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Lifetime risk of stroke stratified by chronic kidney disease and hypertension in the general Asian population: the Ohasama study

Abstract

Lifetime risk (LTR) evaluates the absolute risk of developing a disease during the remainder of one’s life. It can be a useful tool, enabling the general public to easily understand their risk of stroke. No study has been performed to determine the LTR of cardiovascular disease in patients with chronic kidney disease (CKD) with or without hypertension; therefore, we performed this study in an Asian population. We followed 1525 participants (66.0% women; age 63.1 years) in the general population of Ohasama, Japan. We defined CKD as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and/or proteinuria. Hypertension was defined as a systolic/diastolic blood pressure ≥140/≥90 mmHg and/or the use of antihypertensive medication. We calculated the sex-specific LTR of stroke adjusted for the competing risk of death. During the mean follow-up period of 16.5 years, a first stroke occurred in 238 participants. The 10-year risk of stroke at the age of 45 years was 0.0% for men and women. The LTRs of stroke at the index age of 45 years (men/women) were 20.9%/14.5% for participants without CKD and hypertension, 34.1%/29.8% for those with CKD but not hypertension, 37.9%/27.3% for those with hypertension but not CKD, and 38.4%/36.4% for those with CKD and hypertension. The LTRs of stroke tended to be higher in younger participants than in older participants with CKD and/or hypertension. CKD contributed to the LTR of stroke, as did hypertension. The prevention of CKD and hypertension can reduce the LTR of stroke, especially in young populations.

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Acknowledgements

We are grateful to the residents and staff members in Ohasama and staff members of the Hanamaki City Government, Iwate Prefectural Central Hospital Attachment Ohasama Regional Clinical Center, Iwate Prefectural Stroke Registry, General Hanamaki Hospital, Teikyo University, Tohoku Medical and Pharmaceutical University, and Tohoku University for their valuable support of the Ohasama study project.

Funding

This study was supported by Grants for Scientific Research (16H05243, 16H05263, 16K09472, 16K11850, 16K15359, 17H04126, 17H06533, 17K15853, 17K19930, 18K09674, 18K09904, 18K17396, 19K19466, 19H03908, 19K10662, and 20K08612) from the Ministry of Education, Culture, Sports, Science, and Technology, Japan; a Grant-in-Aid for Young Scientists of Showa Pharmaceutical University H28-4; the Japan Arteriosclerosis Prevention Fund; Grant–in–aid from the Ministry of Health, Labor, and Welfare, Japan  (H26-Junkankitou [Seisaku]-Ippan-001, H29–Junkankitou–Ippan–003 and 20FA1002); A Scheme to Revitalize Agriculture and Fisheries in Disaster Area through Deploying Highly Advanced Technology (NouEi 2-02) from the Ministry of Agriculture, Forestry and Fisheries, Japan; the internal research grants from Keio University; Advanced Comprehensive Research Grants of Teikyo University; the Academic Contributions from Pfizer Japan Inc.; scholarship donations from Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd.; research supports from Astellas Pharma Inc. and Takeda Pharmaceutical Co., Ltd.; the Health Care Science Institute Research Grant; and the Health Science Center Research Grant.

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Correspondence to Michihiro Satoh.

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H.M., K.A., Y.I., and T.O concurrently held the position of director of the Tohoku Institute for Management of Blood Pressure, supported by Omron Healthcare Co., Ltd.

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Nakayama, S., Satoh, M., Metoki, H. et al. Lifetime risk of stroke stratified by chronic kidney disease and hypertension in the general Asian population: the Ohasama study. Hypertens Res 44, 866–873 (2021). https://doi.org/10.1038/s41440-021-00635-z

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Keywords

  • Lifetime risk
  • stroke
  • chronic kidney disease
  • hypertension
  • epidemiology

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