Blood Pressure, Low-Density Lipoprotein Cholesterol, and Incidences of Coronary Artery Disease and Ischemic Stroke in Japanese: The Suita Study
Open accessAbstract
BACKGROUND: Blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) are risk factors for coronary artery disease (CAD) and ischemic stroke. However, the hazards of their coexistence are not fully understood in Asian populations. We investigated whether the relationship between BP and cardiovascular disease (CVD) outcomes are modified by LDL-C level in a Japanese population. METHODS: Individuals aged 30-79 years (n = 5,151) were classified into 6 groups according to LDL-C levels (<140 and ≥140mg/dL or lipid medication) and BP levels (optimal BP, prehypertension, and hypertension; reference: low LDL-C and optimal BP). Hazard ratios (HRs) were calculated after adjusting for age, high-density lipoprotein cholesterol, diabetes, smoking status, and alcohol consumption. The effect modification of LDL-C on BP-CVD association was assessed using likelihood ratio tests. RESULTS: There were 264 CAD and 215 ischemic stroke events during 13 years of follow-up. With low LDL-C, the HRs of prehypertension and hypertension for CAD were 2.01 and 4.71, respectively. Similar trends of HRs were observed with high LDL-C (optimal BP = 2.09, prehypertension = 3.45, hypertension = 5.94). However, the HRs for ischemic stroke did not differ between normal and high LDL-C levels at the same BP level. The apparent effect modification of LDL-C was not observed in the BP-CVD association in either CAD (P = 0.48) or ischemic stroke (P = 0.39). CONCLUSIONS: The HRs for CAD in prehypertensive and hypertensive groups were higher than those in the optimal BP group at the same LDL-C levels in a Japanese population; however, there was no statistical effect modification of LDL-C on the BP-CAD association.
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With the same degree of hypertension, the addition of hyper-LDL cholesterolemia increases CVD risk.
“even with the same degree of hypertension, the addition of hyper-LDL cholesterolemia contributes to an increased risk for cardiovascular diseases47).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [47]
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- Authors
- Tsukinoki, R., Okamura, T., Watanabe, M., Kokubo, Y., Higashiyama, A., Nishimura, K., Takegami, M., Murakami, Y., Okayama, A., & Miyamoto, Y.
- Affiliations
- Osaka Medical and Pharmaceutical University (JP)
- Keio University (JP)
- National Cerebral and Cardiovascular Center (JP)
- Hyogo Medical University (JP)
- Shiga University of Medical Science (JP)
- Japan Anti Tuberculosis Association (JP)
- ORCID
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-04-08
- Volume
- 27
- Issue
- 11
- Pages
- 1362-1369
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- PMC
- PMC4263939
- OpenAlex
- W2167638950
- Cited by
- 27
- References
- 37
- Citations by year
- 2026: 1 · 2024: 4 · 2023: 2 · 2021: 2 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 3 · 2014: 1
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Hypertension (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- blood pressure, LDL cholesterol, coronary artery disease, ischemic stroke, hypertension, prehypertension, effect modification, cardiovascular risk factors, Japanese population
- MeSH terms
- Adult, Aged, Blood Pressure, Brain Ischemia, Coronary Artery Disease, Female, Health Surveys, Humans, Hypertension, Japan, Life Style, Cholesterol, LDL, Male, Middle Aged, Risk Factors, Time Factors, Biomarkers, Incidence, Chi-Square Distribution, Likelihood Functions, Proportional Hazards Models, Odds Ratio, Stroke, Asian People, Dyslipidemias, Prehypertension
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