The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort: The Suita Study

Yoshihiro Kokubo, Tomonori Okamura, Makoto Watanabe, Aya Higashiyama, Yuu Ono, Yoshihiro Miyamoto, Yoko Furukawa, Kei Kamide, Katsuyuki Kawanishi, Akira Okayama, Yasunao Yoshimasa

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Few prospective studies have examined the combined impact of blood pressure (BP) categories and glucose abnormalities on the incidence of cardiovascular disease (CVD) in the general Asian population. This study aimed to examine the effect of the combined risks of these factors on the incidence of CVD in a general Japanese population. We studied 5321 Japanese individuals (aged 30-79 years), without CVD at baseline, who received follow-up for an average of 11.7 years. Serum fasting glucose categories were defined according to the 2003 American Diabetes Association recommendations. BP categories were defined by the 2009 Japanese Society of Hypertension Guidelines for the Management of Hypertension. The Cox proportional hazard ratios (HRs) for CVD according to the serum glucose and BP categories were calculated. In 62 036 person-years of follow-up, we documented 364 CVD events (198 stroke and 166 coronary heart disease (CHD)). Compared with normoglycemic subjects, the multivariable HRs (95% confidence intervals (CIs)) for CVD, CHD and stroke were 1.25 (1.00-1.58), 1.46 (1.04-2.04) and 1.11 (0.81-1.52), respectively, in individuals with impaired fasting glucose (IFG), whereas these values were 2.13 (1.50-3.03), 2.28 (1.34-3.88) and 2.08 (1.29-3.35), respectively, in individuals with diabetes mellitus (DM). Compared with normoglycemic and optimal blood pressure (BP) subjects, increased risks of CVD were observed in the normoglycemic subjects with high-normal BP or hypertension, the IFG subjects with normal or higher BP, and the DM subjects regardless of BP category (P-value for interaction0.046). In conclusion, the high-normal BP subjects in all glucose categories and the normal BP subjects with IFG showed increased risk of CVD in this Japanese population. Further investigation of larger cohorts of DM subjects should be conducted to better understand this phenomenon.

Original languageEnglish
Pages (from-to)1238-1243
Number of pages6
JournalHypertension Research
Volume33
Issue number12
DOIs
Publication statusPublished - 2010 Dec
Externally publishedYes

Fingerprint

Blood Glucose
Cardiovascular Diseases
Blood Pressure
Incidence
Hypertension
Glucose
Fasting
Diabetes Mellitus
Coronary Disease
Stroke
Population
Serum
Prospective Studies
Guidelines
Confidence Intervals

Keywords

  • blood pressure category
  • cardiovascular disease
  • cohort study
  • diabetes mellitus
  • impaired fasting glucose

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort : The Suita Study. / Kokubo, Yoshihiro; Okamura, Tomonori; Watanabe, Makoto; Higashiyama, Aya; Ono, Yuu; Miyamoto, Yoshihiro; Furukawa, Yoko; Kamide, Kei; Kawanishi, Katsuyuki; Okayama, Akira; Yoshimasa, Yasunao.

In: Hypertension Research, Vol. 33, No. 12, 12.2010, p. 1238-1243.

Research output: Contribution to journalArticle

Kokubo, Y, Okamura, T, Watanabe, M, Higashiyama, A, Ono, Y, Miyamoto, Y, Furukawa, Y, Kamide, K, Kawanishi, K, Okayama, A & Yoshimasa, Y 2010, 'The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort: The Suita Study', Hypertension Research, vol. 33, no. 12, pp. 1238-1243. https://doi.org/10.1038/hr.2010.174
Kokubo, Yoshihiro ; Okamura, Tomonori ; Watanabe, Makoto ; Higashiyama, Aya ; Ono, Yuu ; Miyamoto, Yoshihiro ; Furukawa, Yoko ; Kamide, Kei ; Kawanishi, Katsuyuki ; Okayama, Akira ; Yoshimasa, Yasunao. / The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort : The Suita Study. In: Hypertension Research. 2010 ; Vol. 33, No. 12. pp. 1238-1243.
@article{f5d06d3f66034da3a924ad85a43882f7,
title = "The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort: The Suita Study",
abstract = "Few prospective studies have examined the combined impact of blood pressure (BP) categories and glucose abnormalities on the incidence of cardiovascular disease (CVD) in the general Asian population. This study aimed to examine the effect of the combined risks of these factors on the incidence of CVD in a general Japanese population. We studied 5321 Japanese individuals (aged 30-79 years), without CVD at baseline, who received follow-up for an average of 11.7 years. Serum fasting glucose categories were defined according to the 2003 American Diabetes Association recommendations. BP categories were defined by the 2009 Japanese Society of Hypertension Guidelines for the Management of Hypertension. The Cox proportional hazard ratios (HRs) for CVD according to the serum glucose and BP categories were calculated. In 62 036 person-years of follow-up, we documented 364 CVD events (198 stroke and 166 coronary heart disease (CHD)). Compared with normoglycemic subjects, the multivariable HRs (95{\%} confidence intervals (CIs)) for CVD, CHD and stroke were 1.25 (1.00-1.58), 1.46 (1.04-2.04) and 1.11 (0.81-1.52), respectively, in individuals with impaired fasting glucose (IFG), whereas these values were 2.13 (1.50-3.03), 2.28 (1.34-3.88) and 2.08 (1.29-3.35), respectively, in individuals with diabetes mellitus (DM). Compared with normoglycemic and optimal blood pressure (BP) subjects, increased risks of CVD were observed in the normoglycemic subjects with high-normal BP or hypertension, the IFG subjects with normal or higher BP, and the DM subjects regardless of BP category (P-value for interaction0.046). In conclusion, the high-normal BP subjects in all glucose categories and the normal BP subjects with IFG showed increased risk of CVD in this Japanese population. Further investigation of larger cohorts of DM subjects should be conducted to better understand this phenomenon.",
keywords = "blood pressure category, cardiovascular disease, cohort study, diabetes mellitus, impaired fasting glucose",
author = "Yoshihiro Kokubo and Tomonori Okamura and Makoto Watanabe and Aya Higashiyama and Yuu Ono and Yoshihiro Miyamoto and Yoko Furukawa and Kei Kamide and Katsuyuki Kawanishi and Akira Okayama and Yasunao Yoshimasa",
year = "2010",
month = "12",
doi = "10.1038/hr.2010.174",
language = "English",
volume = "33",
pages = "1238--1243",
journal = "Hypertension Research",
issn = "0916-9636",
publisher = "Nature Publishing Group",
number = "12",

