1. Impact of Major Cardiovascular Risk Factors on the Incidence of Cardiovascular Disease among Overweight and Non-Overweight Individuals: The Circulatory Risk in Communities Study (CIRCS)
- Author
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Hiroyasu Iso, Tomoko Sankai, Mina Hayama-Terada, Renzhe Cui, Tetsuya Ohira, Akihiko Kitamura, Hironori Imano, Takeo Okada, Masahiko Kiyama, Kazumasa Yamagishi, Mitsumasa Umesawa, Isao Muraki, Yasuhiko Kubota, and Takumi Matsumura
- Subjects
Adult ,Male ,medicine.medical_specialty ,Population ,030204 cardiovascular system & hematology ,Overweight ,Risk Assessment ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Humans ,Medicine ,Risk factor ,education ,Aged ,education.field_of_study ,business.industry ,Incidence ,Biochemistry (medical) ,Hazard ratio ,Hemodynamics ,Middle Aged ,medicine.disease ,Blood pressure ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,030217 neurology & neurosurgery ,Kidney disease - Abstract
Aim We aimed to examine the impact of high-risk levels of cardiovascular risk factors on the incidence of cardiovascular disease (CVD) in overweight and non-overweight individuals without treatment for the risk factors. Methods A total of 8,051 individuals aged 40-74 years without a history of CVD and/or without treatment for hypertension, diabetes, hyperlipidemia, and kidney disease at baseline in 1995-2000 were followed up for a median of 14.1 years. We classified the participants into three risk categories (low-, intermediate-, and high-risk groups) on the basis of individual risk factors (blood pressure, serum glucose, low-density lipoprotein cholesterol [LDL-C], and urinary protein) according to the guidelines of Japanese clinical societies. The high-risk group (systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 100 mmHg, fasting serum glucose ≥ 130 mg/dL or non-fasting serum glucose ≥ 180 mg/dL, LDL-C ≥ 180 mg/dL, proteinuria ≥ 2+) needed to refer to physicians or start treatment immediately. Overweight was defined as a body mass index of ≥ 25 kg/m2. Results Compared with those in the non-overweight low-risk group, the hazard ratios (HRs) (95% confidence intervals, population-attributable fractions [PAFs]) of CVD in the high-risk categories of blood pressure were 2.0 (1.4-2.9, 7.0%) in the non-overweight high-risk group and 2.9 (1.9-4.3, 6.8%) in the overweight high-risk group. The corresponding HRs (95% confidence intervals, PAFs) of serum glucose were 2.0 (1.2-3.4, 2.5%) and 2.2 (1.1-4.3, 1.5%) in the non-overweight and overweight high-risk groups, respectively. Such associations were not observed for the high-risk group of LDL-C and proteinuria. Conclusions The present long-term observational study implies that targeting persons with non-treated severe hypertension and diabetes is prioritized to prevent CVD regardless of overweight status.
- Published
- 2022