Cerebral Infarction in Hypertensive and Nonhypertensive Subjects in a Community of Japan: The Hisayama Study

Abstract

To compare the clinical features associated with stroke in hypertensive pa tients with those in nonhypertensives, we analyzed the records and the autopsy findings of cases of cerebral infarction in the Hisayama prospective study from 1961 through 1973. Of the total 128 cases of cerebral infarction, 79 (61.7%) occurred in patients admitted as hypertensives. In addition, of the 17 normotensive subjects at entry, (29.4%) had blood pressure levels that shifted into the hypertension range while 13 of 18 (72.2%) with borderline hypertension at entry had blood pressure levels that changed into the hypertensive range before stroke. In reviewing clinical symptoms and autopsy findings we frequently found that small, deep cerebral infarction, most often located in basal ganglia, in hy pertensive old persons. On the other hand, arrhythmia on ECG and focal in farcts on sytemic organs of the body were more often found in nonhypertensive patients with cerebral infarction than in hypertensives. This suggested that em bolism of cardiac origin may at least contribute to the development. of cerebral infarction in nonhypertensive subjects.