For the study, 82,772 Japanese men and women aged 45 to 74 years without a history of heart disease or cancer were followed from 1995 to 2010. Participants were asked about their breakfast-eating habits and were grouped as having the morning meal 0 to 2, 3 to 4, 5 to 6, or 7 times per week.
During the 15-year follow-up, there were a total of 3,772 strokes, including 1,051 of the brain hemorrhage type, along 870 cases of coronary heart disease.
Analysis showed that those who never ate breakfast had higher risks for heart disease and stroke, and a particularly higher risk for brain hemorrhage strokes, compared with those who ate breakfast every day. The researchers didn't find a link between the frequency of breakfast eating and the risk for heart disease.
A major risk factor for cerebral hemorrhage is high blood pressure -- especially an increase in blood pressure in the morning. The researchers say people in the study who ate breakfast every day were less likely to have high blood pressure compared with those who skipped the meal.
They also say several previous studies have shown that brain hemorrhage strokes happen more frequently in the morning, and other studies have reported drops in blood pressure from eating breakfast.
A past study has shown a link between the frequency of breakfast and the risk for heart disease in American men, the researchers say. They suggest that the difference in the two studies may be because of the different groups of people studied. In Japan, more people have strokes, particularly brain hemorrhages, and fewer people have heart disease compared to Western countries.
People in the new study may have changed their breakfast-eating habits over the follow-up period, the researchers say. Breakfast skippers may be more likely to have other unhealthy habits, too.
The research, published in the journal Stroke, was observational, the researchers say, and there may be other things they didn't take into account.
They note that several previous reports from both Western and Asian countries have shown missing breakfast has been tied to a higher prevalence of obesity, high blood pressure, high cholesterol, and high blood sugar levels, which are well-known risk factors for heart disease.
No guidelines have recommended that adults eat breakfast every day to prevent heart disease, because there is not enough evidence to support such a recommendation.