Rationale, design, and baseline data of the Japanese Primary Prevention Project (JPPP)-A randomized, open-label, controlled trial of aspirin versus no aspirin in patients with multiple risk factors for vascular events

Tamio Teramoto, Kazuyuki Shimada, Shinichiro Uchiyama, Masahiro Sugawara, Yoshio Goto, Nobuhiro Yamada, Shinichi Oikawa, Katsuyuki Ando, Naoki Ishizuka, Tsutomu Yamazaki, Kenji Yokoyama, Mitsuru Murata, Yasuo Ikeda

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Prevention of atherosclerotic disease has become an important public health priority in Japan due to the aging of the population and changes in diet and lifestyle factors. Methods: The Japanese Primary Prevention Project (JPPP) is a multicenter, open-label, randomized, parallel-group trial that is evaluating primary prevention with low-dose aspirin in Japanese patients aged 60 to 85 years with hypertension, dyslipidemia, or diabetes mellitus. The study cohort will be followed for a mean of 4 years. The primary end point is a composite of death from cardiovascular causes (including fatal myocardial infarction [MI], fatal stroke, and other cardiovascular death), nonfatal stroke (ischemic or hemorrhagic), and nonfatal MI. Key secondary end points include a composite of cardiovascular death, nonfatal stroke, nonfatal MI, transient ischemic attack, angina pectoris, or arteriosclerotic disease requiring surgery or intervention; each component of the primary end point; noncerebrovascular and noncardiovascular death; and extracranial hemorrhage requiring transfusion or hospitalization. End point assessment is done by a central adjudication committee that is blinded to treatment assignments. Results: Enrollment began in March 2005 and was completed in June 2007. A total of 14,466 patients were randomly allocated to receive enteric-coated aspirin, 100 mg/d, or no aspirin. At randomization, the study cohort had a mean (SD) age of 70.6 (6.2) years; 57.8% were women, 85.0% had hypertension, 71.7% had dyslipidemia, and 33.9% had diabetes. In the study cohort, 80.4% of patients had ≥3 risk factors. Conclusion: The JPPP is the largest primary prevention trial of aspirin in a Japanese population that is investigating whether the benefit of aspirin in reducing risk of vascular events outweighs any bleeding risk in elderly patients with multiple risk factors.

Original languageEnglish
JournalAmerican Heart Journal
Volume159
Issue number3
DOIs
Publication statusPublished - 2010 Mar

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Primary Prevention
Aspirin
Blood Vessels
Myocardial Infarction
Cohort Studies
Dyslipidemias
Stroke
Hemorrhage
Hypertension
Health Priorities
Transient Ischemic Attack
Angina Pectoris
Random Allocation
Population
Life Style
Cause of Death
Diabetes Mellitus
Japan
Hospitalization
Public Health

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Rationale, design, and baseline data of the Japanese Primary Prevention Project (JPPP)-A randomized, open-label, controlled trial of aspirin versus no aspirin in patients with multiple risk factors for vascular events. / Teramoto, Tamio; Shimada, Kazuyuki; Uchiyama, Shinichiro; Sugawara, Masahiro; Goto, Yoshio; Yamada, Nobuhiro; Oikawa, Shinichi; Ando, Katsuyuki; Ishizuka, Naoki; Yamazaki, Tsutomu; Yokoyama, Kenji; Murata, Mitsuru; Ikeda, Yasuo.

In: American Heart Journal, Vol. 159, No. 3, 03.2010.

Research output: Contribution to journalArticle

Teramoto, Tamio ; Shimada, Kazuyuki ; Uchiyama, Shinichiro ; Sugawara, Masahiro ; Goto, Yoshio ; Yamada, Nobuhiro ; Oikawa, Shinichi ; Ando, Katsuyuki ; Ishizuka, Naoki ; Yamazaki, Tsutomu ; Yokoyama, Kenji ; Murata, Mitsuru ; Ikeda, Yasuo. / Rationale, design, and baseline data of the Japanese Primary Prevention Project (JPPP)-A randomized, open-label, controlled trial of aspirin versus no aspirin in patients with multiple risk factors for vascular events. In: American Heart Journal. 2010 ; Vol. 159, No. 3.
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abstract = "Background: Prevention of atherosclerotic disease has become an important public health priority in Japan due to the aging of the population and changes in diet and lifestyle factors. Methods: The Japanese Primary Prevention Project (JPPP) is a multicenter, open-label, randomized, parallel-group trial that is evaluating primary prevention with low-dose aspirin in Japanese patients aged 60 to 85 years with hypertension, dyslipidemia, or diabetes mellitus. The study cohort will be followed for a mean of 4 years. The primary end point is a composite of death from cardiovascular causes (including fatal myocardial infarction [MI], fatal stroke, and other cardiovascular death), nonfatal stroke (ischemic or hemorrhagic), and nonfatal MI. Key secondary end points include a composite of cardiovascular death, nonfatal stroke, nonfatal MI, transient ischemic attack, angina pectoris, or arteriosclerotic disease requiring surgery or intervention; each component of the primary end point; noncerebrovascular and noncardiovascular death; and extracranial hemorrhage requiring transfusion or hospitalization. End point assessment is done by a central adjudication committee that is blinded to treatment assignments. Results: Enrollment began in March 2005 and was completed in June 2007. A total of 14,466 patients were randomly allocated to receive enteric-coated aspirin, 100 mg/d, or no aspirin. At randomization, the study cohort had a mean (SD) age of 70.6 (6.2) years; 57.8{\%} were women, 85.0{\%} had hypertension, 71.7{\%} had dyslipidemia, and 33.9{\%} had diabetes. In the study cohort, 80.4{\%} of patients had ≥3 risk factors. Conclusion: The JPPP is the largest primary prevention trial of aspirin in a Japanese population that is investigating whether the benefit of aspirin in reducing risk of vascular events outweighs any bleeding risk in elderly patients with multiple risk factors.",
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AU - Teramoto, Tamio

