BACKGROUND AND PURPOSE: Hypertension is a major risk factor for stroke. However, a substantial decrease in blood pressure levels in Japanese during the past 3 decades may have reduced contributions of hypertension to risk of stroke. The population attributable fraction, the percentage of outcomes attributable to exposure, of blood pressure for the incidence of stroke was investigated during 3 survey periods between 1963 and 1994 by means of a population-based cohort study. METHODS: We explored 3 cohort data of residents aged 40 to 69 years in 4 Japanese communities in 1963 to 1971 (n=5439), 1975 to 1984 (n=9945), and 1985 to 1994 (n=11 788) baseline surveys. Mean follow-up period for each cohort was 10 years. RESULTS: Higher blood pressure levels were associated with higher risk of stroke. Positive associations were also observed even within nonhypertension levels. From the first to the third cohorts, the blood pressure category with a majority of stroke incidence shifted from severe or moderate hypertension to mild hypertension. The population attributable fraction of the severe hypertension category in the first, second, and third cohorts were 20%, 14%, and 9%, respectively, and those of the moderate hypertension category were 19%, 24%, and 11%, respectively, whereas those of the mild hypertension category were 17%, 26%, and 23%, respectively. The results were similar when participants on antihypertensive medication were excluded. CONCLUSIONS: The higher risk of stroke incidence with higher blood pressure levels even in nonhypertension categories and the shift of stroke burden from severe/moderate hypertension to mild hypertension support the early management of hypertension and primary prevention of high blood pressures for the prevention of stroke.
BACKGROUND AND PURPOSE:Hypertension is a major risk factor for stroke. However, a substantial decrease in blood pressure levels in Japanese during the past 3 decades may have reduced contributions of hypertension to risk of stroke. The population attributable fraction, the percentage of outcomes attributable to exposure, of blood pressure for the incidence of stroke was investigated during 3 survey periods between 1963 and 1994 by means of a population-based cohort study. METHODS: We explored 3 cohort data of residents aged 40 to 69 years in 4 Japanese communities in 1963 to 1971 (n=5439), 1975 to 1984 (n=9945), and 1985 to 1994 (n=11 788) baseline surveys. Mean follow-up period for each cohort was 10 years. RESULTS: Higher blood pressure levels were associated with higher risk of stroke. Positive associations were also observed even within nonhypertension levels. From the first to the third cohorts, the blood pressure category with a majority of stroke incidence shifted from severe or moderate hypertension to mild hypertension. The population attributable fraction of the severe hypertension category in the first, second, and third cohorts were 20%, 14%, and 9%, respectively, and those of the moderate hypertension category were 19%, 24%, and 11%, respectively, whereas those of the mild hypertension category were 17%, 26%, and 23%, respectively. The results were similar when participants on antihypertensive medication were excluded. CONCLUSIONS: The higher risk of stroke incidence with higher blood pressure levels even in nonhypertension categories and the shift of stroke burden from severe/moderate hypertension to mild hypertension support the early management of hypertension and primary prevention of high blood pressures for the prevention of stroke.
Authors: I Muraki; T Tanigawa; K Yamagishi; S Sakurai; T Ohira; H Imano; A Kitamura; M Kiyama; S Sato; T Shimamoto; M Konishi; H Iso Journal: Diabetologia Date: 2009-11-28 Impact factor: 10.122
