A18797 Lifetime Risk of Stroke and Coronary Heart Disease Death according to Blood Pressure Level: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan

Objectives: Lifetime risk (LTR) provides an absolute risk assessment during the remainder of life in individuals. However, few studies have assessed the LTRs of stroke and coronary heart disease (CHD) based on fine blood pressure categories in Asian populations. We aimed to assess these associations using a large database of a meta-analysis with the individual participant data in Japan. Methods: The present meta-analysis included 107,737 Japanese participants (42.4% men; mean age, 55.1 years) from 13 cohorts. Remaining sex-specific LTR of stroke and CHD death at 35, 45, 55, 65, and 75 years, were each estimated according to six blood pressure categories defined by the recent Guidelines. Results: During the mean follow-up of 15.2 years (1,559,136 person-years), 1,922 participants died from stroke and 913 from CHD. The LTRs of stroke death at 35 years (men/women) were 6.1%/4.8% for optimal blood pressure, 5.7%/6.3% for normal blood pressure, 6.6%/6.0% for high normal blood pressure, 9.1%/7.9% for Grade 1 hypertension, 14.5%/10.3% for Grade 2 hypertension, and 14.6%/14.3% for Grade 3 hypertension (Figure) although the corresponding 10-year risks at index age of 35 years were ≤1.9%. Such positive trends between LTRs and blood pressure were consistently observed irrespective of index ages but were clearer at younger index age than at older index age. The LTRs of CHD death similarly elevated with an increase in blood pressure, although they were one-half of those of stroke death (LTRs ≤7.2%). Conclusion: Blood pressure levels were strongly associated with an increase in the LTR of stroke or CHD death in this Asian population. These results would help young people with hypertension to adopt a healthy lifestyle or start antihypertensive therapy early.