S-52-4: BLOOD PRESSURE CATEGORIES AND PROGRESSION OF COMMON CAROTID ARTERY STENOSIS DEGREE IN A JAPANESE URBAN POPULATION: THE SUITA STUDY

Abstract

Objective: Little is known about the impacts of systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels on the risk of a common carotid artery (CCA) stenosis degree progression in the general population. The objective of the present study was to examine the impact of blood pressure levels on the progression of CCA stenosis degree in the general population. Design and method: We studied 3,823 Japanese men and women without CCA stenosis at baseline whose CCA was measured by carotid ultrasonography on both sides (April 1994 to March 2005). We confirmed stenosis by Doppler and calculated the stenosis degree as a percentage of the stenotic area of the lumen in the cross-section perpendicular to the long axis. We measured BPs twice more than one min apart and used the average of two measurements of BPs for the analyses. The Cox proportional hazard model was used to calculate the multivariable-adjusted hazard ratios (HRs) with 95 % confidence intervals (CIs) of CCA stenosis degree progression according to the BP categories defined by the ESC/ESH 2018 guideline. Results: During 22,877 person-years of follow-up, we observed 74 cases of new progression of CCA stenosis (25 % or more). The high BP was associated with increased risks of CCA stenosis (25 % or more) progression; the multivariable-adjusted HRs with 95 % CIs were 1.34 (0.68-2.65) for participants with normal BP (120–139 and/or 80–89 mm Hg) and 2.13 (1.05–4.30) for those with hypertension (SBP ≧ 140 mm Hg and/or DBP ≧ 90 mm Hg), compared to those with optimal BP (SBP < 120 mm Hg and DBP < 80 mm Hg). Similar positive associations were observed between SBP and DBP and the risk of carotid stenosis incidence, but only statistically significant for SBP; the multivariable-adjusted HRs per 10 mm Hg increase were 1.15 (1.02–1.31) for SBP and 1.18 (0.94–1.49) for DBP. Conclusions: This is the first study to show that high BP was associated with increased risks of CCA stenosis degree progression in the general population, independent of cholesterol levels. A stronger association was found with SBP than DBP. In addition to managing dyslipidemia, adequate control of SBP can prevent the development of CCA stenosis.