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Reduction in age-adjusted mortality rate of cerebrovascular disease is one of the target of National Health Promotion 'Health Japan 21' and this is to be attained not only by the improvement of the personal health but also by developing good social environment and circumstances. This article focused on the relationship between the socioeconomic status (SES) and stroke. Personal, regional, and international comparison data shows robust relationship between low SES and higher stroke incidence, severity and mortality. Bio-Psycho-Social model is proposed as a mechanisms how SES influences stroke. Allostatic overload, behavioral difference, influence of life course, and sense of coherence explain some part of this model. New approaches in consideration of SES are needed such as 'Visualization' of the problems of patient's background, improvement of social environment through the policy, and modification of social circumstances.

Background: 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins), which are widely used to lower plasma cholesterol levels, have been reported to have various pleiotropic effects such as protective effect of endothelial cells, angiogenic effect, antioxidant effect and anti-inflammatory effect. It is unclear, however, whether statins have any effects on the progression from left ventricular (LV) hypertrophy to heart failure in the established hypertrophied heart., Methods and Results: C57BL/6 mice were treated with pitavastatin (pitava) or vehicle (control) from 2 weeks (established hypertrophy stage) after transverse aortic constriction (TAC) and the treatment was continued for 4 weeks. Pitavastatin significantly inhibited the progression from LV hypertrophy to heart failure as assessed on echocardiography. The cardiomyocyte cross-sectional area was significantly increased in the control group compared to the sham-operated mice (sham group), but it was not significantly different between the control group and the pitava group at 6 weeks after TAC. Moreover, pitavastatin induced myocardial angiogenesis (ratio of number of endothelial cells to cardiomyocytes) and decreased the myocardial fibrosis and oxidative stress. The expression of angiopoietin-1 in the heart was significantly increased by pitavastatin at 6 weeks after TAC., Conclusions: Pitavastatin has preventive effects on the progression of heart failure even in the hypertrophied heart.