Serum Albumin and Risks of Stroke and Its Subtypes ― The Circulatory Risk in Communities Study (CIRCS) ―

Abstract

Background:Few studies have investigated the association between serum albumin levels and the risk of stroke subtypes among the general Japanese population. Methods and Results:In this study, 5,071 men and 7,969 women aged 40–74 years, initially free from stroke, coronary artery disease, and kidney and hepatic failure, and residing in 4 Japanese communities completed a baseline risk factor survey between 1985 and 1994. During the 24-year follow-up, 528 men and 553 women experienced stroke. In the entire study cohort, multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) of total stroke, ischemic stroke, and intracerebral hemorrhage for the lowest vs. highest quartiles of serum albumin were 1.45 (1.18–1.77), 1.52 (1.17–1.97), and 1.57 (1.04–2.37), respectively. In men, multivariable HRs (95% CIs) for total stroke, ischemic stroke, and intracerebral hemorrhage in the lowest vs. highest serum albumin quartile were 1.44 (1.07–1.92), 1.48 (1.03–2.11) and 1.71 (0.92–3.18), respectively, whereas in women they were 1.50 (1.13–1.99), 1.63 (1.11–2.39), and 1.56 (0.89–2.74), respectively. Similar inverse associations were observed for each of the ischemic stroke subtypes, but not for subarachnoid hemorrhage. Conclusions:Low serum albumin levels were associated with an increased risk of total stroke, ischemic stroke, ischemic stroke subtypes, and intracerebral hemorrhage.