Key result
A 10 mmHg increase in systolic blood pressure was associated with a significantly higher risk of recurrent ischemic episodes (OR 1.678) in patients with coronary artery disease.
Why the study?
Do abnormal glucose tolerance and hypertension increase the severity and recurrence of coronary artery disease in Japanese patients?
Cohort (n=474)
No
Do abnormal glucose tolerance and hypertension increase the severity and recurrence of coronary artery disease in Japanese patients?
Odds Ratio: 1.678 (95% CI 1.252–2.25)
p-value: p=0.001
Abnormal glucose tolerance and elevated systolic blood pressure are significant risk factors for the progression and recurrence of coronary artery disease in Japanese patients.
SBP rise may heighten recurrent ischemia risk in CAD; extends observational hypertension data but leaves glucose tolerance role open.
BACKGROUND: The degree to which abnormal glucose tolerance contributes to the development of coronary artery disease (CAD) has not been clarified in Japanese. The relationship between abnormal glucose tolerance and severity of coronary artery stenosis, as well as the contributions of hypertension, diabetes and other risk factors for CAD to recurrence of the disease, were investigated in the present study. METHODS AND RESULTS: The subjects were 474 consecutive patients (mean age: 63.8+/-11.3 years) with suspected CAD who were admitted to Sapporo Medical University Hospital during April 1, 1997 to March 31, 2004. The coronary index and stenosis score were higher in subjects with diabetes mellitus (DM) and in subjects with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) than in subjects with normal glucose tolerance (NGT). Ischemic episodes recurred during the observation period (mean 2.5 years) in 61 of 341 patients diagnosed as having CAD. In the follow-up subjects, systolic blood pressure (SBP) was significantly higher in the recurrence group than in the non-recurrence group, and SBP was a significant variable in logistic regression analysis after adjustment for age, gender, hemoglobin A1c, total cholesterol, body mass index, smoking history, family history and stenosis score. The relative risk of recurrence became 1.7-fold higher with a rise in SBP of 10 mmHg (95% confidence interval: 1.252-2.250). Analysis of the relationship between glucose tolerance and recurrence showed that the rate of recurrence was higher in patients with IFG+IGT+DM than in those with NGT. CONCLUSIONS: CAD progresses not only in patients with DM but also in those with IGT. The rate of recurrence of ischemic episodes increases in individuals with IGT or DM, and suggesting that hypertension is a risk factor for recurrence of ischemic episodes. Management of glucose tolerance and blood pressure is therefore important for prevention of CAD in Japanese.
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Nakamura et al. (2006) conducted a cohort in Coronary Artery Disease (n=474). 10 mmHg rise in systolic blood pressure was evaluated on Recurrence of ischemic episodes (OR 1.678, 95% CI 1.252-2.250, p=0.001). A 10 mmHg increase in systolic blood pressure was associated with a significantly higher risk of recurrent ischemic episodes (OR 1.678) in patients with coronary artery disease.
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