Association of obesity and other cardiovascular risk factors with stroke The Japan Arteriosclerosis Longitudinal Study– Existing Cohorts Combined (JALS-ECC)

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  • OHASHI Yasuo
    Department of Biostatistics, School of Public Health, University of Tokyo Japan Arteriosclerosis Longitudinal Study Group
  • SHIMAMOTO Kazuaki
    Sapporo Medical University Japan Arteriosclerosis Longitudinal Study Group
  • SATO Shinichi
    Chiba Prefectural Institute of Public Health Japan Arteriosclerosis Longitudinal Study Group
  • ISO Hiroyasu
    Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine Japan Arteriosclerosis Longitudinal Study Group
  • KITA Yoshikuni
    Department of Health Science, Shiga University of Medical Science Japan Arteriosclerosis Longitudinal Study Group
  • KITAMURA Akihiko
    Osaka Medical Center for Health Science and Promotion Japan Arteriosclerosis Longitudinal Study Group
  • SAITO Isao
    Department of Public Health, Ehime University Graduate School of Medicine Japan Arteriosclerosis Longitudinal Study Group
  • KIYOHARA Yutaka
    Department of Environmental Medicine Graduate School of Medical Sciences, Kyushu University Japan Arteriosclerosis Longitudinal Study Group
  • KAWANO Hiroaki
    Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine Japan Arteriosclerosis Longitudinal Study Group
  • NAKAGAWA Hideaki
    Department of Epidemiology and Public Health, Kanazawa Medical University Japan Arteriosclerosis Longitudinal Study Group
  • TOYOSHIMA Hideaki
    Health Care Center of Anjo Kosei Hospital Japan Arteriosclerosis Longitudinal Study Group
  • ANDO Takashi
    Japan Clinical Research Support Unit Japan Arteriosclerosis Longitudinal Study Group
  • TAGURI Masataka
    Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University Yokohama City University Medical Center Japan Arteriosclerosis Longitudinal Study Group
  • HARADA Akiko
    Stress Science Research Institute, Public Health Research Foundation Japan Arteriosclerosis Longitudinal Study Group
  • UESHIMA Hirotsugu
    Lifestyle-Related Disease Prevention Center, Shiga University of Medical Science Japan Arteriosclerosis Longitudinal Study Group

Bibliographic Information

Other Title
  • 肥満を含む循環器リスクファクターの重積と脳卒中発症リスクの検討 日本動脈硬化縦断研究(JALS)0 次統合研究
  • ヒマン オ フクム ジュンカンキ リスクファクター ノ ジュウ セキ ト ノウソッチュウ ハッショウ リスク ノ ケントウ : ニホン ドウミャク コウカ ジュウダン ケンキュウ(JALS)0ジ トウゴウ ケンキュウ
  • Meta-analysis identifies common variants associated with body mass index in east Asians
  • Mice Lacking Hypertension Candidate Gene ATP2B1 in Vascular Smooth Muscle Cells Show Significant Blood Pressure Elevation

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Abstract

Objectives To assess the relationship between metabolic risk factors and the incidence of stroke stratified by obesity, by conducting a meta-analysis using individual participant data from prospective cohort studies.<br/>Methods A total of 19,173 individuals from 10 cohort studies participated at baseline after 1985. Metabolic risk factors were defined using the established criteria in Japan. Participants were subdivided into five categories according to the levels of risk factors and obesity defined by BMI≥25(kg/m2). Multivariate adjusted hazard ratios (HRs) for the incidence of stroke and the population attributable risk (PAR) were estimated by Poisson regression.<br/>Results During an average 7.1-year follow-up period, 374 stroke events occurred. Hypertension was highest among the risk factors not concerned with BMI stratification. The HR for stroke was 2.48 (95%CI:1.75–3.5) for BMI<25 with 1 other risk factor and 3.75 (2.58–5.45) with 2 or more, 2.38 while it was (1.58–3.59) for BMI≥25 with 0 or 1 factor and 3.26 (2.11–5.02) with 2 or more. The HR was significantly elevated in all categories with one or more risk factors. The PAR was highest in the category of BMI<25 with 1 risk factor (23.3%) and second highest in the category of BMI<25 with 2 or more. The respective PARs for BMI≥25 with 0 or 1 and 2 or more risk factors were 8.1% and 8.0%. Similar results were found from the analyses of different stroke subtypes.<br/>Conclusion The HR was found to be significantly elevated with the number of risk factors both with and without obesity. The attributable risk for stroke was larger in the non-obese group. Therefore, public health intervention based only on obesity may miss many of those at high risk of stroke so the focus should not only be on obesity but also cardiovascular risk factors.

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