Attributable Risk Fraction of Prehypertension on Cardiovascular Disease Mortality in the Japanese Population: The Ohsaki Study (original) (raw)

Journal Article

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1

Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine

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Sendai

,

Japan

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1

Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine

,

Sendai

,

Japan

Search for other works by this author on:

,

1

Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine

,

Sendai

,

Japan

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,

1

Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine

,

Sendai

,

Japan

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,

2

Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science and Medicine

,

Sendai

,

Japan

3

Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”

,

Sendai

,

Japan

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Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine

,

Sendai

,

Japan

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Revision requested:

21 August 2008

Accepted:

23 October 2008

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Atsushi Hozawa, Shinichi Kuriyama, Masako Kakizaki, Kaori Ohmori-Matsuda, Takayoshi Ohkubo, Ichiro Tsuji, Attributable Risk Fraction of Prehypertension on Cardiovascular Disease Mortality in the Japanese Population: The Ohsaki Study, American Journal of Hypertension, Volume 22, Issue 3, March 2009, Pages 267–272, https://doi.org/10.1038/ajh.2008.335
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Abstract

Background

Although relative risk of prehypertension (pre-HT) on cardiovascular disease (CVD) mortality is modest, prevalence of pre-HT is large, that is, population attributable fraction (PAF) of pre-HT on CVD mortality might be large. However, no studies have reported the fraction.

Methods

We followed 12,928 Japanese National Health Insurance (NHI) beneficiaries aged 40–79 years without a history of CVD. On the basis of their blood pressure (BP), the participants were categorized as normal BP, pre-HT, and hypertension (HT) (Seventh Report of the Joint National Committee criteria). Multivariate-adjusted Cox proportional hazards model was used to estimate the hazard ratio (HR) of the BP status vs. CVD mortality.

Results

During 12-years of follow-up, 321 participants died of CVD. As positive relation between BP category and CVD mortality was steeper in middle-aged (40–64 years) than that in elderly (65–79 years), we separately calculated PAF on CVD mortality among middle-aged and elderly. HR (95% confidence interval) for cardiovascular mortality for pre-HT and HT, respectively, was 1.31 (0.59–2.94) and 2.98 (1.39–6.41) in middle-aged, and 1.03 (0.62–1.70) and 1.65 (1.02–2.64) in elderly. Non-normal BP, i.e., pre-HT and HT, accounted for 47 and 26% of the CVD deaths among the middle-aged and elderly participants, respectively. Although the PAF of pre-HT was larger in the middle-aged participants (7%) than that in the elderly ones (0%), neither fraction was considered large.

Conclusion

The PAF on CVD mortality in pre-HT was not large compared with that in HT.

American Journal of Hypertension 2009; doi:10.1038/ajh.2008.335

© American Journal of Hypertension, Ltd. 2009

Topic:

• hypertension
• cardiovascular diseases
• blood pressure
• follow-up
• middle-aged adult
• mortality
• older adult
• prehypertension
• attributable risk fraction
• japanese

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