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.