Impacts of chronic kidney disease and diabetes on cardiovascular mortality in a general Japanese population

A 20-year follow-up of the NIPPON DATA90 study

Aya Hirata, Tomonori Okamura, Daisuke Sugiyama, Kazuyo Kuwabara, Aya Kadota, Akira Fujiyoshi, Katsuyuki Miura, Nagako Okuda, Takayoshi Ohkubo, Akira Okayama, Hirotsugu Ueshima

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Studies have shown significant associations of chronic kidney disease (CKD) and diabetes mellitus (DM) with cardiovascular disease (CVD) mortality. The impact on the general population is an important public health issue. However, the population attributable fraction (PAF) of CVD because of CKD and/or DM in a general population is uncertain. Methods We followed 7229 participants (age: ≥30 years) with no history of CVD in a Japanese community. We divided participants into four categories according to CKD and/or DM and calculated hazard ratios (HRs) of CVD mortality for each category using a Cox proportional hazards model adjusted for age, dyslipidemia, smoking and alcohol consumption. In addition, PAFs of CVD were estimated among populations with CKD and/or DM. Results During 20-year follow-up, 488 participants died. HRs for CVD were 1.63 [95% confidence interval (CI): 1.16-2.30] with DM only, 1.42 (95% CI: 1.08-1.86) with CKD only and 2.37 (95% CI: 1.40-4.01) with CKD + DM. In men, the corresponding HRs for CVD were 1.88 (95% CI: 1.19-2.97), 1.71 (95% CI: 1.15-2.56) and 3.26 (95% CI: 1.69-6.30), respectively; the corresponding PAFs of CVD were 4.1%, 5.1% and 2.9%, respectively. PAFs for CVD among women were lower than those in men, 1.6% for DM only, 2.0% for CKD only and 0.7% for CKD + DM. Conclusions PAFs of CVD mortality due to CKD and/or DM were not so high in past 20 years; however, they might increase in the future because of recent increase in prevalence of these in Japanese population.

Original languageEnglish
Pages (from-to)505-513
Number of pages9
JournalEuropean Journal of Preventive Cardiology
Volume24
Issue number5
DOIs
Publication statusPublished - 2017 Mar 1

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Chronic Renal Insufficiency
Cardiovascular Diseases
Diabetes Mellitus
Mortality
Population
Confidence Intervals
Dyslipidemias
Proportional Hazards Models
Alcohol Drinking
Public Health
Smoking

Keywords

  • Cardiovascular disease
  • chronic kidney disease
  • cohort studies
  • diabetes
  • general population
  • mortality
  • population attributable fraction

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

Cite this

Impacts of chronic kidney disease and diabetes on cardiovascular mortality in a general Japanese population : A 20-year follow-up of the NIPPON DATA90 study. / Hirata, Aya; Okamura, Tomonori; Sugiyama, Daisuke; Kuwabara, Kazuyo; Kadota, Aya; Fujiyoshi, Akira; Miura, Katsuyuki; Okuda, Nagako; Ohkubo, Takayoshi; Okayama, Akira; Ueshima, Hirotsugu.

In: European Journal of Preventive Cardiology, Vol. 24, No. 5, 01.03.2017, p. 505-513.

Research output: Contribution to journalArticle

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abstract = "Background Studies have shown significant associations of chronic kidney disease (CKD) and diabetes mellitus (DM) with cardiovascular disease (CVD) mortality. The impact on the general population is an important public health issue. However, the population attributable fraction (PAF) of CVD because of CKD and/or DM in a general population is uncertain. Methods We followed 7229 participants (age: ≥30 years) with no history of CVD in a Japanese community. We divided participants into four categories according to CKD and/or DM and calculated hazard ratios (HRs) of CVD mortality for each category using a Cox proportional hazards model adjusted for age, dyslipidemia, smoking and alcohol consumption. In addition, PAFs of CVD were estimated among populations with CKD and/or DM. Results During 20-year follow-up, 488 participants died. HRs for CVD were 1.63 [95{\%} confidence interval (CI): 1.16-2.30] with DM only, 1.42 (95{\%} CI: 1.08-1.86) with CKD only and 2.37 (95{\%} CI: 1.40-4.01) with CKD + DM. In men, the corresponding HRs for CVD were 1.88 (95{\%} CI: 1.19-2.97), 1.71 (95{\%} CI: 1.15-2.56) and 3.26 (95{\%} CI: 1.69-6.30), respectively; the corresponding PAFs of CVD were 4.1{\%}, 5.1{\%} and 2.9{\%}, respectively. PAFs for CVD among women were lower than those in men, 1.6{\%} for DM only, 2.0{\%} for CKD only and 0.7{\%} for CKD + DM. Conclusions PAFs of CVD mortality due to CKD and/or DM were not so high in past 20 years; however, they might increase in the future because of recent increase in prevalence of these in Japanese population.",
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T1 - Impacts of chronic kidney disease and diabetes on cardiovascular mortality in a general Japanese population

