Stroke risk and antihypertensive drug treatment in the general population: the Japan arteriosclerosis longitudinal study.

Abstract:

OBJECTIVE:To evaluate the association between stroke risk and blood pressure (BP) levels with regard to the usage of antihypertensive medications. METHODS:From the Japan arteriosclerosis longitudinal study, 11,371 participants from the four population-based cohort studies (aged 40-89) were followed up for a mean of 9.5 years. A Poisson regression model, adjusting for possible confounding factors, was used to investigate the risk of first stroke among six BP-based categories (BP defined according to recent guidelines), in relation to the use of antihypertensive medications. RESULTS:There were 324 incident cases of first stroke. Among untreated groups, the relative hazard increased linearly with the elevation of BP grade (trend P = 0.0001). The untreated group with normal BP had a significantly higher stroke risk [relative hazard 2.09, 95% confidence interval 1.09-4.01] than the untreated group with optimal BP. There was no stepwise increase in stroke risk observed among treated groups (trend P = 0.1). The stroke risk among treated groups, even among those with optimal BP (relative hazard 4.10, 95% confidence interval 1.17-14.4), was significantly higher than that in the untreated groups with the same BP level. CONCLUSION:Treated individuals with optimal BP had a higher stroke risk than untreated ones with optimal BP. Healthcare providers need to be vigilant for residual cardiovascular risks in treated hypertensive patients.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Asayama K,Ohkubo T,Yoshida S,Suzuki K,Metoki H,Harada A,Murakami Y,Ohashi Y,Ueshima H,Imai Y,Japan Arteriosclerosis Longitudinal Study (JALS) group.

doi

10.1097/HJH.0b013e32831967ca

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

357-64

issue

2

eissn

0263-6352

issn

1473-5598

pii

00004872-200902000-00024

journal_volume

27

pub_type

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