In Western population, blood pressure (BP) was reported to predict long-term (over 20 years) future mortality of cardiovascular diseases (CVD). However, there is few reports based on long-term follow-up studies in Asian population where stroke is dominant among CVDs. We investigated the association between BP and 24 year mortality risk of total and components of CVD in a representative Japanese population.
Methods A cohort study of nationwide representative Japanese samples, a total of 8592 men and women age 30 and over without history of CVD and anti-hypertensive medication was followed for 24 years (mean follow-up, 21.3 years). Multivariate-adjusted HRs of total and components of CVD death according to the BP categories (Seventh Report of the Joint national Committee criteria) were calculated using the Cox proportional hazard model.
Results During the follow-up period, 689 participants died from CVD. Multivariate-adjusted HR of total and components of CVD mortality was progressively and significantly greater from the lowest BP group. Compared with normal BP, adjusted HRs in stage 2 hypertension was 2.45 for total CVD death and 5.99 for cerebral haemorrhage death. An adjusted HR for total CVD were higher in younger participants aged 30 to 59 years than that in elder aged 60 years and over at baseline.
Conclusion Blood pressure in general Japanese retain a strong association with total and components of CVD death during next 24 years. The association was steeper in younger participants. Primordial prevention of high BP from younger age is necessary to prevent future CVD.
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