AU - Shimada, Kazuyuki

AU - Uchiyama, Shinichiro

AU - Sugawara, Masahiro

AU - Goto, Yoshio

AU - Yamada, Nobuhiro

AU - Oikawa, Shinichi

AU - Ando, Katsuyuki

AU - Ishizuka, Naoki

AU - Yamazaki, Tsutomu

AU - Yokoyama, Kenji

AU - Murata, Mitsuru

AU - Ikeda, Yasuo

PY - 2010/3

Y1 - 2010/3

N2 - Background: Prevention of atherosclerotic disease has become an important public health priority in Japan due to the aging of the population and changes in diet and lifestyle factors. Methods: The Japanese Primary Prevention Project (JPPP) is a multicenter, open-label, randomized, parallel-group trial that is evaluating primary prevention with low-dose aspirin in Japanese patients aged 60 to 85 years with hypertension, dyslipidemia, or diabetes mellitus. The study cohort will be followed for a mean of 4 years. The primary end point is a composite of death from cardiovascular causes (including fatal myocardial infarction [MI], fatal stroke, and other cardiovascular death), nonfatal stroke (ischemic or hemorrhagic), and nonfatal MI. Key secondary end points include a composite of cardiovascular death, nonfatal stroke, nonfatal MI, transient ischemic attack, angina pectoris, or arteriosclerotic disease requiring surgery or intervention; each component of the primary end point; noncerebrovascular and noncardiovascular death; and extracranial hemorrhage requiring transfusion or hospitalization. End point assessment is done by a central adjudication committee that is blinded to treatment assignments. Results: Enrollment began in March 2005 and was completed in June 2007. A total of 14,466 patients were randomly allocated to receive enteric-coated aspirin, 100 mg/d, or no aspirin. At randomization, the study cohort had a mean (SD) age of 70.6 (6.2) years; 57.8% were women, 85.0% had hypertension, 71.7% had dyslipidemia, and 33.9% had diabetes. In the study cohort, 80.4% of patients had ≥3 risk factors. Conclusion: The JPPP is the largest primary prevention trial of aspirin in a Japanese population that is investigating whether the benefit of aspirin in reducing risk of vascular events outweighs any bleeding risk in elderly patients with multiple risk factors.

AB - Background: Prevention of atherosclerotic disease has become an important public health priority in Japan due to the aging of the population and changes in diet and lifestyle factors. Methods: The Japanese Primary Prevention Project (JPPP) is a multicenter, open-label, randomized, parallel-group trial that is evaluating primary prevention with low-dose aspirin in Japanese patients aged 60 to 85 years with hypertension, dyslipidemia, or diabetes mellitus. The study cohort will be followed for a mean of 4 years. The primary end point is a composite of death from cardiovascular causes (including fatal myocardial infarction [MI], fatal stroke, and other cardiovascular death), nonfatal stroke (ischemic or hemorrhagic), and nonfatal MI. Key secondary end points include a composite of cardiovascular death, nonfatal stroke, nonfatal MI, transient ischemic attack, angina pectoris, or arteriosclerotic disease requiring surgery or intervention; each component of the primary end point; noncerebrovascular and noncardiovascular death; and extracranial hemorrhage requiring transfusion or hospitalization. End point assessment is done by a central adjudication committee that is blinded to treatment assignments. Results: Enrollment began in March 2005 and was completed in June 2007. A total of 14,466 patients were randomly allocated to receive enteric-coated aspirin, 100 mg/d, or no aspirin. At randomization, the study cohort had a mean (SD) age of 70.6 (6.2) years; 57.8% were women, 85.0% had hypertension, 71.7% had dyslipidemia, and 33.9% had diabetes. In the study cohort, 80.4% of patients had ≥3 risk factors. Conclusion: The JPPP is the largest primary prevention trial of aspirin in a Japanese population that is investigating whether the benefit of aspirin in reducing risk of vascular events outweighs any bleeding risk in elderly patients with multiple risk factors.

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