Role of hypertension, dyslipidemia and diabetes mellitus in the development of coronary atherosclerosis in Japan.

The present study evaluated the effect of hypertension (HT), dyslipidemia and diabetes mellitus (DM) on the development of coronary atherosclerosis in the Japanese population, using a cross-sectional study of 433 patients (254 men and 179 women) aged 30 years or older who underwent coronary angiography for suspected or known coronary heart disease angina at 5 cardiology departments in the Fukuoka area between September 1996 and August 1997. Patients with a disease duration of 6 months or more were excluded. The main outcome measure was angiographically defined coronary artery stenosis and was found to a significant degree in 146 patients (33.7%). HT, DM, low levels of high-density lipoprotein cholesterol (HDL-C) and hypertriglyceridemia remained as significant coronary artery disease (CAD) risk factors even after controlling for age, sex, hospital, smoking, alcohol use, body mass index and leisure time physical activity. However, hypercholesterolemia was not a significant risk factor after adjusting for these variables. After controlling for these variables, DM, low HDL-C and hypertriglyceridemia were significant CAD risk factors for men, but only DM was a significant CAD risk factor in women. These results indicate that in Japan DM, low HDL-C and hypertriglyceridemia may be more important CAD risk factors than hypercholesterolemia.

[1]  Y. Miyake Risk Factors for Non-Fatal Acute Myocardial Infarction in Middle-Aged and Older Japanese , 2000 .

[2]  K. Arakawa,et al.  Insulin resistance and angiographical characteristics of coronary atherosclerosis. , 1999, Japanese circulation journal.

[3]  M. Laakso,et al.  Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policemen Study. , 1998, Circulation.

[4]  A. Gotto,et al.  Triglyceride: the forgotten risk factor. , 1998, Circulation.

[5]  R. Holman,et al.  Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23) , 1998, BMJ.

[6]  O. Faergeman,et al.  Cholesterol-lowering therapy in women and elderly patients with myocardial infarction or angina pectoris: findings from the Scandinavian Simvastatin Survival Study (4S) , 1997, Circulation.

[7]  M. Laakso,et al.  Dyslipidemia and Hyperglycemia Predict Coronary Heart Disease Events in Middle-Aged Patients With NIDDM , 1997, Diabetes.

[8]  M. Kohno,et al.  Effect of coronary risk factors on coronary angiographic morphology in patients with ischemic heart disease. , 1997, Japanese circulation journal.

[9]  Alan C. Wilson,et al.  Serum lipids and incidence of coronary heart disease. Findings from the Systolic Hypertension in the Elderly Program (SHEP). , 1996, Circulation.

[10]  K. Kodama,et al.  The NI-HON-SAN Study , 1996 .

[11]  T. Tanigawa,et al.  Trends for Cardiovascular Risk Factors and Diseases in Japan , 1996 .

[12]  M. Fujishima,et al.  Diabetes and Cardiovascular Disease in a Prospective Population Survey in Japan: The Hisayama Study , 1996, Diabetes.

[13]  B R Davis,et al.  Coronary heart disease risk factors in men and women aged 60 years and older: findings from the Systolic Hypertension in the Elderly Program. , 1996, Circulation.

[14]  N. Sakuma,et al.  Higher level of plasma cholesteryl ester transfer activity from high‐density lipoprotein to Apo B‐containing lipoproteins in subjects with angiographically detectable coronary artery disease , 1996, Clinical cardiology.

[15]  H. Iso,et al.  A case-reference study on plasma fibrinogen concentrations and coronary atherosclerosis in Japanese. , 1996, Journal of epidemiology.

[16]  G J Boerma,et al.  Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels. The Regression Growth Evaluation Statin Study (REGRESS). , 1995, Circulation.

[17]  Scandinavian Simvastatin Survival Study Group Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) , 1994, The Lancet.

[18]  M-heart investigators Effect of simvastatin on coronary atheroma: the Multicentre Anti-Atheroma Study (MAAS) , 1994, The Lancet.

[19]  A. Folsom,et al.  High-density lipoprotein cholesterol and premature coronary heart disease in urban Japanese men. , 1994, Circulation.

[20]  D. Wilcken,et al.  Determinants of severity of coronary artery disease in Australian men and women. , 1994, Circulation.

[21]  H. Toshima Coronary artery disease trends in Japan. , 1994, Japanese circulation journal.

[22]  M. Marmot,et al.  Changes in total serum cholesterol and other risk factors for cardiovascular disease in Japan 1980-1989. , 1993, International journal of epidemiology.

[23]  G. Hallmans,et al.  High serum insulin, insulin resistance and their associations with cardiovascular risk factors The Northern Sweden MONICA population study , 1993, Journal of internal medicine.

[24]  Jessica A. Mayer,et al.  Recent evidence on drug therapy of mild to moderate hypertension and decreased risk of coronary heart disease. , 1993, Archives of internal medicine.

[25]  J. Neaton,et al.  Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. , 1993, Archives of internal medicine.

[26]  R. Hoffmann,et al.  Cholesterol and coronary artery disease: age as an effect modifier. , 1992, Journal of clinical epidemiology.

