Trends in the incidence of stroke and cardiovascular risk factors on the isolated island of Okinawa: the Miyakojima study

J Stroke Cerebrovasc Dis. 2013 Oct;22(7):e118-23. doi: 10.1016/j.jstrokecerebrovasdis.2012.08.016. Epub 2012 Nov 2.


Background: Rapid deterioration of cardiovascular risk control, especially obesity, has occurred in Okinawa; this may affect cardiovascular disease incidence, including stroke.

Methods: Cross-sectional field studies were conducted in 2 periods, 1988-1991 as the first period, and 2002-2005 as the second period, in the isolated island of Okinawa, Miyakojima. To evaluate population backgrounds related to cardiovascular risk factors, data from the health checkup programs conducted in 1987 and 2001 were surveyed.

Results: Total of 257 patients in the first period and 370 in the second were diagnosed with first-time stroke. The age-adjusted annual incidence rate of first-time stroke of the first and second periods was 124 and 144 per 100,000 standard population of Japan. The age-adjusted annual incidence rate showed an upward trend for brain infarction (50 to 73) and downward trend for brain hemorrhage (61 to 54); however, those trends were not significant. The health checkup surveys illustrated that blood pressure decreased in all age groups during the second survey period. However, the body mass index increased in patients aged 50 years or more. Fasting blood glucose levels of patients aged 30-79 years and non-HDL cholesterol levels of patients aged 50-79 years significantly increased.

Conclusions: In Miyakojima, the incidence of first-time stroke and all of its subtypes did not change significantly between two periods, even though blood pressure decreased significantly in the second period. Metabolic deterioration may be associated with the upward trend in incidence of brain infarction.

Keywords: Incidence; metabolic syndrome and stroke; obesity; stroke epidemiology.

MeSH terms

  • Adult
  • Aged
  • Blood Glucose
  • Blood Pressure
  • Body Mass Index
  • Brain Ischemia / epidemiology*
  • Brain Ischemia / etiology
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Cerebral Hemorrhage / epidemiology*
  • Cerebral Hemorrhage / etiology
  • Female
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / epidemiology*
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / etiology


  • Blood Glucose