著者

Minako Wakasugi Ichiei Narita Kunitoshi Iseki Koichi Asahi Kunihiro Yamagata Shouichi Fujimoto Toshiki Moriyama Tsuneo Konta Kazuhiko Tsuruya Masato Kasahara Yugo Shibagaki Masahide Kondo Tsuyoshi Watanabe The Japan Specific Health Checkups (J-SHC) Study Group

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8992-21, (Released:2022-03-05)

参考文献数

41

被引用文献数

6

---

Objective Whether or not combined lifestyle factors are associated with similar decreases in risks of incident hypertension and diabetes among individuals with and without chronic kidney disease (CKD) remains unclear. Methods This population-based prospective cohort study included participants 40-74 years old who were free from heart disease, stroke, renal failure, hypertension, diabetes, and hypercholesterolemia at baseline (n =60,234). Healthy lifestyle scores (HLSs) were calculated by adding the total number of 5 healthy lifestyle factors (non-smoking, body mass index <25 kg/m2, regular exercise, healthy eating habits, and moderate or less alcohol consumption). Cox proportional hazards models were used to examine associations between the HLS and incident hypertension or type 2 diabetes and whether or not CKD modified these associations. Results During a median of 4 years, there were 2,773 incident hypertension cases (30.1 cases per 1,000 person-years) and 263 incident diabetes cases (2.4 cases per 1,000 person-years). The risk of developing hypertension and diabetes decreased linearly as participants adhered to more HLS components. Compared with adhering to 0, 1, or 2 components, adherence to all 5 HLS components was associated with a nearly one-half reduction in the risk of hypertension (hazard ratio [HR] =0.52; 95% confidence interval [CI], 0.45-0.60) and diabetes (HR =0.51; 95% CI, 0.32-0.81) in fully adjusted models. CKD did not have a modifying effect on associations between the HLS and incident hypertension (Pinteraction =0.6) or diabetes (Pinteraction =0.3). Conclusion Adherence to HLS components was associated with reduced risks of incident hypertension and diabetes, regardless of CKD status.

著者

Yoichiro Otaki Tetsu Watanabe Tsuneo Konta Masafumi Watanabe Shouichi Fujimoto Yuji Sato Koichi Asahi Kunihiro Yamagata Kazuhiko Tsuruya Ichiei Narita Masato Kasahara Yugo Shibagaki Kunitoshi Iseki Toshiki Moriyama Masahide Kondo Tsuyoshi Watanabe

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.11, pp.2776-2782, 2018-10-25 (Released:2018-10-25)

参考文献数

28

被引用文献数

13

---

Background: Aortic artery disease (AAD), such as aortic dissection or aortic aneurysm rupture, is fatal, with an extremely high mortality. Because of its low incidence, the risk for the development of AAD has not yet been elucidated. Hypertension (HT) is an established risk factor for cardiovascular disease, but there has been no prospective study on the effect of HT on AAD-related mortality. Methods and Results: We used a nationwide database of 276,197 subjects (aged 40–75 years) who participated in the annual “Specific Health Check and Guidance in Japan” from 2008 to 2010. There were 80 AAD-related deaths during the follow-up period of 1,049,549 person-years. On multivariate Cox proportional hazard regression, HT was an independent risk factor for AAD-related death in apparently healthy subjects. On receiver operating characteristics curve analysis for AAD-related death, abnormal systolic and diastolic blood pressure (SBP and DBP) were 130 mmHg and 82 mmHg, respectively. The prediction capacity was significantly improved by the addition of SBP to confounding risk factors. Notably, further improvement of the C index was observed by addition of DBP to the model with SBP. Conclusions: This is the first report to prospectively show that HT is a risk factor for AAD-related death. Both SBP and DBP are of critical importance in the primary prevention of AAD-related death in apparently healthy subjects.