Cigarette smoking as a risk factor for stroke death in Japan NIPPON DATA80

Hirotsugu Ueshima, Sohel Reza Choudhury, Akira Okayama, Takehito Hayakawa, Yoshikuni Kita, Takashi Kadowaki, Tomonori Okamura, Masumi Minowa, Osamu Iimura

Research output: Contribution to journalArticle

139 Citations (Scopus)

Abstract

Background and Purpose - Some previous Japanese cohort studies failed to show an association between smoking and stroke risk. Because such an association has been noted in other populations, this issue should be re-examined in a recent representative Japanese cohort with a higher total cholesterol level. Methods - A total of 9638 men and women aged 30 years and older without a history of cardiovascular disease (CVD) at baseline in 1980 were followed-up for 14 years. Results - We observed 203 stroke deaths (107 cerebral infarctions, 45 cerebral hemorrhages, and 51 others), 191 heart disease deaths, and 413 CVD deaths. The average serum total cholesterol level was ≈4.91 mmol/L. Cox proportional hazard ratios were calculated adjusting for age, systolic blood pressure, and other conventional risk factors. The hazard ratios for men who smoked 1 to 20 cigarettes/day for all strokes, cerebral infarction, and cerebral hemorrhage were 1.60 (95% CI, 0.91 to 2.79), 2.97 (CI, 1.27 to 6.98), and 0.42 (CI, 0.16 to 1.09), respectively, and for those who smoked ≥21 cigarettes/day, they were 2.17 (CI, 1.09 to 4.30), 3.26 (CI, 1.11 to 9.56), and 0.68 (CI, 0.20 to 2.33), respectively. For women who smoked ≥21 cigarettes/day, the hazard ratio for all strokes was 3.91 (CI, 1.18 to 12.90). For CVD, all heart disease, and ischemic heart disease, the hazard risks of smoking were significant (1.49 to 4.25) for men but not significant for women. Conclusions - Smoking in a cohort with moderate serum total cholesterol level was a potent risk factor for stroke, especially cerebral infarction, for both men and women, and for CVD and ischemic heart disease for men.

Original languageEnglish
Pages (from-to)1836-1841
Number of pages6
JournalStroke
Volume35
Issue number8
DOIs
Publication statusPublished - 2004 Aug
Externally publishedYes

Fingerprint

Japan
Smoking
Stroke
Cerebral Infarction
Cardiovascular Diseases
Tobacco Products
Cerebral Hemorrhage
Myocardial Ischemia
Heart Diseases
Cholesterol
Blood Pressure
Hypercholesterolemia
Serum
Cohort Studies
Population

Keywords

  • Cerebrovascular disorders
  • Epidemiology
  • Risk factors
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Ueshima, H., Choudhury, S. R., Okayama, A., Hayakawa, T., Kita, Y., Kadowaki, T., ... Iimura, O. (2004). Cigarette smoking as a risk factor for stroke death in Japan NIPPON DATA80. Stroke, 35(8), 1836-1841. https://doi.org/10.1161/01.STR.0000131747.84423.74

Cigarette smoking as a risk factor for stroke death in Japan NIPPON DATA80. / Ueshima, Hirotsugu; Choudhury, Sohel Reza; Okayama, Akira; Hayakawa, Takehito; Kita, Yoshikuni; Kadowaki, Takashi; Okamura, Tomonori; Minowa, Masumi; Iimura, Osamu.

In: Stroke, Vol. 35, No. 8, 08.2004, p. 1836-1841.

Research output: Contribution to journalArticle

Ueshima, H, Choudhury, SR, Okayama, A, Hayakawa, T, Kita, Y, Kadowaki, T, Okamura, T, Minowa, M & Iimura, O 2004, 'Cigarette smoking as a risk factor for stroke death in Japan NIPPON DATA80', Stroke, vol. 35, no. 8, pp. 1836-1841. https://doi.org/10.1161/01.STR.0000131747.84423.74
Ueshima H, Choudhury SR, Okayama A, Hayakawa T, Kita Y, Kadowaki T et al. Cigarette smoking as a risk factor for stroke death in Japan NIPPON DATA80. Stroke. 2004 Aug;35(8):1836-1841. https://doi.org/10.1161/01.STR.0000131747.84423.74
Ueshima, Hirotsugu ; Choudhury, Sohel Reza ; Okayama, Akira ; Hayakawa, Takehito ; Kita, Yoshikuni ; Kadowaki, Takashi ; Okamura, Tomonori ; Minowa, Masumi ; Iimura, Osamu. / Cigarette smoking as a risk factor for stroke death in Japan NIPPON DATA80. In: Stroke. 2004 ; Vol. 35, No. 8. pp. 1836-1841.
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abstract = "Background and Purpose - Some previous Japanese cohort studies failed to show an association between smoking and stroke risk. Because such an association has been noted in other populations, this issue should be re-examined in a recent representative Japanese cohort with a higher total cholesterol level. Methods - A total of 9638 men and women aged 30 years and older without a history of cardiovascular disease (CVD) at baseline in 1980 were followed-up for 14 years. Results - We observed 203 stroke deaths (107 cerebral infarctions, 45 cerebral hemorrhages, and 51 others), 191 heart disease deaths, and 413 CVD deaths. The average serum total cholesterol level was ≈4.91 mmol/L. Cox proportional hazard ratios were calculated adjusting for age, systolic blood pressure, and other conventional risk factors. The hazard ratios for men who smoked 1 to 20 cigarettes/day for all strokes, cerebral infarction, and cerebral hemorrhage were 1.60 (95{\%} CI, 0.91 to 2.79), 2.97 (CI, 1.27 to 6.98), and 0.42 (CI, 0.16 to 1.09), respectively, and for those who smoked ≥21 cigarettes/day, they were 2.17 (CI, 1.09 to 4.30), 3.26 (CI, 1.11 to 9.56), and 0.68 (CI, 0.20 to 2.33), respectively. For women who smoked ≥21 cigarettes/day, the hazard ratio for all strokes was 3.91 (CI, 1.18 to 12.90). For CVD, all heart disease, and ischemic heart disease, the hazard risks of smoking were significant (1.49 to 4.25) for men but not significant for women. Conclusions - Smoking in a cohort with moderate serum total cholesterol level was a potent risk factor for stroke, especially cerebral infarction, for both men and women, and for CVD and ischemic heart disease for men.",
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AU - Ueshima, Hirotsugu

