Effect of Hypertension on Aortic Artery Disease-Related Mortality ― 3.8-Year Nationwide Community-Based Prospective Cohort Study
Background: Aortic artery disease (AAD), such as aortic dissection or aortic aneurysm rupture, is fatal, with an extremely high mortality. Because of its low incidence, the risk for the development of AAD has not yet been elucidated. Hypertension (HT) is an established risk factor for cardiovascular...
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| Veröffentlicht in: | Circulation Journal 2018/10/25, Vol.82(11), pp.2776-2782 |
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| creator | Otaki, Yoichiro Watanabe, Tetsu Konta, Tsuneo Watanabe, Masafumi Fujimoto, Shouichi Sato, Yuji Asahi, Koichi Yamagata, Kunihiro Tsuruya, Kazuhiko Narita, Ichiei Kasahara, Masato Shibagaki, Yugo Iseki, Kunitoshi Moriyama, Toshiki Kondo, Masahide Watanabe, Tsuyoshi |
| description | Background: Aortic artery disease (AAD), such as aortic dissection or aortic aneurysm rupture, is fatal, with an extremely high mortality. Because of its low incidence, the risk for the development of AAD has not yet been elucidated. Hypertension (HT) is an established risk factor for cardiovascular disease, but there has been no prospective study on the effect of HT on AAD-related mortality. Methods and Results: We used a nationwide database of 276,197 subjects (aged 40–75 years) who participated in the annual “Specific Health Check and Guidance in Japan” from 2008 to 2010. There were 80 AAD-related deaths during the follow-up period of 1,049,549 person-years. On multivariate Cox proportional hazard regression, HT was an independent risk factor for AAD-related death in apparently healthy subjects. On receiver operating characteristics curve analysis for AAD-related death, abnormal systolic and diastolic blood pressure (SBP and DBP) were 130 mmHg and 82 mmHg, respectively. The prediction capacity was significantly improved by the addition of SBP to confounding risk factors. Notably, further improvement of the C index was observed by addition of DBP to the model with SBP. Conclusions: This is the first report to prospectively show that HT is a risk factor for AAD-related death. Both SBP and DBP are of critical importance in the primary prevention of AAD-related death in apparently healthy subjects. |
| doi_str_mv | 10.1253/circj.CJ-18-0721 |
| format | Article |
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Because of its low incidence, the risk for the development of AAD has not yet been elucidated. Hypertension (HT) is an established risk factor for cardiovascular disease, but there has been no prospective study on the effect of HT on AAD-related mortality. Methods and Results: We used a nationwide database of 276,197 subjects (aged 40–75 years) who participated in the annual “Specific Health Check and Guidance in Japan” from 2008 to 2010. There were 80 AAD-related deaths during the follow-up period of 1,049,549 person-years. On multivariate Cox proportional hazard regression, HT was an independent risk factor for AAD-related death in apparently healthy subjects. On receiver operating characteristics curve analysis for AAD-related death, abnormal systolic and diastolic blood pressure (SBP and DBP) were 130 mmHg and 82 mmHg, respectively. The prediction capacity was significantly improved by the addition of SBP to confounding risk factors. Notably, further improvement of the C index was observed by addition of DBP to the model with SBP. Conclusions: This is the first report to prospectively show that HT is a risk factor for AAD-related death. Both SBP and DBP are of critical importance in the primary prevention of AAD-related death in apparently healthy subjects.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-18-0721</identifier><identifier>PMID: 30298835</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Adult ; Aged ; Aortic artery disease-related mortality ; Aortic Dissection - complications ; Aortic Dissection - mortality ; Aortic Dissection - physiopathology ; Aortic Rupture - complications ; Aortic Rupture - mortality ; Aortic Rupture - physiopathology ; Apparently healthy subject ; Databases, Factual ; Female ; Follow-Up Studies ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - mortality ; Hypertension - physiopathology ; Male ; Middle Aged ; Models, Cardiovascular ; Risk Factors</subject><ispartof>Circulation Journal, 2018/10/25, Vol.82(11), pp.2776-2782</ispartof><rights>2018 