T2 - A 20-year follow-up of the NIPPON DATA90 study

AU - Hirata, Aya

AU - Okamura, Tomonori

AU - Sugiyama, Daisuke

AU - Kuwabara, Kazuyo

AU - Kadota, Aya

AU - Fujiyoshi, Akira

AU - Miura, Katsuyuki

AU - Okuda, Nagako

AU - Ohkubo, Takayoshi

AU - Okayama, Akira

AU - Ueshima, Hirotsugu

PY - 2017/3/1

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N2 - Background Studies have shown significant associations of chronic kidney disease (CKD) and diabetes mellitus (DM) with cardiovascular disease (CVD) mortality. The impact on the general population is an important public health issue. However, the population attributable fraction (PAF) of CVD because of CKD and/or DM in a general population is uncertain. Methods We followed 7229 participants (age: ≥30 years) with no history of CVD in a Japanese community. We divided participants into four categories according to CKD and/or DM and calculated hazard ratios (HRs) of CVD mortality for each category using a Cox proportional hazards model adjusted for age, dyslipidemia, smoking and alcohol consumption. In addition, PAFs of CVD were estimated among populations with CKD and/or DM. Results During 20-year follow-up, 488 participants died. HRs for CVD were 1.63 [95% confidence interval (CI): 1.16-2.30] with DM only, 1.42 (95% CI: 1.08-1.86) with CKD only and 2.37 (95% CI: 1.40-4.01) with CKD + DM. In men, the corresponding HRs for CVD were 1.88 (95% CI: 1.19-2.97), 1.71 (95% CI: 1.15-2.56) and 3.26 (95% CI: 1.69-6.30), respectively; the corresponding PAFs of CVD were 4.1%, 5.1% and 2.9%, respectively. PAFs for CVD among women were lower than those in men, 1.6% for DM only, 2.0% for CKD only and 0.7% for CKD + DM. Conclusions PAFs of CVD mortality due to CKD and/or DM were not so high in past 20 years; however, they might increase in the future because of recent increase in prevalence of these in Japanese population.

AB - Background Studies have shown significant associations of chronic kidney disease (CKD) and diabetes mellitus (DM) with cardiovascular disease (CVD) mortality. The impact on the general population is an important public health issue. However, the population attributable fraction (PAF) of CVD because of CKD and/or DM in a general population is uncertain. Methods We followed 7229 participants (age: ≥30 years) with no history of CVD in a Japanese community. We divided participants into four categories according to CKD and/or DM and calculated hazard ratios (HRs) of CVD mortality for each category using a Cox proportional hazards model adjusted for age, dyslipidemia, smoking and alcohol consumption. In addition, PAFs of CVD were estimated among populations with CKD and/or DM. Results During 20-year follow-up, 488 participants died. HRs for CVD were 1.63 [95% confidence interval (CI): 1.16-2.30] with DM only, 1.42 (95% CI: 1.08-1.86) with CKD only and 2.37 (95% CI: 1.40-4.01) with CKD + DM. In men, the corresponding HRs for CVD were 1.88 (95% CI: 1.19-2.97), 1.71 (95% CI: 1.15-2.56) and 3.26 (95% CI: 1.69-6.30), respectively; the corresponding PAFs of CVD were 4.1%, 5.1% and 2.9%, respectively. PAFs for CVD among women were lower than those in men, 1.6% for DM only, 2.0% for CKD only and 0.7% for CKD + DM. Conclusions PAFs of CVD mortality due to CKD and/or DM were not so high in past 20 years; however, they might increase in the future because of recent increase in prevalence of these in Japanese population.

KW - Cardiovascular disease

KW - chronic kidney disease

KW - cohort studies

KW - diabetes

KW - general population

KW - mortality

KW - population attributable fraction

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