AU - Choudhury, Sohel Reza

AU - Okayama, Akira

AU - Hayakawa, Takehito

AU - Kita, Yoshikuni

AU - Kadowaki, Takashi

AU - Okamura, Tomonori

AU - Minowa, Masumi

AU - Iimura, Osamu

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N2 - Background and Purpose - Some previous Japanese cohort studies failed to show an association between smoking and stroke risk. Because such an association has been noted in other populations, this issue should be re-examined in a recent representative Japanese cohort with a higher total cholesterol level. Methods - A total of 9638 men and women aged 30 years and older without a history of cardiovascular disease (CVD) at baseline in 1980 were followed-up for 14 years. Results - We observed 203 stroke deaths (107 cerebral infarctions, 45 cerebral hemorrhages, and 51 others), 191 heart disease deaths, and 413 CVD deaths. The average serum total cholesterol level was ≈4.91 mmol/L. Cox proportional hazard ratios were calculated adjusting for age, systolic blood pressure, and other conventional risk factors. The hazard ratios for men who smoked 1 to 20 cigarettes/day for all strokes, cerebral infarction, and cerebral hemorrhage were 1.60 (95% CI, 0.91 to 2.79), 2.97 (CI, 1.27 to 6.98), and 0.42 (CI, 0.16 to 1.09), respectively, and for those who smoked ≥21 cigarettes/day, they were 2.17 (CI, 1.09 to 4.30), 3.26 (CI, 1.11 to 9.56), and 0.68 (CI, 0.20 to 2.33), respectively. For women who smoked ≥21 cigarettes/day, the hazard ratio for all strokes was 3.91 (CI, 1.18 to 12.90). For CVD, all heart disease, and ischemic heart disease, the hazard risks of smoking were significant (1.49 to 4.25) for men but not significant for women. Conclusions - Smoking in a cohort with moderate serum total cholesterol level was a potent risk factor for stroke, especially cerebral infarction, for both men and women, and for CVD and ischemic heart disease for men.

AB - Background and Purpose - Some previous Japanese cohort studies failed to show an association between smoking and stroke risk. Because such an association has been noted in other populations, this issue should be re-examined in a recent representative Japanese cohort with a higher total cholesterol level. Methods - A total of 9638 men and women aged 30 years and older without a history of cardiovascular disease (CVD) at baseline in 1980 were followed-up for 14 years. Results - We observed 203 stroke deaths (107 cerebral infarctions, 45 cerebral hemorrhages, and 51 others), 191 heart disease deaths, and 413 CVD deaths. The average serum total cholesterol level was ≈4.91 mmol/L. Cox proportional hazard ratios were calculated adjusting for age, systolic blood pressure, and other conventional risk factors. The hazard ratios for men who smoked 1 to 20 cigarettes/day for all strokes, cerebral infarction, and cerebral hemorrhage were 1.60 (95% CI, 0.91 to 2.79), 2.97 (CI, 1.27 to 6.98), and 0.42 (CI, 0.16 to 1.09), respectively, and for those who smoked ≥21 cigarettes/day, they were 2.17 (CI, 1.09 to 4.30), 3.26 (CI, 1.11 to 9.56), and 0.68 (CI, 0.20 to 2.33), respectively. For women who smoked ≥21 cigarettes/day, the hazard ratio for all strokes was 3.91 (CI, 1.18 to 12.90). For CVD, all heart disease, and ischemic heart disease, the hazard risks of smoking were significant (1.49 to 4.25) for men but not significant for women. Conclusions - Smoking in a cohort with moderate serum total cholesterol level was a potent risk factor for stroke, especially cerebral infarction, for both men and women, and for CVD and ischemic heart disease for men.

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KW - Epidemiology

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