[27]  S. Haffner,et al.  Prospective analysis of the insulin-resistance syndrome (syndrome X). , 1992, Diabetes.

[28]  S. Haffner,et al.  Prospective Analysis of The Insulin-Resistance Syndrome (Syndrome X) , 1992, Diabetes.

[29]  E. Barrett-Connor,et al.  Why is diabetes mellitus a stronger risk factor for fatal ischemic heart disease in women than in men? The Rancho Bernardo Study. , 1991, JAMA.

[30]  S. Cummings,et al.  High blood cholesterol in elderly men and the excess risk for coronary heart disease. , 1990, Annals of internal medicine.

[31]  M. Fujishima,et al.  Smoking and cardiovascular disease in the general population in Japan. , 1990, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[32]  M. Moser Antihypertensive medications: relative effectiveness and adverse reactions , 1990, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[33]  K. Kodama,et al.  Trend of coronary heart disease and its relationship to risk factors in a Japanese population: a 26-year follow-up, Hiroshima/Nagasaki study. , 1990, Japanese circulation journal.

[34]  H. Iso,et al.  Trends for coronary heart disease and its risk factors in Japan: epidemiologic and pathologic studies. , 1990, Japanese circulation journal.

[35]  R. Collins,et al.  Blood pressure, stroke, and coronary heart disease Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias , 1990, The Lancet.

[36]  W. Aronow,et al.  41‐Month Follow‐Up of Risk Factors Correlated With New Coronary Events in 708 Elderly Patients , 1989, Journal of the American Geriatrics Society.

[37]  G. Assmann,et al.  Diabetes mellitus and hypertension in the elderly: concomitant hyperlipidemia and coronary heart disease risk. , 1989, The American journal of cardiology.

[38]  D. Levy,et al.  Cardiovascular risk factors in the elderly. , 1989, The American journal of cardiology.

[39]  M. Austin Plasma triglyceride as a risk factor for coronary heart disease. The epidemiologic evidence and beyond. , 1989, American journal of epidemiology.

[40]  G. Reaven Role of Insulin Resistance in Human Disease , 1988, Diabetes.

[41]  W. Kannel,et al.  Proportional Hazards Analysis of Risk Factors for Coronary Heart Disease in Individuals Aged 65 or Older , 1988, Journal of the American Geriatrics Society.

[42]  M. Laakso,et al.  Diabetes and atherosclerosis: an epidemiologic view. , 1987, Diabetes/metabolism reviews.

[43]  J. Neaton,et al.  Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). , 1986, JAMA.

[44]  G. Gensini,et al.  A more meaningful scoring system for determining the severity of coronary heart disease. , 1983, The American journal of cardiology.

[45]  T. Welborn,et al.  Coronary Heart Disease Incidence and Cardiovascular Mortality in Busselton with Reference to Glucose and Insulin Concentrations , 1979, Diabetes Care.

[46]  D L McGee,et al.  Diabetes and Cardiovascular Risk Factors: The Framingham Study , 1979, Circulation.

[47]  M C Hjortland,et al.  High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. , 1977, The American journal of medicine.

[48]  M Marmot,et al.  Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Incidence of myocardial infarction and death from coronary heart disease. , 1977, The American journal of cardiology.

[49]  R. Worth,et al.  Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Coronary heart disease risk factors in Japan and Hawaii. , 1977, The American journal of cardiology.

[50]  S. Syme,et al.  Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: prevalence of coronary and hypertensive heart disease and associated risk factors. , 1975, American journal of epidemiology.

[51]  R. Frye,et al.  A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. , 1975, Circulation.

[52]  S. Syme,et al.  Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: demographic, physical, dietary and biochemical characteristics. , 1974, Journal of chronic diseases.

[53]  A. Keys CORONARY HEART DISEASE IN SEVEN COUNTRIES , 1971, The Medical journal of Australia.

[54]  H. Kunii,et al.  Lipoprotein(a) is a potential coronary risk factor. , 2000, Japanese circulation journal.

[55]  Ames,et al.  PREVENTION OF CORONARY HEART DISEASE WITH PRAVASTATIN IN MEN WITH HYPERCHOLESTEROLEMIA , 2000 .

[56]  武井泉,et al.  United Kingdom Prospective Diabetes Study (UKPDS) , 1999 .

[57]  K. Iseki,et al.  Relationship between serum cholesterol and the risk of acute myocardial infarction in a screened cohort in Okinawa, Japan. , 1998, Japanese circulation journal.

[58]  M. Laakso,et al.  Glycemic Control and the Risk for Coronary Heart Disease in Patients with Non-Insulin-dependent Diabetes Mellitus: The Finnish Studies , 1996, Annals of Internal Medicine.

[59]  A. Chait Pathogenesis of macrovascular disease in diabetes. , 1994 .

[60]  Y. Takeda,et al.  Multiple risk factors in coronary artery disease patients with abnormal glucose tolerance. , 1991, Japanese heart journal.

[61]  Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. , 1991, JAMA.

[62]  E. Barrett-Connor,et al.  Ischemic heart disease risk factors after age 50. , 1984, Journal of chronic diseases.

[63]  H. Kato,et al.  Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: incidence of stroke in Japan and Hawaii. , 1984, Stroke.