}

TY - JOUR

T1 - The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort

T2 - The Suita Study

AU - Kokubo, Yoshihiro

AU - Okamura, Tomonori

AU - Watanabe, Makoto

AU - Higashiyama, Aya

AU - Ono, Yuu

AU - Miyamoto, Yoshihiro

AU - Furukawa, Yoko

AU - Kamide, Kei

AU - Kawanishi, Katsuyuki

AU - Okayama, Akira

AU - Yoshimasa, Yasunao

PY - 2010/12

Y1 - 2010/12

N2 - Few prospective studies have examined the combined impact of blood pressure (BP) categories and glucose abnormalities on the incidence of cardiovascular disease (CVD) in the general Asian population. This study aimed to examine the effect of the combined risks of these factors on the incidence of CVD in a general Japanese population. We studied 5321 Japanese individuals (aged 30-79 years), without CVD at baseline, who received follow-up for an average of 11.7 years. Serum fasting glucose categories were defined according to the 2003 American Diabetes Association recommendations. BP categories were defined by the 2009 Japanese Society of Hypertension Guidelines for the Management of Hypertension. The Cox proportional hazard ratios (HRs) for CVD according to the serum glucose and BP categories were calculated. In 62 036 person-years of follow-up, we documented 364 CVD events (198 stroke and 166 coronary heart disease (CHD)). Compared with normoglycemic subjects, the multivariable HRs (95% confidence intervals (CIs)) for CVD, CHD and stroke were 1.25 (1.00-1.58), 1.46 (1.04-2.04) and 1.11 (0.81-1.52), respectively, in individuals with impaired fasting glucose (IFG), whereas these values were 2.13 (1.50-3.03), 2.28 (1.34-3.88) and 2.08 (1.29-3.35), respectively, in individuals with diabetes mellitus (DM). Compared with normoglycemic and optimal blood pressure (BP) subjects, increased risks of CVD were observed in the normoglycemic subjects with high-normal BP or hypertension, the IFG subjects with normal or higher BP, and the DM subjects regardless of BP category (P-value for interaction0.046). In conclusion, the high-normal BP subjects in all glucose categories and the normal BP subjects with IFG showed increased risk of CVD in this Japanese population. Further investigation of larger cohorts of DM subjects should be conducted to better understand this phenomenon.

AB - Few prospective studies have examined the combined impact of blood pressure (BP) categories and glucose abnormalities on the incidence of cardiovascular disease (CVD) in the general Asian population. This study aimed to examine the effect of the combined risks of these factors on the incidence of CVD in a general Japanese population. We studied 5321 Japanese individuals (aged 30-79 years), without CVD at baseline, who received follow-up for an average of 11.7 years. Serum fasting glucose categories were defined according to the 2003 American Diabetes Association recommendations. BP categories were defined by the 2009 Japanese Society of Hypertension Guidelines for the Management of Hypertension. The Cox proportional hazard ratios (HRs) for CVD according to the serum glucose and BP categories were calculated. In 62 036 person-years of follow-up, we documented 364 CVD events (198 stroke and 166 coronary heart disease (CHD)). Compared with normoglycemic subjects, the multivariable HRs (95% confidence intervals (CIs)) for CVD, CHD and stroke were 1.25 (1.00-1.58), 1.46 (1.04-2.04) and 1.11 (0.81-1.52), respectively, in individuals with impaired fasting glucose (IFG), whereas these values were 2.13 (1.50-3.03), 2.28 (1.34-3.88) and 2.08 (1.29-3.35), respectively, in individuals with diabetes mellitus (DM). Compared with normoglycemic and optimal blood pressure (BP) subjects, increased risks of CVD were observed in the normoglycemic subjects with high-normal BP or hypertension, the IFG subjects with normal or higher BP, and the DM subjects regardless of BP category (P-value for interaction0.046). In conclusion, the high-normal BP subjects in all glucose categories and the normal BP subjects with IFG showed increased risk of CVD in this Japanese population. Further investigation of larger cohorts of DM subjects should be conducted to better understand this phenomenon.

KW - blood pressure category

KW - cardiovascular disease

KW - cohort study

KW - diabetes mellitus

KW - impaired fasting glucose

UR - http://www.scopus.com/inward/record.url?scp=78649853538&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649853538&partnerID=8YFLogxK

U2 - 10.1038/hr.2010.174

DO - 10.1038/hr.2010.174

M3 - Article

C2 - 20927111

AN - SCOPUS:78649853538

VL - 33

SP - 1238

EP - 1243

JO - Hypertension Research

JF - Hypertension Research

SN - 0916-9636

IS - 12

ER -