Abstract
Coronary events and stroke are leading causes of death in Japan. However, the effects of hypertension on the risk of coronary events and stroke have not been well established in Japanese hypercholesterolemic patients. This study aimed to determine the relationship between the risk of coronary events or stroke and blood pressure and cholesterol levels during low-dose simvastatin treatment using data from the Japan Lipid Intervention Trial (J-LIT) study (a large scale nationwide cohort study). In the present study, 47,294 hypercholesterolemic patients were treated with open-labeled simvastatin (5 to 10 mg/day) for 6 years by a large number of physicians in a clinical setting. The adjusted incidence rates of coronary events in males and females were 8.9 and 2.3 and those of stroke were 17.6 and 11.3/1,000 patients during the 6-year period, respectively. The incidence rate of stroke was higher than that of coronary events in both males and females. An obvious sex difference was observed in terms of the incidence of coronary events. The risk of coronary events, stroke, and total cardiovascular events were increased, with elevations in blood pressure observed in patients treated for hypercholesterolemia. The risk of total cardiovascular events in the groups exhibiting less lipid control increased, with lower blood pressure levels than those of the well-controlled group. For patients with hypercholesterolemia and hypertension, blood pressure should be strictly controlled in order to prevent both coronary events and stroke, and the serum total cholesterol levels should be maintained at low levels as well.
Similar content being viewed by others
Article PDF
References
Ministry of Health, Labour and Welfare : Vital Statistics. 2001.
Matsuzaki M, Kita T, Mabuchi H, et al: Large scale cohort study of the relationship between serum cholesterol concentration and coronary events with low-dose simvastatin therapy in Japanese patients with hypercholesterolemia. Circ J 2002; 66: 1087–1095.
Mabuchi H, Kita T, Matsuzaki M, et al: Large scale cohort study of the relationship between serum cholesterol concentration and coronary events with low-dose simvastatin therapy in Japanese patients with hypercholesterolemia and coronary heart disease: secondary prevention cohort study of the Japan Lipid Intervention Trial (J-LIT). Circ J 2002; 66: 1096–1100.
Kannel WB, McGee D, Gordon T : A general cardiovascular risk profile: the Framingham study. Am J Cardiol 1976; 38: 46–51.
Stamler J, Stamler R, Neaton JD : Blood pressure, systolic and diastolic, and cardiovascular risks: US population data. Arch Intern Med 1993; 153: 598–615.
Stegmayr B, Asplund K, Kuulasmaa K, Rajakangas AM, Thorvaldsen P, Tuomilehto J : Stroke incidence and mortality correlated to stroke risk factors in the WHO MONICA Project: an ecological study of 18 populations. Stroke 1997; 28: 1367–1374.
He J, Whelton PK : Elevated systolic blood pressure and risk of cardiovascular and renal disease: overview of evidence from observational epidemiologic studies and randomized controlled trials. Am Heart J 1999; 138: S211–S219.
Nishigaki K, Yamazaki T, Fukunishi M, Tanihata S, Fujiwara H : Assessment of acute myocardial infarction in Japan by the Japanese Coronary Intervention Study (JCIS) Group. Circ J 2004; 68: 515–519.
Takeya Y, Popper JS, Shimizu Y, Kato H, Rhoads GG, Kagan A : Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: incidence of stroke in Japan and Hawaii. Stroke 1984; 15: 15–23.
Fujisawa J, Saitoh S, Takagi S, Tanaka S, Shimamoto K : Incidence rate of acute myodical infarction in Hokkaido, Japan. Jpn J Geriatr 1998; 35: 910–917.
Arima H, Tanizaki Y, Kiyohara Y, et al: Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly, the Hisayama study. Arch Intern Med 2003; 163: 361–366.
Eastern Stroke and Coronary Heart Disease Collaborative Research Group : Blood pressure, cholesterol, and stroke in eastern Asia. Lancet 1998; 352: 1801–1807.
Matsubara K, Yamamoto Y, Sonoyama K, et al: Current status of lipid management of hypertensive patients. Hypertens Res 2003; 26: 699–704.
Matsuzawa Y, Kita T, Mabuchi H, et al: Sustained reduction of serum cholesterol in low-dose 6-year simvastatin treatment with minimum side effects in 51,321 Japanese hypercholesterolemic patients. Circ J 2003; 67: 287–294.
Matsuzawa Y, Itakura H, Kita T, et al: Design and baseline characteristics of a cohort study in Japanese patients with hypercholesterolemia: the Japan Lipid Intervention Trial (J-LIT). Curr Ther Res 2000; 61: 219–243.
Chobanian AV, Bakris GL, Black HR, et al: The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289: 2560–2572.
Statistics and Information Department, Minister's Secretariat, Ministry of Health and Welfare : Vital Statistics. Japan Health and Welfare Statistics Association, 1993.
Nakaya N, Itakura H, Kita T, et al: Large scale cohort study on the relationship between serum lipid concentrations and risk of cerebrovascular disease under low-dose simvastatin in Japanese patients with hypercholesterolemia: sub-analysis of Japan Lipid Intervention Trial (J-LIT). Circ J 2005; 69: 1016–1021.
Lawes CM, Rodgers A, Bennett DA, et al: Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens 2003; 21: 707–716.
Sasaki J, Arakawa K, Iwashita M, et al: Reduction in serum total cholesterol and risks of coronary events and cerebral infarction in Japanese men—the Kyushu lipid intervention study—. Circ J 2003; 67: 473–478.
Green R, Kwok S, Durrington PN : Preventing cardiovascular disease in hypertension: effects of lowering blood pressure and cholesterol. QJM 2002; 95: 821–826.
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
Shimamoto, K., Kita, T., Mabuchi, H. et al. The Risk of Cardiovascular Events in Japanese Hypertensive Patients with Hypercholesterolemia: Sub-Analysis of the Japan Lipid Intervention Trial (J-LIT) Study, a Large-Scale Observational Cohort Study. Hypertens Res 28, 879–887 (2005). https://doi.org/10.1291/hypres.28.879
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1291/hypres.28.879
Keywords
This article is cited by
-
Chapter 2. Measurement and clinical evaluation of blood pressure
Hypertension Research (2014)
-
Chapter 7. Hypertension complicated by other diseases
Hypertension Research (2014)
-
Association of the G-protein β3 subunit gene polymorphism with the incidence of cardiovascular disease independent of hypertension: the Funagata study
Journal of Human Hypertension (2013)
