TY - JOUR
T1 - A combination of blood pressure and total cholesterol increases the lifetime risk of coronary heart disease mortality
T2 - EPOCH–JAPAN
AU - Evidence For Cardiovascular Prevention From Observational Cohorts In Japan (Epoch-Japan) Research Group
AU - Satoh, Michihiro
AU - Ohkubo, Takayoshi
AU - Asayama, Kei
AU - Murakami, Yoshitaka
AU - Sugiyama, Daisuke
AU - Waki, Takashi
AU - Tanaka-Mizuno, Sachiko
AU - Yamada, Michiko
AU - Saitoh, Shigeyuki
AU - Sakata, Kiyomi
AU - Irie, Fujiko
AU - Sairenchi, Toshimi
AU - Ishikawa, Shizukiyo
AU - Kiyama, Masahiko
AU - Okayama, Akira
AU - Miura, Katsuyuki
AU - Imai, Yutaka
AU - Ueshima, Hirotsugu
AU - Okamura, Tomonori
N1 - Funding Information:
This research was supported by a grant-in-aid from the Ministry of Health, Labour and Welfare, Health and Labor Sciences research grants, Japan (Research on Health Services: H17-Kenkou-007; Comprehensive Research on Cardiovascular Disease and Life-Related Disease: H18-Junkankitou [Seishuu]-Ippan-012; Comprehensive Research on Cardiovascular Disease and Life-Related Disease: H19-Junkanki-tou [Seishuu]-Ippan-012; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H20-Junkankitou [Seishuu]-Ippan-013; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H23-Junkankitou [Seishuu]-Ippan-005), and an Intramural Research Fund (22-4-5) for Cardiovascular Diseases of National Cerebral and Cardiovascular Center; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H26-Junk-ankitou [Seisaku]-Ippan-001; and H29-Junkankitou-Ippan-003.
PY - 2021
Y1 - 2021
N2 - Aim: Lifetime risk (LTR) indicates the absolute risk of disease during the remainder of an individual’s lifetime. We aimed to assess the LTRs for coronary heart disease (CHD) mortality associated with blood pressure (BP) and total cholesterol levels in an Asian population using a meta-analysis of individual participant data because no previous studies have assessed this risk. Methods: We analyzed data from 105,432 Japanese participants in 13 cohorts. Apart from grade 1 and 2–3 hypertension groups, we defined “normal BP” as systolic/diastolic BP <130/<80 mmHg and “high BP” as 130–139/80–89 mmHg. The sex-specific LTR was estimated while considering the competing risk of death. Results: During the mean follow-up period of 15 years (1,553,735 person-years), 889 CHD deaths were recorded. The 10-year risk of CHD mortality at index age 35 years was ≤ 0.11%, but the corresponding LTR was ≥ 1.84%. The LTR of CHD at index age 35 years steeply increased with an increase in BP of participants with high total cholesterol levels [≥ 5.7 mmol/L (220 mg/dL)]. This risk was 7.73%/5.77% (95% confidence interval: 3.53%–10.28%/3.83%–7.25%) in men/women with grade 2–3 hypertension and high total cholesterol levels. In normal and high BP groups, the absolute differences in LTRs between the low and high total cholesterol groups were ≤ 0.25% in men and ≤ 0.40% in women. Conclusions: High total cholesterol levels contributed to an elevated LTR of CHD mortality in hypertensive individuals. These findings could help guide high-risk young individuals toward initiating lifestyle changes or treatments.
AB - Aim: Lifetime risk (LTR) indicates the absolute risk of disease during the remainder of an individual’s lifetime. We aimed to assess the LTRs for coronary heart disease (CHD) mortality associated with blood pressure (BP) and total cholesterol levels in an Asian population using a meta-analysis of individual participant data because no previous studies have assessed this risk. Methods: We analyzed data from 105,432 Japanese participants in 13 cohorts. Apart from grade 1 and 2–3 hypertension groups, we defined “normal BP” as systolic/diastolic BP <130/<80 mmHg and “high BP” as 130–139/80–89 mmHg. The sex-specific LTR was estimated while considering the competing risk of death. Results: During the mean follow-up period of 15 years (1,553,735 person-years), 889 CHD deaths were recorded. The 10-year risk of CHD mortality at index age 35 years was ≤ 0.11%, but the corresponding LTR was ≥ 1.84%. The LTR of CHD at index age 35 years steeply increased with an increase in BP of participants with high total cholesterol levels [≥ 5.7 mmol/L (220 mg/dL)]. This risk was 7.73%/5.77% (95% confidence interval: 3.53%–10.28%/3.83%–7.25%) in men/women with grade 2–3 hypertension and high total cholesterol levels. In normal and high BP groups, the absolute differences in LTRs between the low and high total cholesterol groups were ≤ 0.25% in men and ≤ 0.40% in women. Conclusions: High total cholesterol levels contributed to an elevated LTR of CHD mortality in hypertensive individuals. These findings could help guide high-risk young individuals toward initiating lifestyle changes or treatments.
KW - Blood pressure
KW - Cholesterol
KW - Cohort study
KW - Coronary heart disease
KW - Lifetime risk
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U2 - 10.5551/jat.52613
DO - 10.5551/jat.52613
M3 - Article
C2 - 32269207
AN - SCOPUS:85099044358
VL - 28
SP - 6
EP - 24
JO - Journal of Atherosclerosis and Thrombosis
JF - Journal of Atherosclerosis and Thrombosis
SN - 1340-3478
IS - 1
ER -