Journal Mobile Options
Table of Contents
Vol. 20, No. 4, 2005
Issue release date: September 2005
Cerebrovasc Dis 2005;20:233–238
(DOI:10.1159/000087704)

Hypertension and Stroke in Centenarians, Okinawa, Japan

Arakawa M. · Miyake Y. · Taira K.
aDepartment of Public Health, Fukuoka University School of Medicine, Fukuoka, and bDepartment of Lifelong Health Promotion, College of Education, University of the Ryukyus, Okinawa, Japan

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Objective: To investigate the relationship between a history of hypertension, cigarette smoking and alcohol intake and the lifetime prevalence of stroke in the oldest-old population. Design: A cross-sectional study. Subjects: All of the Japanese centenarians in the Okinawa Prefecture (266 men and 1,378 women). Methods: Okinawa Prefectural Government conducted health surveys among all of the centenarians in Okinawa. The variables used for analysis were sex, history of stroke, age at the first diagnosis of stroke, history of hypertension, cigarette smoking and alcohol intake. We used multiple logistic regression analysis taking the history of stroke as the dependent variable. Results: The lifetime prevalence value for stroke was 11.0% in Japanese centenarians. Hypertension was independently associated with an increased lifetime prevalence of stroke (adjusted odds ratio = 2.97 and 95% confidence interval: 2.16–4.08). There was no material relationship between sex, cigarette smoking, oralcohol intake and the prevalence of stroke. When the lifetime prevalence of stroke was divided according to whether stroke had been diagnosed for the first time at the age of 90 years or less or over the age of 90, a significant positive association between hypertension and stroke was more pronounced in centenarians with a diagnosis of stroke at the age of 90 years or less than in those over the age of 90. Conclusions: The findings suggest that hypertension may increase the likelihood of stroke in Japanese centenarians in Okinawa although the association between hypertension and stroke was more pronounced in those having stroke at 90 years or younger.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Sarti C, Rastenyte D, Cepaitis Z, Tuomilehto J: International trends in mortality from stroke, 1968 to 1994. Stroke 2000;31:1588–1601.
  2. Thorvaldsen P, Kuulasmaa K, Rajakangas AM, Rastenyte D, Sarti C, Wilhelmsen L: Stroke trend in the WHO MONICA project. Stroke 1997;28:500–506.
  3. Murray CJL, Lopez AD: Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 1997;349:1498–1504.
  4. Foulkes MA, Wolf PA, Price TR, Mohr JP, Hier DB: The stroke data bank: design methods, and baseline characteristics. Stroke 1988;19:547–554.
  5. Cabinet Office, Japan: Annual Report on the Aging Society. Tokyo, Independent Administrative Institution National Printing Bureau, 2004.
  6. Vaupel JW, Carey JR, Christensen K, Johnson TE, Yashin AI, Holm NV, Iachine IA, Kannisto V, Khazaeli AA, Liedo P, Longo VD, Zeng Y, Manton KG, Curtsinger JW: Biodemographic trajectories of longevity. Science 1998;280:855–860.
  7. Welin L, Svardsudd K, Wilhelmsen L, Larsson B, Tibblin G: Analysis of risk factors for stroke in a cohort of men born in 1913. N Engl J Med 1987;317:521–526.
  8. Prospective Studies Collaboration: Cholesterol, diastolic blood pressure, and stroke: 13,000 strokes in 450,000 people in 45 prospective cohorts. Lancet 1995;346:1647–1653.
  9. Eastern Stroke and Coronary Heart Disease Collaborative Research Group: Blood pressure, cholesterol, and stroke in eastern Asia. Lancet 1998;352:1801–1807.
  10. Berger K, Schulte H, Stogbauer F, Assmann G: Incidence and risk factors for stroke in an occupational cohort: the PROCAM Study. Stroke 1998;29:1562–1566.
  11. Yamada S, Koizumi A, Iso H, Wada Y, Watanabe Y, Date C, Yamamoto A, Kikuchi S, Inaba Y, Toyoshima H; Japan Collaborative Cohort Study Group: Risk factors for fatal subarachnoid hemorrhage: the Japan Collaborative Cohort Study. Stroke 2003;34:2781–2787.
  12. Whisnant JP: Effectiveness versus efficacy of treatment of hypertension for stroke prevention. Neurology 1996;46:301–307.
  13. Curb JD, Abbott RD, MacLean CJ, Rodriguez BL, Burchfiel CM, Sharp DS, Ross GW, Yano K: Age-related changes in stroke risk in men with hypertension and normal blood pressure. Stroke 1996;27:819–824.
  14. Abbott RD, Curb JD, Rodriguez BL, Masaki KH, Popper JS, Ross GW, Petrovitch H: Age-related changes in risk factor effects on the incidence of thromboembolic and hemorrhagic stroke. J Clin Epidemiol 2003;56:479–486.
  15. Liebetrau M, Steen B, Skoog I: Stroke in 85-year-olds: prevalence, incidence, risk factors, and relation to mortality and dementia. Stroke 2003;34:2617–2622.
  16. D’Agostino RB, Wolf PA, Belanger AJ, Kannel WB: Stroke risk profile: adjustment for antihypertensive medication. The Framingham Study. Stroke 1994;25:40–43.
  17. Lawes CM, Rodgers A, Bennett DA, Parag V, Suh I, Ueshima H, MacMahon S; Asia Pacific Cohort Studies Collaboration: Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens 2003;21:673–675.
  18. Arima H, Tanizaki Y, Kiyohara Y, Tsuchihashi T, Kato I, Kubo M, Tanaka K, Ohkubo K, Nakamura H, Abe I, Fujishima M, Iida M: Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly: the Hisayama study. Arch Intern Med 2003;163:361–366.
  19. Nakayama T, Yokoyama T, Yoshiike N, Zaman MM, Date C, Tanaka H, Detels R: Population attributable fraction of stroke incidence in middle-aged and elderly people: contributions of hypertension, smoking and atrial fibrillation. Neuroepidemiology 2000;19:217–226.
  20. Health and Welfare Statistics Association: Vital statistics of Japan. J Health Welfare Stat 2003;50:377–421.
  21. O’Mahony PG, Dobson R, Rodgers H, James OF, Thomson RG: Validation of a population screening questionnaire to assess prevalence of stroke. Stroke 1995;26:1334–1337.
  22. Bots ML, Looman SJ, Koudstaal PJ, Hofman A, Hoes AW, Grobbee DE: Prevalence of stroke in the general population. The Rotterdam Study. Stroke 1996;27:1499–1501.
  23. Evert J, Lawler E, Bogan H, Perls T: Morbidity profiles of centenarians: survivors, delayers, and escapers. J Gerontol A Biol Sci Med Sci 2003;58:232–237.
  24. Kono S, Ikeda M, Tokudome S, Nishizumi M, Kuratsune M: Smoking and mortalities from cancer, coronary heart disease and stroke in male Japanese physicians. J Cancer Res Clin Oncol 1985;110:161–164.
  25. Kiyohara Y, Ueda K, Fujishima M: Smoking and cardiovascular disease in the general population in Japan. J Hypertens 1990;8:S9–S15.

