Regional Variation in Parental Stroke History Among Korean Populations: Insights into Chronic Disease Risk

Background: Despite having one of the highest prevalences of hypertension in Korea, Jeju Island maintains the lowest rate of stroke mortality nationwide. This paradoxical cardiovascular disease health profile raises questions about the underlying factors contributing to differential stroke risk in the Jeju population. Methods: We used health data from the Korea National Health and Nutrition Examination Survey (KNHANES) to investigate whether differences in regional stroke outcomes can be explained by known environmental and behavioral health contributors to increased cerebrovascular disease risk. We applied logistic regression with backward feature selection and cross-validation to identify predictors of parental history of stroke. Results: We found that individuals from Jeju Island were less likely to report a parental history of stroke compared to individuals from Seoul. This finding persisted even after adjusting for known cerebrovascular risk factors, including age, sex, SBP, antihypertensive use, dietary sodium intake, BMI, and hematocrit. Conclusions: Our results suggest that other hidden factors may contribute to the risk of cerebrovascular disease. Given the unique genetic architecture of the island, these findings prompt future analyses to explore whether genetic variation on Jeju contributes meaningfully to their reduced stroke mortality.