Lifetime risk of stroke stratified by chronic kidney disease and hypertension in the general Asian population: the Ohasama study
Lifetime risk of stroke stratified by chronic kidney disease and hypertension in the general Asian population: the Ohasama study
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DOI：
10.1038/s41440-021-00635-z
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发表时间：
2021-03-19
影响因子：
5.4
通讯作者：
Ohkubo, Takayoshi
中科院分区：
文献类型：
--
作者：
Nakayama, Shingo;Satoh, Michihiro;Ohkubo, Takayoshi
终身风险（LTR）评估了在一个人的余生中发生疾病的绝对风险。它可以是一个有用的工具，使公众能够轻松了解他们的中风风险。尚未进行研究来确定慢性肾脏疾病（CKD）伴或不伴高血压患者的心血管疾病LTR;因此，我们在亚洲人群中进行了这项研究。我们随访了1525名参与者（66.0%女性，年龄63.1岁），来自日本Ohasama的普通人群。我们将CKD定义为估计肾小球滤过率（eGFR）= 140/>= 90 mmHg和/或使用抗高血压药物。我们计算了调整了死亡竞争风险的卒中性别特异性LTR。在平均16.5年的随访期间，238名参与者发生了首次中风。男性和女性45岁时的10年中风风险为0.0%。在45岁的指数年龄（男性/女性），无CKD和高血压的参与者的卒中LTR分别为20.9%/14.5%，有CKD但无高血压的参与者为34.1%/29.8%，有高血压但无CKD的参与者为37.9%/27.3%，有CKD和高血压的参与者为38.4%/36.4%。年轻参与者的卒中LTR往往高于患有CKD和/或高血压的老年参与者。慢性肾脏病和高血压都是导致中风长期复发的原因。CKD和高血压的预防可以降低卒中的LTR，特别是在年轻人群中。
Lifetime risk (LTR) evaluates the absolute risk of developing a disease during the remainder of one's life. It can be a useful tool, enabling the general public to easily understand their risk of stroke. No study has been performed to determine the LTR of cardiovascular disease in patients with chronic kidney disease (CKD) with or without hypertension; therefore, we performed this study in an Asian population. We followed 1525 participants (66.0% women; age 63.1 years) in the general population of Ohasama, Japan. We defined CKD as an estimated glomerular filtration rate (eGFR) = 140/>= 90 mmHg and/or the use of antihypertensive medication. We calculated the sex-specific LTR of stroke adjusted for the competing risk of death. During the mean follow-up period of 16.5 years, a first stroke occurred in 238 participants. The 10-year risk of stroke at the age of 45 years was 0.0% for men and women. The LTRs of stroke at the index age of 45 years (men/women) were 20.9%/14.5% for participants without CKD and hypertension, 34.1%/29.8% for those with CKD but not hypertension, 37.9%/27.3% for those with hypertension but not CKD, and 38.4%/36.4% for those with CKD and hypertension. The LTRs of stroke tended to be higher in younger participants than in older participants with CKD and/or hypertension. CKD contributed to the LTR of stroke, as did hypertension. The prevention of CKD and hypertension can reduce the LTR of stroke, especially in young populations.