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Risk factors and predictors of coronary arterial lesions in Japanese hypertensive patients
1Department of Medicine, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai, Japan.
Insights
Lifestyle changes in Japan increase coronary artery disease risk. Smoking, high cholesterol, and high blood pressure are key risk factors for coronary arterial lesions in hypertensive patients. The combination of these factors significantly elevates risk.
Area of Science:
- Cardiology
- Hypertension Research
- Epidemiology
Background:
- Coronary artery disease (CAD) morbidity is rising in Japan, linked to Westernized lifestyle changes.
- Essential hypertension is a significant risk factor for cardiovascular events.
Purpose of the Study:
- To investigate risk factors and predictors of coronary arterial lesions in Japanese patients with essential hypertension.
- To identify specific modifiable and non-modifiable factors contributing to CAD in this population.
Main Methods:
- Coronary angiography was performed on 109 essential hypertension patients with chest pain.
- Multiple logistic regression analysis identified significant risk factors (smoking, hypercholesterolemia, diastolic blood pressure) and predictors (carotid intima-media thickness).
Main Results:
- Significant risk factors for coronary arterial lesions included smoking habit (OR: 4.48), hypercholesterolemia (OR: 5.34), and 24-h diastolic blood pressure (OR: 2.33).
- Carotid intima-media thickness was a significant predictor (OR: 5.85).
- The presence of two or more major risk factors (smoking, hypercholesterolemia, impaired glucose tolerance) alongside hypertension synergistically increased lesion risk 6.7 to 10.1 times.
Conclusions:
- Established Caucasian risk factors like smoking, hypercholesterolemia, and blood pressure levels are also critical for coronary arterial lesions in Japanese essential hypertension patients.
- Aggressive management of these risk factors is crucial for preventing CAD in hypertensive individuals.
Abstract:
The morbidity rate of coronary artery disease has recently increased in Japan. This is attributable to changes from traditional to more westernized lifestyles. In this study, we therefore examined the risk factors and predictors of coronary arterial lesions in Japanese patients with essential hypertension. Coronary angiography was performed in 109 consecutive essential hypertension patients (57 men and 52 women; 66 +/- 8.0 years of age) with either angina pectoris or atypical chest pain, who were chosen from 485 consecutive hypertensive patients in a hypertension clinic in Sendai, Japan. Coronary arterial stenosis of greater than 50% was defined as significant and used as a dependent variable for the multiple regression analysis. Risk factors were defined as factors confirmed to have a causal relationship with coronary arterial lesions, whereas arteriosclerotic complications and hypertensive target organ damage were defined as predictors. Multiple logistic regression analysis was performed using these parameters as independent variables. Of 109 patients, 25 had a coronary arterial stenosis greater than 50%. A smoking habit (odds ratio (OR): 4.48; 95% confidence interval (CI): 1.13-17.82; p<0.05), hypercholesterolemia (OR: 5.34; 95% CI: 1.52-18.73; p<0.05), and 24-h diastolic blood pressure (OR: 2.33; 95% CI: 1.06-5.16; p<0.05) were significant risk factors, whereas carotid intima-media thickness (OR: 5.85; 95% CI: 1.48-23.2; p<0.05) was a significant predictor of coronary arterial lesion. When two of the major risk factors (a smoking habit, hypercholesterolemia, or impaired glucose tolerance including diabetes mellitus) were clustered in addition to the hypertension, the risk of coronary arterial lesions increased by 6.7 to 10.1 times. These findings indicate that the major risk factors established in Caucasians, i.e., a smoking habit, hypercholesterolemia and blood pressure level, are also risk factors for coronary arterial lesions in Japanese with essential hypertension. The presence of two or more risk factors increases the risk of coronary arterial lesions synergistically in the presence of hypertension.