Blood pressure levels and risk of cardiovascular disease mortality among Japanese men and women: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study).
J Hypertens
; 37(7): 1366-1371, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-30882600
ABSTRACT
OBJECTIVE:
To examine the association of blood pressure (BP) with cardiovascular mortality in real-world settings and investigate whether that association varied by use of antihypertensive medication at baseline.METHODS:
Data from 27â728 Japanese men and women, aged 40-79 years, free of stroke, coronary heart disease, cancer, and kidney disease at entry (1988-1990) were used in this study. Mortality surveillance was completed through 2009, resulting in 449â800 person-years of follow-up. Hazard ratios for cardiovascular mortality were analysed by BP category (based on 2018 European guidelines) at admission.RESULTS:
There were 1477 deaths from cardiovascular diseases (CVDs). Relative to high-normal BP at admission, the multivariable hazard ratios (95% confidence intervals) of CVD were 0.85 (0.69-1.04) for optimal BP; 0.96 (0.81-1.15) for normal BP; 1.26 (1.09-1.46) for Grade 1 hypertension; and 1.55 (1.31-1.84) for Grade 2-3 hypertension. A similar linear association was observed among persons not taking antihypertensive medication at admission. Among patients treated for hypertension, a U-shaped association with CVD mortality was observed; hazard ratiosâ=â2.31 (1.25-4.27), 1.68 (1.05-2.69), 1.56 (1.10-2.22), and 1.63 (1.13-2.36), respectively. Similar patterns were observed for stroke and coronary heart disease, although not always statistically significant.CONCLUSION:
BP categories at baseline were linearly and positively associated with CVD mortality overall and also among participants not taking antihypertensive medication. A higher risk of mortality from CVD was observed among patients already treated for hypertension with optimal and normal BPs than those with high-normal BP, suggesting the importance of careful monitoring of BP and comorbidities of such patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pressão Sanguínea
/
Doenças Cardiovasculares
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Hipertensão
Tipo de estudo:
Etiology_studies
/
Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
/
Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article