Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly the hisayama study

Hisatomi Arima, Yumihiro Tanizaki, Yutaka Kiyohara, Takuya Tsuchihashi, Isao Kato, Michiaki Kubo, Keiichi Tanaka, Ken Ohkubo, Hidetoshi Nakamura, Isao Abe, Masatoshi Fujishima, Mitsuo Iida

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Abstract

Background: It is not known whether the treatment recommendations presented in the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure are applicable to the Japanese elderly population. Methods: We followed up 588 cardiovascular disease-free residents of a Japanese community who were 60 years or older from November 1, 1961, through October 31, 1993. Treated hypertensive patients were excluded from the analysis. During this period, CVD occurred in 179 subjects. The incidences were estimated by the pooling of repeated observations method. Results: The age- and sex-adjusted incidences of cardiovascular disease significantly increased with elevated blood pressure levels. The hazard ratio for stage 3 hypertension was 5.34 (95% confidence interval, 2.66-10.71; P<.001) compared with optimal blood pressure after adjustment for other covariates. Among subjects aged 60 to 79 years, the incidences for stages 1 through 3 hypertension were significantly higher than for those with optimal and normal blood pressure. In comparison, among those 80 years or older, the incidence was significantly higher only in patients with stage 3 hypertension. We further estimated the incidences according to the risk stratification system. In the younger elderly subjects, the incidences increased with rising blood pressure levels in each risk stratum. Similar relationships were not observed among the older elderly subjects. Conclusions: Our findings demonstrate that the recommendations of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure were potentially applicable to the Japanese elderly subjects 79 years or younger. Based on our findings, however, hypertension might not be a risk factor for cardiovascular disease among very old hypertensive patients with advanced atherosclerosis.

Original languageEnglish
Pages (from-to)361-366
Number of pages6
JournalArchives of Internal Medicine
Volume163
Issue number3
DOIs
Publication statusPublished - 10-02-2003

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Hypertension
Incidence
Population
Blood Pressure
Cardiovascular Diseases
Atherosclerosis
Therapeutics
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Arima, Hisatomi ; Tanizaki, Yumihiro ; Kiyohara, Yutaka ; Tsuchihashi, Takuya ; Kato, Isao ; Kubo, Michiaki ; Tanaka, Keiichi ; Ohkubo, Ken ; Nakamura, Hidetoshi ; Abe, Isao ; Fujishima, Masatoshi ; Iida, Mitsuo. / Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly the hisayama study. In: Archives of Internal Medicine. 2003 ; Vol. 163, No. 3. pp. 361-366.
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Arima, H, Tanizaki, Y, Kiyohara, Y, Tsuchihashi, T, Kato, I, Kubo, M, Tanaka, K, Ohkubo, K, Nakamura, H, Abe, I, Fujishima, M & Iida, M 2003, 'Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly the hisayama study', Archives of Internal Medicine, vol. 163, no. 3, pp. 361-366. https://doi.org/10.1001/archinte.163.3.361

Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly the hisayama study. / Arima, Hisatomi; Tanizaki, Yumihiro; Kiyohara, Yutaka; Tsuchihashi, Takuya; Kato, Isao; Kubo, Michiaki; Tanaka, Keiichi; Ohkubo, Ken; Nakamura, Hidetoshi; Abe, Isao; Fujishima, Masatoshi; Iida, Mitsuo.

In: Archives of Internal Medicine, Vol. 163, No. 3, 10.02.2003, p. 361-366.

Research output: Contribution to journalArticle

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T1 - Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly the hisayama study

AU - Arima, Hisatomi

AU - Tanizaki, Yumihiro

AU - Kiyohara, Yutaka

AU - Tsuchihashi, Takuya

AU - Kato, Isao

AU - Kubo, Michiaki

AU - Tanaka, Keiichi

AU - Ohkubo, Ken

AU - Nakamura, Hidetoshi

AU - Abe, Isao

AU - Fujishima, Masatoshi

AU - Iida, Mitsuo

PY - 2003/2/10

Y1 - 2003/2/10

N2 - Background: It is not known whether the treatment recommendations presented in the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure are applicable to the Japanese elderly population. Methods: We followed up 588 cardiovascular disease-free residents of a Japanese community who were 60 years or older from November 1, 1961, through October 31, 1993. Treated hypertensive patients were excluded from the analysis. During this period, CVD occurred in 179 subjects. The incidences were estimated by the pooling of repeated observations method. Results: The age- and sex-adjusted incidences of cardiovascular disease significantly increased with elevated blood pressure levels. The hazard ratio for stage 3 hypertension was 5.34 (95% confidence interval, 2.66-10.71; P<.001) compared with optimal blood pressure after adjustment for other covariates. Among subjects aged 60 to 79 years, the incidences for stages 1 through 3 hypertension were significantly higher than for those with optimal and normal blood pressure. In comparison, among those 80 years or older, the incidence was significantly higher only in patients with stage 3 hypertension. We further estimated the incidences according to the risk stratification system. In the younger elderly subjects, the incidences increased with rising blood pressure levels in each risk stratum. Similar relationships were not observed among the older elderly subjects. Conclusions: Our findings demonstrate that the recommendations of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure were potentially applicable to the Japanese elderly subjects 79 years or younger. Based on our findings, however, hypertension might not be a risk factor for cardiovascular disease among very old hypertensive patients with advanced atherosclerosis.

AB - Background: It is not known whether the treatment recommendations presented in the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure are applicable to the Japanese elderly population. Methods: We followed up 588 cardiovascular disease-free residents of a Japanese community who were 60 years or older from November 1, 1961, through October 31, 1993. Treated hypertensive patients were excluded from the analysis. During this period, CVD occurred in 179 subjects. The incidences were estimated by the pooling of repeated observations method. Results: The age- and sex-adjusted incidences of cardiovascular disease significantly increased with elevated blood pressure levels. The hazard ratio for stage 3 hypertension was 5.34 (95% confidence interval, 2.66-10.71; P<.001) compared with optimal blood pressure after adjustment for other covariates. Among subjects aged 60 to 79 years, the incidences for stages 1 through 3 hypertension were significantly higher than for those with optimal and normal blood pressure. In comparison, among those 80 years or older, the incidence was significantly higher only in patients with stage 3 hypertension. We further estimated the incidences according to the risk stratification system. In the younger elderly subjects, the incidences increased with rising blood pressure levels in each risk stratum. Similar relationships were not observed among the older elderly subjects. Conclusions: Our findings demonstrate that the recommendations of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure were potentially applicable to the Japanese elderly subjects 79 years or younger. Based on our findings, however, hypertension might not be a risk factor for cardiovascular disease among very old hypertensive patients with advanced atherosclerosis.

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