Lifetime Risk of Stroke and Coronary Heart Disease Deaths According to Blood Pressure Level: EPOCH-JAPAN (Evidence for Cardiovascular Prevention From Observational Cohorts in Japan)

EPOCH-JAPAN Research Group

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Abstract

Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one’s life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. The present metaanalysis included 107 737 Japanese (42.4% men; mean age, 55.1 years) from 13 cohorts. During the mean follow-up of 15.2±5.3 years (1 559 136 person-years), 1922 died from stroke and 913 from CHD. We estimated risks after adjusting for competing risk of death other than the outcome of interest. The 10-year risk of stroke and CHD deaths at index age of 35 years was ≤1.9% and ≤0.3%, respectively. The LTRs of stroke death at the index age of 35 years (men/women) were 6.1%/4.8% for optimal, 5.7%/6.3% for normal, and 6.6%/6.0% for high-normal blood pressure groups, and 9.1%/7.9% for grade 1, 14.5%/10.3% for grade 2, and 14.6%/14.3% for grade 3 hypertension groups. The LTRs of CHD death similarly elevated with an increase in blood pressure but were lower (≤7.2%) than those of stroke death. In conclusion, blood pressure was clearly associated with an elevated LTR of stroke or CHD death, although the LTR of CHD death was one-half of that of stroke death in an Asian population. These results would help young people with hypertension to adopt a healthy lifestyle or start antihypertensive therapy early.

Original languageEnglish
Pages (from-to)52-59
Number of pages8
JournalHypertension (Dallas, Tex. : 1979)
Volume73
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

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Coronary Disease
Japan
Stroke
Blood Pressure
Hypertension
Blood Group Antigens
Antihypertensive Agents
Population
Meta-Analysis
Databases

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

@article{6da50bdcafef4ef5bc702b3e245fa081,
title = "Lifetime Risk of Stroke and Coronary Heart Disease Deaths According to Blood Pressure Level: EPOCH-JAPAN (Evidence for Cardiovascular Prevention From Observational Cohorts in Japan)",
abstract = "Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one’s life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. The present metaanalysis included 107 737 Japanese (42.4{\%} men; mean age, 55.1 years) from 13 cohorts. During the mean follow-up of 15.2±5.3 years (1 559 136 person-years), 1922 died from stroke and 913 from CHD. We estimated risks after adjusting for competing risk of death other than the outcome of interest. The 10-year risk of stroke and CHD deaths at index age of 35 years was ≤1.9{\%} and ≤0.3{\%}, respectively. The LTRs of stroke death at the index age of 35 years (men/women) were 6.1{\%}/4.8{\%} for optimal, 5.7{\%}/6.3{\%} for normal, and 6.6{\%}/6.0{\%} for high-normal blood pressure groups, and 9.1{\%}/7.9{\%} for grade 1, 14.5{\%}/10.3{\%} for grade 2, and 14.6{\%}/14.3{\%} for grade 3 hypertension groups. The LTRs of CHD death similarly elevated with an increase in blood pressure but were lower (≤7.2{\%}) than those of stroke death. In conclusion, blood pressure was clearly associated with an elevated LTR of stroke or CHD death, although the LTR of CHD death was one-half of that of stroke death in an Asian population. These results would help young people with hypertension to adopt a healthy lifestyle or start antihypertensive therapy early.",
author = "{EPOCH-JAPAN Research Group} and Michihiro Satoh and Takayoshi Ohkubo and Kei Asayama and Yoshitaka Murakami and Daisuke Sugiyama and Michiko Yamada and Shigeyuki Saitoh and Kiyomi Sakata and Fujiko Irie and Toshimi Sairenchi and Shizukiyo Ishikawa and Masahiko Kiyama and Hirofumi Ohnishi and Katsuyuki Miura and Yutaka Imai and Hirotsugu Ueshima and Tomonori Okamura",
year = "2019",
month = "1",
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doi = "10.1161/HYPERTENSIONAHA.118.11635",
language = "English",
volume = "73",
pages = "52--59",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
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T1 - Lifetime Risk of Stroke and Coronary Heart Disease Deaths According to Blood Pressure Level

T2 - EPOCH-JAPAN (Evidence for Cardiovascular Prevention From Observational Cohorts in Japan)

AU - EPOCH-JAPAN Research Group

AU - Satoh, Michihiro

AU - Ohkubo, Takayoshi

AU - Asayama, Kei

AU - Murakami, Yoshitaka

AU - Sugiyama, Daisuke

AU - Yamada, Michiko

AU - Saitoh, Shigeyuki

AU - Sakata, Kiyomi

AU - Irie, Fujiko

AU - Sairenchi, Toshimi

AU - Ishikawa, Shizukiyo

AU - Kiyama, Masahiko

AU - Ohnishi, Hirofumi

AU - Miura, Katsuyuki

AU - Imai, Yutaka

AU - Ueshima, Hirotsugu

AU - Okamura, Tomonori

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one’s life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. The present metaanalysis included 107 737 Japanese (42.4% men; mean age, 55.1 years) from 13 cohorts. During the mean follow-up of 15.2±5.3 years (1 559 136 person-years), 1922 died from stroke and 913 from CHD. We estimated risks after adjusting for competing risk of death other than the outcome of interest. The 10-year risk of stroke and CHD deaths at index age of 35 years was ≤1.9% and ≤0.3%, respectively. The LTRs of stroke death at the index age of 35 years (men/women) were 6.1%/4.8% for optimal, 5.7%/6.3% for normal, and 6.6%/6.0% for high-normal blood pressure groups, and 9.1%/7.9% for grade 1, 14.5%/10.3% for grade 2, and 14.6%/14.3% for grade 3 hypertension groups. The LTRs of CHD death similarly elevated with an increase in blood pressure but were lower (≤7.2%) than those of stroke death. In conclusion, blood pressure was clearly associated with an elevated LTR of stroke or CHD death, although the LTR of CHD death was one-half of that of stroke death in an Asian population. These results would help young people with hypertension to adopt a healthy lifestyle or start antihypertensive therapy early.

AB - Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one’s life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. The present metaanalysis included 107 737 Japanese (42.4% men; mean age, 55.1 years) from 13 cohorts. During the mean follow-up of 15.2±5.3 years (1 559 136 person-years), 1922 died from stroke and 913 from CHD. We estimated risks after adjusting for competing risk of death other than the outcome of interest. The 10-year risk of stroke and CHD deaths at index age of 35 years was ≤1.9% and ≤0.3%, respectively. The LTRs of stroke death at the index age of 35 years (men/women) were 6.1%/4.8% for optimal, 5.7%/6.3% for normal, and 6.6%/6.0% for high-normal blood pressure groups, and 9.1%/7.9% for grade 1, 14.5%/10.3% for grade 2, and 14.6%/14.3% for grade 3 hypertension groups. The LTRs of CHD death similarly elevated with an increase in blood pressure but were lower (≤7.2%) than those of stroke death. In conclusion, blood pressure was clearly associated with an elevated LTR of stroke or CHD death, although the LTR of CHD death was one-half of that of stroke death in an Asian population. These results would help young people with hypertension to adopt a healthy lifestyle or start antihypertensive therapy early.

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