PS-BPP04-6: DIASTOLIC BLOOD PRESSURE LEVELS AND CARDIOVASCULAR EVENTS: THE JAPAN EPIDEMIOLOGY COLLABORATION ON OCCUPATIONAL HEALTH STUDY

Abstract

Objective: In Japan, data are sparse as to the association of diastolic blood pressure (DBP) within the elevated blood pressure range (i.e., DBP of 80 to 89 mm Hg) with risk of cardiovascular diseases (CVD) in young to middle-aged adults. We examined this association by using prospective data collected in the Japan Epidemiology Collaboration on Occupational Health (JECOH) Study. Methods: Participants were 81,876 workers (67,150 men and 14,636 women, aged 20 to 64 years) without taking antihypertensive medication who underwent periodic health checkup in 2011 or 2010 (baseline). Blood pressures categories at baseline were used as exposure. Data on fatal and non-fatal cardiovascular events (ICD10: I21 to I25, I46, I48 to I50, I60 to I69, I71 to I72) that occurred between April 2012 and March 2021 were retrieved from a within-study registry. Multivariable-adjusted hazard ratios according to DBP levels were calculated using Cox regression. Results: Over the 9 years of follow-up (0.5 million person years), 319 cardiovascular events (hemorrhage or ischemic stroke [ICD10: I60/I63], 177 cases; myocardial infarction [ICD10: I21], 77 cases) including 74 cardiovascular deaths were documented. Higher levels of DBP were associated with increased risk of cardiovascular events. As compared with DBP of < 80 mm Hg, multivariable adjusted hazard ratios (95% confidence intervals) of cardiovascular events were 1.58 (1.12, 2.22), 2.25 (1.75, 2.91), 2.85 (1.97, 4.11), 2.89 (1.52, 5.48), and 5.60 (2.52, 12.42) for DBP of 80 to 84, 85 to 89, 90 to 99, 100 to 109, and ≧ 110 mm Hg, respectively (P value for trend < 0.001). Risk of CVD mortality was also increased, albeit not significantly, at DBP of 80 to 84 and 85 to 89 mm Hg (19% and 59% increase, respectively). Conclusion: The present data from JECOH Study showed that DBP of 80 to 84 mm Hg was associated with a significantly higher risk of cardiovascular events. Our results support the blood pressure classification in the Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH2019) for CVD prevention.