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c623t-c25b59db8c235da7d00878ae23c0375cd901a7e4d2e87e3287d001ff8e8fef0b3</citedby><cites>FETCH-LOGICAL-c623t-c25b59db8c235da7d00878ae23c0375cd901a7e4d2e87e3287d001ff8e8fef0b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30298835$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Otaki, Yoichiro</creatorcontrib><creatorcontrib>Watanabe, Tetsu</creatorcontrib><creatorcontrib>Konta, Tsuneo</creatorcontrib><creatorcontrib>Watanabe, Masafumi</creatorcontrib><creatorcontrib>Fujimoto, Shouichi</creatorcontrib><creatorcontrib>Sato, Yuji</creatorcontrib><creatorcontrib>Asahi, Koichi</creatorcontrib><creatorcontrib>Yamagata, Kunihiro</creatorcontrib><creatorcontrib>Tsuruya, Kazuhiko</creatorcontrib><creatorcontrib>Narita, Ichiei</creatorcontrib><creatorcontrib>Kasahara, Masato</creatorcontrib><creatorcontrib>Shibagaki, Yugo</creatorcontrib><creatorcontrib>Iseki, Kunitoshi</creatorcontrib><creatorcontrib>Moriyama, Toshiki</creatorcontrib><creatorcontrib>Kondo, Masahide</creatorcontrib><creatorcontrib>Watanabe, Tsuyoshi</creatorcontrib><title>Effect of Hypertension on Aortic Artery Disease-Related Mortality ― 3.8-Year Nationwide Community-Based Prospective Cohort Study</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background: Aortic artery disease (AAD), such as aortic dissection or aortic aneurysm rupture, is fatal, with an extremely high mortality. Because of its low incidence, the risk for the development of AAD has not yet been elucidated. Hypertension (HT) is an established risk factor for cardiovascular disease, but there has been no prospective study on the effect of HT on AAD-related mortality. Methods and Results: We used a nationwide database of 276,197 subjects (aged 40–75 years) who participated in the annual “Specific Health Check and Guidance in Japan” from 2008 to 2010. There were 80 AAD-related deaths during the follow-up period of 1,049,549 person-years. On multivariate Cox proportional hazard regression, HT was an independent risk factor for AAD-related death in apparently healthy subjects. On receiver operating characteristics curve analysis for AAD-related death, abnormal systolic and diastolic blood pressure (SBP and DBP) were 130 mmHg and 82 mmHg, respectively. The prediction capacity was significantly improved by the addition of SBP to confounding risk factors. Notably, further improvement of the C index was observed by addition of DBP to the model with SBP. Conclusions: This is the first report to prospectively show that HT is a risk factor for AAD-related death. Both SBP and DBP are of critical importance in the primary prevention of AAD-related death in apparently healthy subjects.</description><subject>Adult</subject><subject>Aged</subject><subject>Aortic artery disease-related mortality</subject><subject>Aortic Dissection - complications</subject><subject>Aortic Dissection - mortality</subject><subject>Aortic Dissection - physiopathology</subject><subject>Aortic Rupture - complications</subject><subject>Aortic Rupture - mortality</subject><subject>Aortic Rupture - physiopathology</subject><subject>Apparently healthy subject</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - complications</subject><subject>Hypertension - mortality</subject><subject>Hypertension - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Cardiovascular</subject><subject>Risk Factors</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkLtuFDEUhi1EREKgp0Iuabz4MpPxlMsQEqIkIC4FleW1j4lXc1lsD2i6LXgFXhBeJJ7skkiWfeTznd_Wh9ALRheMl-K18cGsF80FYZLQirNH6IiJoiKF5PTxXX1CalmIQ_Q0xjWlvKZl_QQdilxJKcoj9PvUOTAJDw6fTxsICfrohx7ntRxC8gYv812Y8FsfQUcgn6DVCSy-yl3d-jT9227_bv9gsZDkG-iAr3XKAb-8BdwMXTf2mSFv8qjFH8MQN_k1_3Pu3eQE_DmNdnqGDpxuIzzfn8fo67vTL805ufxw9r5ZXhJzwkUihpersrYrabgora4spbKSGrgwVFSlsTVluoLCcpAVCC5ngjknQTpwdCWO0atd7iYMP0aISXU-Gmhb3cMwRsUZq0RWVBYZpTvU5D_HAE5tgu90mBSjanav7tyr5kIxqWb3eeTlPn1cdWDvB_7LzsDZDljHpL_DPaBnzy3sEyVXjM37Q_QDcaODgl7cAt8FncQ</recordid><startdate>20181025</startdate><enddate>20181025</enddate><creator>Otaki, Yoichiro</creator><creator>Watanabe, Tetsu</creator><creator>Konta, Tsuneo</creator><creator>Watanabe, Masafumi</creator><creator>Fujimoto, Shouichi</creator><creator>Sato, Yuji</creator><creator>Asahi, Koichi</creator><creator>Yamagata, Kunihiro</creator><creator>Tsuruya, Kazuhiko</creator><creator>Narita, Ichiei</creator><creator>Kasahara, Masato</creator><creator>Shibagaki, Yugo</creator><creator>Iseki, Kunitoshi</creator><creator>Moriyama, Toshiki</creator><creator>Kondo, Masahide</creator><creator>Watanabe, Tsuyoshi</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20181025</creationdate><title>Effect of Hypertension on Aortic Artery Disease-Related Mortality ― 3.8-Year Nationwide Community-Based Prospective Cohort Study</title><author>Otaki, Yoichiro ; Watanabe, Tetsu ; Konta, Tsuneo ; Watanabe, Masafumi ; Fujimoto, Shouichi ; Sato, Yuji ; Asahi, Koichi ; Yamagata, Kunihiro ; Tsuruya, Kazuhiko ; Narita, Ichiei ; Kasahara, Masato ; Shibagaki, Yugo ; Iseki, Kunitoshi ; Moriyama, Toshiki ; Kondo, Masahide ; Watanabe, Tsuyoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c623t-c25b59db8c235da7d00878ae23c0375cd901a7e4d2e87e3287d001ff8e8fef0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aortic artery disease-related mortality</topic><topic>Aortic Dissection - complications</topic><topic>Aortic Dissection - mortality</topic><topic>Aortic Dissection - physiopathology</topic><topic>Aortic Rupture - complications</topic><topic>Aortic Rupture - mortality</topic><topic>Aortic Rupture - physiopathology</topic><topic>Apparently healthy subject</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - complications</topic><topic>Hypertension - mortality</topic><topic>Hypertension - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Cardiovascular</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Otaki, Yoichiro</creatorcontrib><creatorcontrib>Watanabe, Tetsu</creatorcontrib><creatorcontrib>Konta, Tsuneo</creatorcontrib><creatorcontrib>Watanabe, Masafumi</creatorcontrib><creatorcontrib>Fujimoto, Shouichi</creatorcontrib><creatorcontrib>Sato, Yuji</creatorcontrib><creatorcontrib>Asahi, Koichi</creatorcontrib><creatorcontrib>Yamagata, Kunihiro</creatorcontrib><creatorcontrib>Tsuruya, Kazuhiko</creatorcontrib><creatorcontrib>Narita, Ichiei</creatorcontrib><creatorcontrib>Kasahara, Masato</creatorcontrib><creatorcontrib>Shibagaki, Yugo</creatorcontrib><creatorcontrib>Iseki, Kunitoshi</creatorcontrib><creatorcontrib>Moriyama, Toshiki</creatorcontrib><creatorcontrib>Kondo, Masahide</creatorcontrib><creatorcontrib>Watanabe, Tsuyoshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Otaki, Yoichiro</au><au>Watanabe, Tetsu</au><au>Konta, Tsuneo</au><au>Watanabe, Masafumi</au><au>Fujimoto, Shouichi</au><au>Sato, Yuji</au><au>Asahi, Koichi</au><au>Yamagata, Kunihiro</au><au>Tsuruya, Kazuhiko</au><au>Narita, Ichiei</au><au>Kasahara, Masato</au><au>Shibagaki, Yugo</au><au>Iseki, Kunitoshi</au><au>Moriyama, Toshiki</au><au>Kondo, Masahide</au><au>Watanabe, Tsuyoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Hypertension on Aortic Artery Disease-Related Mortality ― 3.8-Year Nationwide Community-Based Prospective Cohort Study</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2018-10-25</date><risdate>2018</risdate><volume>82</volume><issue>11</issue><spage>2776</spage><epage>2782</epage><pages>2776-2782</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background: Aortic artery disease (AAD), such as aortic dissection or aortic aneurysm rupture, is fatal, with an extremely high mortality. Because of its low incidence, the risk for the development of AAD has not yet been elucidated. Hypertension (HT) is an established risk factor for cardiovascular disease, but there has been no prospective study on the effect of HT on AAD-related mortality. Methods and Results: We used a nationwide database of 276,197 subjects (aged 40–75 years) who participated in the annual “Specific Health Check and Guidance in Japan” from 2008 to 2010. There were 80 AAD-related deaths during the follow-up period of 1,049,549 person-years. On multivariate Cox proportional hazard regression, HT was an independent risk factor for AAD-related death in apparently healthy subjects. On receiver operating characteristics curve analysis for AAD-related death, abnormal systolic and diastolic blood pressure (SBP and DBP) were 130 mmHg and 82 mmHg, respectively. The prediction capacity was significantly improved by the addition of SBP to confounding risk factors. Notably, further improvement of the C index was observed by addition of DBP to the model with SBP. Conclusions: This is the first report to prospectively show that HT is a risk factor for AAD-related death. Both SBP and DBP are of critical importance in the primary prevention of AAD-related death in apparently healthy subjects.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>30298835</pmid><doi>10.1253/circj.CJ-18-0721</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aortic artery disease-related mortality Aortic Dissection - complications Aortic Dissection - mortality Aortic Dissection - physiopathology Aortic Rupture - complications Aortic Rupture - mortality Aortic Rupture - physiopathology Apparently healthy subject Databases, Factual Female Follow-Up Studies Humans Hypertension Hypertension - complications Hypertension - mortality Hypertension - physiopathology Male Middle Aged Models, Cardiovascular Risk Factors |
| title | Effect of Hypertension on Aortic Artery Disease-Related Mortality ― 3.8-Year Nationwide Community-Based Prospective Cohort Study |
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