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Objectives The association between hematocrit levels and the risk of cardiovascular disease (CVD) has been reported inconsistently. We aimed to investigate the association of hematocrit levels with the development of stroke and coronary heart disease (CHD) in a general Japanese population. Methods A total of 2585 community-dwelling Japanese individuals aged 40 years or older in 1988 were followed up for 19 years. These subjects were divided into four groups according to the sex-specific quartiles of hematocrit at baseline. Results During the follow-up, 301 subjects developed stroke (210 ischemic and 91 hemorrhagic) and 187 developed CHD. The risk of ischemic stroke was higher in both the lowest (Q1: men, ≤44.7%; women, ≤39.3%) and the highest (Q4: men, ≥49.7%; women, ≥43.8%) quartiles than in the third quartile (Q3: men, 47.1%–49.6%; women, 41.7%–43.7%) used as a reference (multivariable-adjusted hazard ratios [95% confidence intervals]: Q1, 1.55 [0.99–2.43]; Q2, 1.44 [0.93–2.23]; Q3, 1.00; and Q4, 1.62 [1.06–2.50]; P = 0.86 for trend). In contrast, hematocrit levels and the risk of hemorrhagic stroke showed a linear inverse association (Q1, 1.91 [1.03–3.54]; Q2, 1.26 [0.68–2.34]; Q3, 1.00; and Q4, 0.81 [0.41–1.61]; P = 0.009 for trend). The risk of CHD increased significantly in Q4 (Q1, 1.13 [0.71–1.80]; Q2, 1.08 [0.69–1.71]; Q3, 1.00; and Q4, 1.60 [1.04–2.46]; P = 0.13 for trend). Conclusions Our findings suggest that both elevated and decreased hematocrit levels are associated with an increased risk of CVD, but the influence of hematocrit is different among subtypes of CVD. [ABSTRACT FROM AUTHOR]

Abstract: Background and purpose: It has not been fully determined whether non-high-density lipoprotein cholesterol (non-HDLC) levels are involved in vascular events, especially stroke, in general Asian populations. We evaluated the association between non-HDLC levels and the risk of type-specific cardiovascular disease in a prospective cohort study in Japan. Methods: A total of 2452 community-dwelling Japanese subjects aged ≥40 years were followed prospectively for 24 years. Results: The age- and sex-adjusted incidence of coronary heart diseases (CHD) significantly increased with elevating non-HDLC levels (P for trend < 0.001), but no such association was observed for ischemic and hemorrhagic strokes. With regard to ischemic stroke subtypes, the age- and sex-adjusted incidence of lacunar infarction significantly increased with elevating non-HDLC levels (P for trend < 0.01), and such tendency was seen for atherothrombotic infarction (P for trend = 0.098), while a significant inverse association was observed for cardioembolic infarction (P for trend = 0.007). After adjustment for confounders, namely, age, sex, diabetes, body mass index, systolic blood pressure, electrocardiogram abnormalities, current drinking, current smoking, and regular exercise, the associations remained significant for CHD [adjusted hazard ratio (HR) for a 1 standard deviation of non-HDLC concentrations = 1.17, 95% confidence interval (CI) = 1.02 to 1.35], atherothrombotic infarction (adjusted HR = 1.39, 95% CI = 1.09 to 1.79), and cardioembolic infarction (adjusted HR = 0.64, 95% CI = 0.47 to 0.85). Conclusions: Our findings suggest that elevated non-HDLC levels are a significant risk factor for the development of atherothrombotic infarction as well as CHD but reduce the risk of cardioembolic infarction in the general Japanese population. [Copyright &y& Elsevier]