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

Atherosclerosis. 2012 Apr;221(2):565-9. doi: 10.1016/j.atherosclerosis.2012.01.013. Epub 2012 Jan 25.


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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asians* / statistics & numerical data
  • Biomarkers / blood
  • Brain Ischemia / blood
  • Brain Ischemia / ethnology*
  • Chi-Square Distribution
  • Cholesterol / blood*
  • Female
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / ethnology*
  • Japan
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke / blood
  • Stroke / ethnology*
  • Time Factors
  • Up-Regulation


  • Biomarkers
  • Cholesterol