446-P: Associations of Blood Pressure (BP) with Incidence of Coronary Artery Disease (CAD)/Cerebrovascular Disease (CVD) According to Glucose Tolerance Status (GTS)

Abstract

Although the 2017 ACC/AHA guidelines indicated a generalized BP goal of less than 130/80 mm Hg, the impact of BP separately on CAD or CVD in people with different GTSs has yet to be clarified. To clarify this, data from a nationwide claims database involving 293,396 participants without prior CAD or CVD during 2008-16 were analyzed. Multivariate Cox regression model was used to identify risks of a CAD and/or CVD event. Hazard ratios (HRs) were compared among 4 groups of participants divided according to stratified levels of BP [i.e., <130/90 mmHg, systolic BP (SBP) =130-139 and/or diastolic BP (DBP) =80-89 mmHg, SBP≥140 or DBP>90 mmHg, ≥140/90 mmHg] according to GTS [i.e., normal glucose tolerance (NGT), prediabetes (pre-DM), diabetes mellitus (DM)]. During the study period, 1099 CAD and 1990 CVD events occurred. Despite that a significant trend between BP and incident CAD was observed regardless of GTS, risk for CVD was dependent on BP only in the NGT and pre-DM groups. Moreover, there were no significant differences in CVD risks between categories of BP<130/90 mmHg and SBP=130-139 and/or DBP=80-89 mmHg among patients with DM. These results implied the necessity of setting specific BP goals according to GTS for prevention of CAD/CVD. Disclosure M. Harada: None. K. Fujihara: None. M. Yamamoto: None. M. Kaneko: None. M. Kitazawa: None. H. Suzuki: None. Y. Matsubayashi: None. T. Yamada: None. N. Yamanaka: None. H. Seida: None. W. Ogawa: Consultant; Self; Abbott. Research Support; Self; Astellas Pharma Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Lilly Diabetes, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Co., Ltd. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.