One-Year Change in Diastolic Blood Pressure and Aortic Disease-Related Mortality in a Japanese General Population Aged 50–75 Years

• Published in: Circulation Journal 2021/11/25, Vol.85(12), pp.2222-2231
• Main Authors: Otaki, Yoichiro, Watanabe, Tetsu, Konta, Tsuneo, Watanabe, Masafumi, Fujimoto, Shouichi, Sato, Yuji, Asahi, Koichi, Yamagata, Kunihiro, Tsuruya, Kazuhiko, Narita, Ichiei, Kasahara, Masato, Shibagaki, Yugo, Iseki, Kunitoshi, Moriyama, Toshiki, Kondo, Masahide, Watanabe, Tsuyoshi
• Format: Article
• Language: English
• Subjects: Aortic disease-related mortality; Aortic Diseases; Aortic Dissection - complications; Apparently healthy subjects; Blood Pressure - physiology; Diastolic blood pressure; Humans; Hypertension; Japan - epidemiology; Risk Factors
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-21-0514

Background:Aortic diseases (ADs), including aortic dissection, aortic aneurysm, and aortic rupture, are fatal diseases with extremely high mortality rates. Hypertension has been reported to be associated with AD development; however, it remains unclear whether a 1-year change in diastolic blood pressure (DBP) is a risk factor for AD-related mortality in the general population.Methods and Results:This study used a nationwide database of 235,076 individuals (aged 50–75 years) who participated in the annual “Specific Health Check and Guidance in Japan” for 2 consecutive years between 2008 and 2010. There were 55 AD-related deaths during the follow-up period of 1,770 days. All subjects were divided into 4 groups based on the baseline DBP and change in DBP at 1 year: persistent high DBP, increasing DBP, decreasing DBP, and normal DBP. Kaplan-Meier analysis demonstrated that the persistent high DBP group had the greatest risk among the 4 groups. Multivariate Cox proportional hazard regression analysis demonstrated that both DBP and 1-year change in DBP were significantly associated with AD-related deaths. The prediction capacity was significantly improved by the addition of 1-year change in DBP to confounding risk factors.Conclusions:This study demonstrated for the first time that a 1-year change in DBP was associated with AD-related deaths in the general population. Monitoring changes in DBP are of critical importance in the primary prevention of AD-related deaths in apparently healthy subjects aged 50–75 years.