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Evaluation of atherosclerosis-associated factors and pulse wave velocity for predicting cerebral infarction: a hospital-based, case-control study in Japan.

Yokokawa H, Goto A, Watanabe K, Yasumura S

Department of Public Health, Fukushima Medical University School of Medicine, The Third Department of Internal Medicine, Fukushima, Japan. yokokawa@fmu.ac.jp

BACKGROUND: The mortality rate for cerebrovascular diseases is much higher in Japan than in North American and West European countries. The primary aim of this study was to elucidate from an epidemiological perspective, the associations between cerebral infarction and demographic factors, medical history and other clinical measurements including pulse wave velocity, a newly introduced non-invasive measurement procedure used to assess aortic stiffness. METHODS: This was a hospital-based, matched case-control study in northern Japan where there is a high incidence of cerebrovascular disease. The study group consisted of 92 matched pairs of cerebral infarction patients (cases) and healthy individuals admitted for a thorough health check-up (controls) at the Southern Tohoku General Hospital in Fukushima Prefecture, Japan. A conditional logistic regression model was used in the statistical analysis. RESULTS: In univariate analyses, 14 variables were significantly associated with cerebral infarction, of which four remained significant in the final multivariate model. These were family history of hypertension (odds ratio (OR) = 8.61), cerebrovascular diseases (OR = 13.70), high-density lipoprotein cholesterol of 40 mg/dL or higher (OR = 0.08), and pulse wave velocity over 1600 cm/s (OR = 2.92). CONCLUSION: Findings from the study indicate that a high pulse wave velocity, in addition to other traditional risk factors, may be associated with a higher risk of cerebral infarction. Further prospective studies are necessary to evaluate the use of this measure as a predictor of the disease.

Published 23 February 2007 in Intern Med J, 37(3): 161-7.
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