Blood Pressure and the Risk of Stroke, Cardiovascular Disease, and All-Cause Mortality Among Japanese: The JPHC Study
Blood Pressure and the Risk of Stroke, Cardiovascular Disease, and All-Cause Mortality Among Japanese: The JPHC Study
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DOI：
10.1038/ajh.2008.356
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发表时间：
2009-03-01
影响因子：
3.2
通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
--
作者：
Ikeda, Ai;Iso, Hiroyasu;Tsugane, Shoichiro
研究背景亚洲人群中血压（BP）对心血管疾病（CVD）结果的影响知之甚少。方法我们在一个33，372名年龄在40-69岁的日本男性和女性的队列中，检查了与BP相关的中风和冠心病（CHD）事件和死亡率的人群归因分数（PAF）和风险比（HR），没有癌症和心血管疾病的早期诊断。根据2003年欧洲高血压学会-欧洲心脏病学会指南的修订标准对BP进行分类。从基线调查（1990-1994年）到2003年12月31日随访结束，共发生943例卒中事件、182例CHD事件、262例卒中死亡和120例CHD死亡。根据PAF的估计，消除正常至严重的高血压将预防64%的男性和50%的女性中风发病率; 67%的男性和29%的女性中风死亡率;在男性和女性中分别占总CVD死亡率的38%和36%。PAF估计的总卒中发病率在轻度高血压中最高，结论正常血压、正常高血压和轻度高血压对脑卒中事件发生的贡献大于中重度高血压，强调初级预防和治疗轻度至中度高血压的重要性。
BACKGROUNDLittle is known about the influence of blood pressure (BP) on cardiovascular disease (CVD) outcomes among Asian populations.METHODSWe examined population attributable fractions (PAFs) and hazard ratios (HRs) associated with BP in relation to stroke and coronary heart disease (CHD) incident and mortality within a cohort of 33,372 Japanese men and women aged 40-69 years, free of prior diagnosis of cancer and CVD. The BP was classified based on modified criteria of the 2003 European Society of Hypertension-European Society of Cardiology guidelines. A total of 943 stroke events, 182 CHD events, 262 stroke deaths, and 120 CHD deaths occurred between the baseline questionnaire (1990-1994) and the end of follow-up In 31 December 2003.RESULTSBP levels were linearly associated with incidence and mortality of CVD in men and women. According to the PAF estimation, the elimination of normal to severe hypertension would prevent 64% of stroke incidence in men and 50% in women; 67% of stroke mortality in men and 29% in women; and 38% of total CVD mortality in men and 36% in women.The PAF estimate fortotal stroke incidence was the highest for mild hypertension, and lower for moderate to severe hypertension in both sexes.CONCLUSIONSThe contributions of normal BP, high normal BP, and mild hypertension to the occurrence of stroke events were greater than those made by moderate and severe hypertension, highlighting the importance of primary prevention and of treatment for low-to-moderate degrees of hypertension.