Abstract
To evaluate the relationship between blood pressure and cerebrovascular death depending on body mass index (BMI) levels, we analysed a database of 9338 subjects from the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged, which was originally conducted a baseline survey in 1980 and followed up in 1999. Relative risk (RR) and a 95% confidence interval (CI) of death from total stroke, cerebral infarction, and intracerebral haemorrhage after adjusting for age, sex, serum cholesterol, albumin, glucose, the use of antihypertensive agents, a past history of diabetes, BMI, smoking, and drinking were estimated with the Cox-proportional hazard model in the BMI tertile groups of a representative Japanese population. Cutoff points of BMI tertiles are 21.2 and 23.8 kg/m2. The results indicated that a 10 mmHg systolic blood pressure (SBP) increase was associated with mortality from intracerebral haemorrhage at low and middle BMI groups (RR= 1.38 and 1.23; 95% CI=1.17–1.62 and 1.03–1.47, respectively). SBP was positively associated with mortality from cerebral infarction in middle and high BMI groups (RR=1.19 and 1.21; 95% CI=1.06–1.33 and 1.06–1.38, respectively). The effects of diastolic blood pressure on intracerebral haemorrhage and infarction had the same tendency as those of SBP. These results suggested that the causal effect of blood pressure on stroke subtypes might be modified by BMI.
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Acknowledgements
This study was supported by the grant-in-aid of the Ministry of Health and Welfare under the auspices of Japanese Association for Cerebro-cardiovascular Disease Control, the Research Grant for Cardiovascular Diseases (7A-2) from the Ministry of Health, Labour and Welfare and a Health and Labour Sciences Research Grant, Japan (Comprehensive Research on Aging and Health: H11-13, Chouju-046, H14-16, Chouju-003). We wish to thank Ms Misao Ohara from the Department of Health Science of Shiga University of Medical Science for her excellent clerical support during this research. We would also like to thank Professor Kazuo Hayakawa and Professor Hiroshi Mikami from the Department of Health Promotion Science of Osaka University for his academic advice.
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Investigators and members of research group are listed in appendix.
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Appendix
List of the NIPPON DATA80 Research group
NIPPON DATA80: ‘National Integrated Projects for Prospective Observation of Non-communicable Diseases And its Trends in the Aged’.
Chairman: Hirotsugu Ueshima (Department of Health Science, Shiga University of Medical Science, Otsu, Shiga).
Consultant: Osamu Iimura (Hokkaido JR Sapporo Hospital, Sapporo, Hokkaido), Teruo Omae (National Cardiovascular Center, Suita, Osaka), Kazuo Ueda (School of Health Science, Kyushu University, Fukuoka, Fukuoka), Hiroshi Yanagawa (Saitama Prefectural University, Koshigata, Saitama).
Research member: Akira Okayama (Preventive Cardiology National Cardiovascular Disease Center, Suita, Osaka), Kazunori Kodama, Fumiyoshi Kasagi (Radiation Effects Research Foundation, Hiroshima, Hiroshima), Tomonori Okamura, Yoshikuni Kita (Department of Health Science, Shiga University of Medical Science, Otsu, Shiga), Shigeyuki Saito (Internal Medicinell, Cardiology and Nephrology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido), Kiyomi Sakata (Department of Public Health, Wakayama Medical University, Wakayama, Wakayama), Takehito Hayakawa, Shinichi Tanihara (Department of Public Health, School of Medicine, Shimane University, Izumo, Shimane), Yosikazu Nakamura (Department of Public Health, Jichi Medical School, Minami Kawachi, Tochigi), Hiroshi Horibe (Keisen Clinic, Akashi, Hyogo), Masumi Minowa (Department of Epidemiology, National Institute of Public Health, Wako, Saitama).
Research associate member: Toshihiro Takeuchi, Mitsuru Hasebe, Fumitsugu Kusano and members of 300 Public Health Centers in Japan, Katsuhiko Kawaminami (Department of Public Health Policy, National Institute of Public Health, Wako, Saitama), Sohel R Choudhury (Department of Community Medicine, School of Medical Sciences University Sains Malaysia), Yutaka Kiyohara (Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Fukuoka), Minoru Iida (Kansai University of Welfare Sciences, Osaka), Tsutomu Hashimoto (Wakayama Red Cross Blood Center, Wakayama, Wakayama), Atsushi Terao (Hikone Public Health Center, Hikone, Shiga), Koryo Sawai (The Japanese Association for Cerebro-cardiovascular Disease Control, Tokyo, Tokyo), Shigeo Shibata (Clinical Nutrition, Kagawa Nutrition University, Saitama).
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Miyamatsu, N., Kadowaki, T., Okamura, T. et al. Different effects of blood pressure on mortality from stroke subtypes depending on BMI levels: a 19-year cohort study in the Japanese general population—NIPPON DATA80. J Hum Hypertens 19, 285–291 (2005). https://doi.org/10.1038/sj.jhh.1001817
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DOI: https://doi.org/10.1038/sj.jhh.1001817