The changing face of the burden of stroke in Japan

The pattern of stroke in Japan has become similar to that in western countries in recent decades: the incidence of stroke, as well as the death rate, has decreased tremendously, with a decreasing stroke/coronary heart disease (CHD) ratio, decreasing proportions of intracerebral hemorrhage (ICH) and lacunar infarction, and increasing proportions of atherothrombotic and cardio embolic stroke. These changes reflect the availability of health insurance for all Japanese, widespread use of antihypertensive therapy, increasing average age of the population, and lifestyle changes. The newly introduced Japan Stroke Society (JSS)-approved stroke specialist system is also described.