵌套病例对照研究，无论是出血性还是非出血性卒中患者，血清多不饱和脂肪，尤其是n-6脂肪酸的比例均低于对照组。在城市人群中，缺血性心脏病患者的n-3脂肪酸比例倾向于低于对照组。4)血清脂肪酸、血浆纤维蛋白原和组织型纤溶酶原激活物抑制物I的相关因素包括吸烟、饮酒和吃鱼。病理研究表明，血管性痴呆的一个可能原因是基底节无症状性腔隙性脑梗塞，并随着年龄和高血压的增加而增加。较少

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