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Hypertension and lifetime risk of stroke

Turin, Tanvir Chowdhurya,b; Okamura, Tomonoric; Afzal, Arfan Raheena; Rumana, Nahidd; Watanabe, Makotob; Higashiyama, Ayae; Nakao, Yokoe; Nakai, Michikazuf; Takegami, Misae; Nishimura, Kunihiroe,f; Kokubo, Yoshihirob; Okayama, Akirag; Miyamoto, Yoshihirob,e,f

doi: 10.1097/HJH.0000000000000753

Background: The lifetime risk (LTR) articulates the probability of disease in the residual lifetime for an index age. These estimates can be useful for general audience-targeted knowledge translation activities against hypertension. There are only a few reports on lifetime of impact of hypertension on stroke events in Asians in whom stroke incidence is higher than Westerners.

Methods: The Suita Study, a cohort study of cardiovascular diseases in Japan, was established in 1989. We included all participants who were stroke free at baseline. Age (in years) was used as the time scale. Age-specific incidence rates were calculated with person-year method within 10-year bands. We estimated the sex and index-age specific LTR of first-ever stroke with taking the competing risk of death into account.

Results: We followed 5783 men and women during 1989–2007 for 74 933 person-years. During the follow-up period, 276 (149 men and 127 women) participants had incident stroke. Of them, majority were cerebral infarction; 166 (102 men and 64 women). The LTR of stroke, accounted for competing risk of death, at 45 years of age for men without hypertension was 17.21% and it was 32.79% for hypertensive men. Among the hypertensive patients, participants with stage 2 or greater hypertension had higher LTR of stroke than the participants with stage 1 hypertension. This increased LTR of stroke for hypertensive patients were also observed among women and across all index ages for stroke.

Conclusion: In this urban community-based population, we observed that hypertension has significant effect on the residual LTR of stroke among both men and women of middle age, specifically for ischemic stroke.

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aDepartment of Family Medicine, University of Calgary, Calgary, Alberta, Canada

bDepartment of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan

cDepartment of Preventive Medicine and Public Health, Keio University, Tokyo, Japan

dSleep Center, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada

eDepartment of Preventive Medicine and Epidemiologic Informatics

fCenter for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka

gResearch Institute of Strategy for Prevention, Tokyo, Japan

Correspondence to Tanvir Chowdhury Turin, MD, MSc, PhD, Department of Family Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, Canada. Tel: +1 403 210 7199; e-mail:

Abbreviations: BP, blood pressure; LTR, lifetime risk

Received 11 July, 2015

Revised 14 August, 2015

Accepted 14 August, 2015

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