| アブストラクト | BACKGROUND: We aimed to precisely quantify the risk of coronary heart disease (CHD) among antihypertensive medication users compared to non-users. We similarly assessed the potential CHD risk among lipid-lowering medication users. METHODS: This retrospective cohort study used claims and health checkup data from 2014 to 2021 provided by DeSC Healthcare, Inc. We used percutaneous coronary intervention (PCI) risk as a proxy for the CHD outcome. RESULTS: Among the 1,740,153 participants without a history of cardiovascular and kidney diseases, 3803 underwent PCI during a mean follow-up of 3.2 years. The Cox model with health insurers as the stratified factor showed that blood pressure (BP) classification according to the hypertension guidelines was linearly associated with PCI risk. In contrast, this association was weaker in antihypertensive medication users than in nonusers. After restricting to 1,309,460 participants with BP <140/<90 mm Hg, the antihypertensive medication users had a 1.51 (95% CI: 1.37-1.66) times higher PCI risk than nonusers even after adjusting for baseline characteristics including systolic BP. This was consistent in all subgroups stratified by characteristics including body mass index, drinking status, diabetes, systolic BP, and follow-up years. Meanwhile, the use of lipid-lowering medications was not associated with PCI risk (hazard ratio: 0.98, 95% CI: 0.88-1.09 in 1,221,390 patients with low-density lipoprotein cholesterol <3.62 mmol/L [<140 mg/dL]). CONCLUSIONS: Especially for hypertension, it is important not only to lower BP with medication but also to avoid the need for medication through early prevention and lifestyle changes. |
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| 組織名 | Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku;Medical and Pharmaceutical University, Sendai, Japan (Drs Satoh, Nakayama,;Hashimoto, Toyama, Iwabe, Yagihashi, Murakami, and Metoki); Department of;Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization,;Tohoku University, Sendai, Japan (Drs Satoh, Hashimoto, Toyama, Murakami, Obara,;and Metoki); Department of Pharmacy, Tohoku Medical and Pharmaceutical University;Hospital, Sendai, Japan (Dr Satoh). Electronic address:;satoh.mchr@tohoku-mpu.ac.jp.;Hashimoto, Toyama, Iwabe, Yagihashi, Murakami, and Metoki); Division of;Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and;Pharmaceutical University, Sendai, Japan (Drs Nakayama and Hashimoto).;and Metoki); Division of Nephrology and Endocrinology, Faculty of Medicine,;Tohoku Medical and Pharmaceutical University, Sendai, Japan (Drs Nakayama and;Hashimoto).;and Metoki); Department of Nephrology, Self-Defense Forces, Sendai Hospital,;Sendai, Japan (Dr Toyama).;Hashimoto, Toyama, Iwabe, Yagihashi, Murakami, and Metoki); Center for Clinical;Research Promotion and Development, Tohoku Medical and Pharmaceutical University;Hospital, Sendai, Japan (Dr Iwabe).;Cerebrovascular Medicine, Konan Hospital, Sendai, Japan (Dr Yagihashi).;and Metoki); Division of Aging and Geriatric Dentistry, Department of;Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai,;Japan (Dr Murakami).;Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank;Organization, Tohoku University, Sendai, Japan (Drs Satoh, Hashimoto, Toyama,;Murakami, Obara, and Metoki); Department of Pharmaceutical Sciences, Tohoku;University Hospital, Sendai, Japan (Dr Obara).;Department of Hygiene and Public Health, Teikyo University School of Medicine,;Tokyo, Japan (Dr Ohkubo); Tohoku Institute for the Management of Blood Pressure,;Sendai, Japan (Drs Ohkubo and Metoki).;and Metoki); Tohoku Institute for the Management of Blood Pressure, Sendai, Japan;(Drs Ohkubo and Metoki). |
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