Document Detail


Influence of coronary risk factors on coronary events in Japanese high-risk hypertensive patients. - Primary and secondary prevention of ischemic heart disease in a subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial-.
MedLine Citation:
PMID:  21778597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial was conducted to compare the effects of candesartan and amlodipine on cardiovascular events in Japanese high-risk hypertensive patients. The aim of the present subanalysis was to evaluate the influence of coronary risk factors on coronary events in these patients as an observational study irrespective of allocated drugs.
METHODS AND RESULTS: The adjusted hazard ratios (HRs) of the association of baseline risk factors including gender, age, allocated drugs, body mass index, systolic/diastolic blood pressure (SBP/DBP), diabetes mellitus (DM), hyperlipidemia (HL), smoking, left ventricular hypertrophy, previous ischemic heart disease (IHD), previous cerebrovascular events, and chronic kidney disease (CKD) with coronary events in 4,703 patients who were enrolled in the CASE-J trial, were examined. The coronary events occurred in 83 patients, and were significantly associated with previous IHD, DM, male sex, CKD, and low DBP. Significant predictors were previous IHD (HR, 3.89), DM (HR, 3.10), male sex (HR, 1.81), CKD (HR, 1.60), and low DBP (HR, 1.36), respectively. In 4,107 patients without previous IHD, DM (HR, 4.88), HL (HR, 2.67), and DBP (HR, 1.39) were significantly associated with the risk of coronary events, while male sex (HR, 3.03), CKD (HR, 2.44), and DM (HR, 2.15) were in 596 patients with previous IHD.
CONCLUSIONS: DM is the important factor in both primary and secondary prevention of coronary events. Comprehensive risk management including surveillance of DM, CKD and HL is needed for preventing coronary events, in addition to blood pressure control.
Authors:
Kenji Ueshima; Koji Oba; Shinji Yasuno; Akira Fujimoto; Shiro Tanaka; Toshio Ogihara; Takao Saruta; Kazuwa Nakao
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-07-20
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-09-22     Completed Date:  2012-03-13     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2411-6     Citation Subset:  IM    
Affiliation:
EBM Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan. kenji.ueshima@at3.ecs.kyoto-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Amlodipine / therapeutic use
Antihypertensive Agents
Asian Continental Ancestry Group
Benzimidazoles / therapeutic use
Coronary Artery Disease / epidemiology*,  etiology
Female
Humans
Hypertension / complications*
Male
Middle Aged
Myocardial Ischemia / prevention & control*
Observation
Risk Factors
Secondary Prevention / methods*
Tetrazoles / therapeutic use
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Benzimidazoles; 0/Tetrazoles; 88150-42-9/Amlodipine; S8Q36MD2XX/candesartan
Comments/Corrections
Comment In:
Circ J. 2011;75(10):2316-7   [PMID:  21873800 ]

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