High serum total cholesterol levels is a risk factor of ischemic stroke for general Japanese population: The JPHC study

Background: High serum total cholesterol levels represent a risk factor of ischemic stroke in Western countries. However, this association has not been thoroughly investigated in Asian populations where the incidence of stroke is high. Methods: Participants were 11,727 men and 21,742 women aged 40-69 years, all free of cardiovascular disease and cancer at baseline. During the median 12-year follow-up, we documented 612 ischemic stroke (293 lacunar infarction, 107 large-artery occlusive infarctions, and 168 embolic infarctions). Results: Excess risk of ischemic stroke was observed in men with serum total cholesterol levels of >= 6.21 mmol/L than those with the lowest category (< 4.65 mmol/L), but not in women. The multivariable hazard ratios (HRs) and 95% confidence interval (95% CI) were 1.63 (1.14-2.35) for men and 1.03 (0.69-1.55) for women. The corresponding HRs of large-artery occlusive infarction were 2.86 (1.31-6.27) for men and 0.75 (0.28-2.01) for women. Serum total cholesterol levels were not associated with risk of lacunar or embolic infarction for either sex. Conclusions: High serum total cholesterol is a risk factor of ischemic stroke, specifically large-artery occlusive infarction for Japanese men. (C) 2012 Elsevier Ireland Ltd. All rights reserved.