title: Influence of coronary risk factors on coronary events in Japanese high-risk hypertensive patients. - Primary and secondary prevention of ischemic heart disease in a subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial-.
abstract: BACKGROUND
  The Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial was conducted to compare the effects of candesartan and amlodipine on cardiovascular events in Japanese high-risk hypertensive patients. The aim of the present subanalysis was to evaluate the influence of coronary risk factors on coronary events in these patients as an observational study irrespective of allocated drugs.
  
  
  RESULTS
  The adjusted hazard ratios (HRs) of the association of baseline risk factors including gender, age, allocated drugs, body mass index, systolic/diastolic blood pressure (SBP/DBP), diabetes mellitus (DM), hyperlipidemia (HL), smoking, left ventricular hypertrophy, previous ischemic heart disease (IHD), previous cerebrovascular events, and chronic kidney disease (CKD) with coronary events in 4,703 patients who were enrolled in the CASE-J trial, were examined. The coronary events occurred in 83 patients, and were significantly associated with previous IHD, DM, male sex, CKD, and low DBP. Significant predictors were previous IHD (HR, 3.89), DM (HR, 3.10), male sex (HR, 1.81), CKD (HR, 1.60), and low DBP (HR, 1.36), respectively. In 4,107 patients without previous IHD, DM (HR, 4.88), HL (HR, 2.67), and DBP (HR, 1.39) were significantly associated with the risk of coronary events, while male sex (HR, 3.03), CKD (HR, 2.44), and DM (HR, 2.15) were in 596 patients with previous IHD.
  
  
  CONCLUSIONS
  DM is the important factor in both primary and secondary prevention of coronary events. Comprehensive risk management including surveillance of DM, CKD and HL is needed for preventing coronary events, in addition to blood pressure control.
authors.affiliation: EBM Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan. kenji.ueshima@at3.ecs.kyoto-u.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Ueshima
authors.forename: Koji
authors.initials: K
authors.lastname: Oba
authors.forename: Shinji
authors.initials: S
authors.lastname: Yasuno
authors.forename: Akira
authors.initials: A
authors.lastname: Fujimoto
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.forename: Toshio
authors.initials: T
authors.lastname: Ogihara
authors.forename: Takao
authors.initials: T
authors.lastname: Saruta
authors.forename: Kazuwa
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents; D044466:Asian People; D001562:Benzimidazoles / Q000627:therapeutic use; D001713:Biphenyl Compounds; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000517:prevention & control*; D019370:Observation; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D013777:Tetrazoles / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; D017311:Amlodipine; C081643:candesartan