Hypertension is a major risk factor for future atherosclerotic changes in the Japanese population

BACKGROUND: Great differences in age-standardized mortality rates by cardiovascular disease exist among countries. We prospectively assessed determinants of future cardiovascular changes in a Japanese cohort. METHODS: In 1996, 1011 men and 1153 women from a Japanese community participated in a study on cardiovascular risk factors at a local health centre. Of these, the 896 subjects who visited the centre both in 1996 and 2001 were selected for the analysis. The presence of cardiovascular changes was defined as the appearance of one or more of the following in five years: positive electrocardiographic findings, intima-media thickness of the carotid artery >or=0.8 mm and retinal vascular changes >or=Keith-Wegener-Barker classification stage I. RESULTS: Of the 607 subjects who had no history of cardiovascular disease in 1996, 421 showed changes in 2001. Both the age-adjusted and multivariate models showed that the risk of the cardiovascular changes increased as systolic blood pressure (SBP) increased to >or=135 mmHg (multivariate odds ratio = 1.739, 95% confidence interval = 1.076-2.810, P < 0.05) compared with those with an SBP of 110-134 mmHg. When we made the analyses only for laboratory test results by excluding SBP, body mass index, alcohol intake and current smoking from the regression model, high-density lipoprotein cholesterol and fasting plasma glucose were significant variables. CONCLUSION: The risk of future cardiovascular changes is significantly greater with higher SBP in the Japanese population.