tion between serum cholesterol and stroke.18 They also argue that even if the causal mechanisms were satisfactorily established, the potentially negative effects of increased serum cholesterol levels on other cardiovascular diseases could readily outweigh the presumed positive effect on stroke. Whether this scepticism is warranted in the case of Japan remains to be seen.
The authors gratefully acknowledge partial support from the Japan Foundation. We would like to thank Shigemi Kono, Anne Pebley, Lorenzo Moreno, and Rachel Weinstein for their comments and advice and Maryann Belanger for her invaluable assistance in locating and providing reference materials.
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