Relationship between blood pressure category and incidence of stroke and myocardial infarction in an Urban Japanese population with and without chronic kidney disease: The suita study

Yoshihiro Kokubo, Satoko Nakamura, Tomonori Okamura, Yasunao Yoshimasa, Hisashi Makino, Makoto Watanabe, Aya Higashiyama, Kei Kamide, Katsuyuki Kawanishi, Akira Okayama, Yuhei Kawano

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90 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE-: Chronic kidney disease (CKD) is increasingly recognized as an independent risk factor for stroke and myocardial infarction (MI). Few studies, however, have examined the relationship between blood pressure (BP) category and these diseases in subjects with and without CKD. METHODS-: We studied 5494 Japanese individuals (ages 30 to 79, without stroke or MI at baseline) who completed a baseline survey and received follow-up through December 2005. The glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease study equation modified by the Japanese coefficient. CKD was defined as an estimated GFR <60 mL/min/1.73m. BP categories were defined by the European Society of Hypertension and European Society of Cardiology 2007 criteria. RESULTS-: In 64 395 person-years of follow-up, we documented 346 incidences of cardiovascular diseases (CVD; 213 strokes and 133 MI events). Compared with the GFR (≥90 mL/min/1.73m) group, the hazard ratios (95% confidential intervals) for stroke were 1.9 (1.3 to 3.0) in the GFR 50 to 59 mL/min/1.73m group and 2.2 (1.2 to 4.1) in the GFR <50 mL/min/1.73m group. Results for cerebral infarction were similar. Compared with the optimal BP subjects without CKD, the normal BP, high-normal BP, and hypertensive subjects without CKD showed increased risks of CVD and stroke; however the impact of each BP category on CVD (P for interaction: 0.04 in men, 0.49 in women) and stroke (0.03 in men, 0.90 in women) was more evident in men with CKD. CONCLUSIONS-: CKD may increase the association of BP and CVD in a Japanese urban population.

Original languageEnglish
Pages (from-to)2674-2679
Number of pages6
JournalStroke
Volume40
Issue number8
DOIs
Publication statusPublished - 2009 Aug

Keywords

  • Blood pressure category
  • Chronic kidney disease
  • Epidemiology
  • General population
  • Myocardial infarction
  • Prospective studies
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

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    Kokubo, Y., Nakamura, S., Okamura, T., Yoshimasa, Y., Makino, H., Watanabe, M., Higashiyama, A., Kamide, K., Kawanishi, K., Okayama, A., & Kawano, Y. (2009). Relationship between blood pressure category and incidence of stroke and myocardial infarction in an Urban Japanese population with and without chronic kidney disease: The suita study. Stroke, 40(8), 2674-2679. https://doi.org/10.1161/STROKEAHA.109.550707