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

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.