Combined effect of blood pressure and total cholesterol levels on long-term risks of subtypes of cardiovascular death: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2015-03, Vol.65 (3), p.517-524
• Main Authors: Satoh, Michihiro, Ohkubo, Takayoshi, Asayama, Kei, Murakami, Yoshitaka, Sakurai, Masaru, Nakagawa, Hideaki, Iso, Hiroyasu, Okayama, Akira, Miura, Katsuyuki, Imai, Yutaka, Ueshima, Hirotsugu, Okamura, Tomonori
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Pressure - physiology; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Cholesterol - blood; Cohort Studies; Coronary Disease - epidemiology; Coronary Disease - mortality; Female; Follow-Up Studies; Humans; Hypertension - blood; Hypertension - complications; Hypertension - physiopathology; Japan - epidemiology; Longitudinal Studies; Male; Middle Aged; Proportional Hazards Models; Risk Factors; Stroke - epidemiology; Stroke - mortality; Survival Rate
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.114.04639

No large-scale, longitudinal studies have examined the combined effects of blood pressure (BP) and total cholesterol levels on long-term risks for subtypes of cardiovascular death in an Asian population. To investigate these relationships, a meta-analysis of individual participant data, which included 73 916 Japanese subjects (age, 57.7 years; men, 41.1%) from 11 cohorts, was conducted. During a mean follow-up of 15.0 years, deaths from coronary heart disease, ischemic stroke, and intraparenchymal hemorrhage occurred in 770, 724, and 345 cases, respectively. Cohort-stratified Cox proportional hazard models were used. After stratifying the participants by 4 systolic BP ×4 total cholesterol categories, the group with systolic BP ≥160 mm Hg with total cholesterol ≥5.7 mmol/L had the greatest risk for coronary heart disease death (adjusted hazard ratio, 4.39; P