Authors: Norihiro Kato; Marie Loh; Fumihiko Takeuchi; Niek Verweij; Xu Wang; Weihua Zhang; Tanika N Kelly; Danish Saleheen; Benjamin Lehne; Irene Mateo Leach; Molly Scannell Bryan; Yik-Ying Teo; Jiang He; Paul Elliott; E Shyong Tai; Pim van der Harst; Jaspal S Kooner; John C Chambers; Alexander W Drong; James Abbott; Simone Wahl; Sian-Tsung Tan; William R Scott; Gianluca Campanella; Marc Chadeau-Hyam; Uzma Afzal; Tarunveer S Ahluwalia; Marc Jan Bonder; Peng Chen; Abbas Dehghan; Todd L Edwards; Tõnu Esko; Min Jin Go; Sarah E Harris; Jaana Hartiala; Silva Kasela; Anuradhani Kasturiratne; Chiea-Chuen Khor; Marcus E Kleber; Huaixing Li; Zuan Yu Mok; Masahiro Nakatochi; Nur Sabrina Sapari; Richa Saxena; Alexandre F R Stewart; Lisette Stolk; Yasuharu Tabara; Ai Ling Teh; Ying Wu; Jer-Yuarn Wu; Yi Zhang; Imke Aits; Alexessander Da Silva Couto Alves; Shikta Das; Rajkumar Dorajoo; Jemma C Hopewell; Yun Kyoung Kim; Robert W Koivula; Jian'an Luan; Leo-Pekka Lyytikäinen; Quang N Nguyen; Mark A Pereira; Iris Postmus; Olli T Raitakari; Robert A Scott; Rossella Sorice; Vinicius Tragante; Michela Traglia; Jon White; Ken Yamamoto; Yonghong Zhang; Linda S Adair; Alauddin Ahmed; Koichi Akiyama; Rasheed Asif; Tin Aung; Inês Barroso; Andrew Bjonnes; Timothy R Braun; Hui Cai; Li-Ching Chang; Chien-Hsiun Chen; Ching-Yu Cheng; Yap-Seng Chong; Rory Collins; Regina Courtney; Gail Davies; Graciela Delgado; Loi D Do; Pieter A Doevendans; Ron T Gansevoort; Yu-Tang Gao; Tanja B Grammer; Niels Grarup; Jagvir Grewal; Dongfeng Gu; Gurpreet S Wander; Anna-Liisa Hartikainen; Stanley L Hazen; Jing He; Chew-Kiat Heng; James E Hixson; Albert Hofman; Chris Hsu; Wei Huang; Lise L N Husemoen; Joo-Yeon Hwang; Sahoko Ichihara; Michiya Igase; Masato Isono; Johanne M Justesen; Tomohiro Katsuya; Muhammad G Kibriya; Young Jin Kim; Miyako Kishimoto; Woon-Puay Koh; Katsuhiko Kohara; Meena Kumari; Kenneth Kwek; Nanette R Lee; Jeannette Lee; Jiemin Liao; Wolfgang Lieb; David C M Liewald; Tatsuaki Matsubara; Yumi Matsushita; Thomas Meitinger; Evelin Mihailov; Lili Milani; Rebecca Mills; Nina Mononen; Martina Müller-Nurasyid; Toru Nabika; Eitaro Nakashima; Hong Kiat Ng; Kjell Nikus; Teresa Nutile; Takayoshi Ohkubo; Keizo Ohnaka; Sarah Parish; Lavinia Paternoster; Hao Peng; Annette Peters; Son T Pham; Mohitha J Pinidiyapathirage; Mahfuzar Rahman; Hiromi Rakugi; Olov Rolandsson; Michelle Ann Rozario; Daniela Ruggiero; Cinzia F Sala; Ralhan Sarju; Kazuro Shimokawa; Harold Snieder; Thomas Sparsø; Wilko Spiering; John M Starr; David J Stott; Daniel O Stram; Takao Sugiyama; Silke Szymczak; W H Wilson Tang; Lin Tong; Stella Trompet; Väinö Turjanmaa; Hirotsugu Ueshima; André G Uitterlinden; Satoshi Umemura; Marja Vaarasmaki; Rob M van Dam; Wiek H van Gilst; Dirk J van Veldhuisen; Jorma S Viikari; Melanie Waldenberger; Yiqin Wang; Aili Wang; Rory Wilson; Tien-Yin Wong; Yong-Bing Xiang; Shuhei Yamaguchi; Xingwang Ye; Robin D Young; Terri L Young; Jian-Min Yuan; Xueya Zhou; Folkert W Asselbergs; Marina Ciullo; Robert Clarke; Panos Deloukas; Andre Franke; Paul W Franks; Steve Franks; Yechiel Friedlander; Myron D Gross; Zhirong Guo; Torben Hansen; Marjo-Riitta Jarvelin; Torben Jørgensen; J Wouter Jukema; Mika Kähönen; Hiroshi Kajio; Mika Kivimaki; Jong-Young Lee; Terho Lehtimäki; Allan Linneberg; Tetsuro Miki; Oluf Pedersen; Nilesh J Samani; Thorkild I A Sørensen; Ryoichi Takayanagi; Daniela Toniolo; Habibul Ahsan; Hooman Allayee; Yuan-Tsong Chen; John Danesh; Ian J Deary; Oscar H Franco; Lude Franke; Bastiaan T Heijman; Joanna D Holbrook; Aaron Isaacs; Bong-Jo Kim; Xu Lin; Jianjun Liu; Winfried März; Andres Metspalu; Karen L Mohlke; Dharambir K Sanghera; Xiao-Ou Shu; Joyce B J van Meurs; Eranga Vithana; Ananda R Wickremasinghe; Cisca Wijmenga; Bruce H W Wolffenbuttel; Mitsuhiro Yokota; Wei Zheng; Dingliang Zhu; Paolo Vineis; Soterios A Kyrtopoulos; Jos C S Kleinjans; Mark I McCarthy; Richie Soong; Christian Gieger; James Scott Journal: Nat Genet Date: 2015-09-21 Impact factor: 38.330