    External Resources

  26. Tanaka H, Ueda Y, Hayashi M, Date C, Baba T, Yamashita H, Shoji H, Tanaka Y, Owada K, Detels R: Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community. Stroke 1982;13:62–73.
  27. Mannami T, Iso H, Baba S, Sasaki S, Okada K, Konishi M, Tsugane S; Japan Public Health Center-Based Prospective Study on Cancer and Cardiovascular Disease Group: Cigarette smoking and risk of stroke and its subtypes among middle-aged Japanese men and women: the JPHC Study Cohort I. Stroke 2004;35:1248–1253.
  28. Shinton R, Beevers G: Meta-analysis of relation between cigarette smoking and stroke. BMJ 1989;298:789–794.
  29. Whisnant JP, Wiebers DO, O’Fallon WM, Sicks JD, Frye RL: A population-based model of risk factors for ischemic stroke: Rochester, Minnesota. Neurology 1996;47:1420–1428.
  30. Japan Health Promotion and Fitness Foundation: Reports of cross-sectional survey on one half samples of the Japanese centenarians, 2002, p 84.
  31. Reynolds K, Lewis B, Nolen JD, Kinney GL, Sathya B, He J: Alcohol consumption and risk of stroke: a meta-analysis. JAMA 2003;289:579–588.
  32. Iso H, Baba S, Mannami T, Sasaki S, Okada K, Konishi M, Tsugane S; JPHC Study Group: Alcohol consumption and risk of stroke among middle-aged men: the JPHC Study Cohort I. Stroke 2004;35:1124–1129.
  33. Engstad T, Bonaa KH, Viitanen M: Validity of self-reported stroke: the Tromso Study. Stroke 2000;31:1602–1607.
  34. Skoog I, Nilsson L, Palmertz B, Andreasson LA, Svanborg A: A population-based study of dementia in 85-year-olds. N Engl J Med 1993;328:153–158.
  35. Abbott RD, Yin Y, Reed DM, Yano K: Risk of stroke in male cigarette smokers. N Engl J Med 1986;315:717–720.
  36. Colditz GA, Bonita R, Stampfer MJ, Willett WC, Rosner B, Speizer FE, Hennekens CH: Cigarette smoking and risk of stroke in middle-aged women. N Engl J Med 1988;318:937–941.
  37. Robbins AS, Manson JE, Lee IM, Satterfield S, Hennekens CH: Cigarette smoking and stroke in a cohort of US male physicians. Ann Intern Med 1994;120:458–462.
  38. Teunissen LL, Rinkel GJ, Algra A, van Gijn J: Risk factors for subarachnoid hemorrhage: a systematic review. Stroke 1996;27:544–549.
  39. Gill JS, Shipley MJ, Tsementzis SA, Hornby R, Gill SK, Hitchcock ER, Beevers DG: Cigarette smoking: a risk factor for hemorrhagic and nonhemorrhagic stroke. Arch Intern Med 1989;149:2053–2057.
  40. Juvela S, Hillbom M, Palomaki H: Risk factors for spontaneous intracerebral hemorrhage. Stroke 1995;26:1558–1564.
  41. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS: Intracerebral hemorrhage versus infarction: stroke severity, risk factors, and prognosis. Am Neurol 1995;38:45–50.
  42. Thrift AG, McNeil JJ, Donnan GA: The risk of intracerebral haemorrhage with smoking: the Melbourne Risk Factor Study Group. Cerebrovasc Dis 1999;9:34–39.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50