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  • Brief Communication
  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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New 2019 JSH guidelines and the risk of incident cardiovascular disease: The Suita Study

Hypertension Research volume 46, pages 583–588 (2023)Cite this article

A Comment to this article was published on 02 February 2023

Abstract

Hypertension is the most critical risk factor for cardiovascular disease (CVD). Since the definition of hypertension varies across guidelines, identifying blood pressure (BP) categories that should be targeted to prevent CVD is needed. Herein, we investigated the association between BP per the 2019 Japanese Society of Hypertension (JSH) guidelines and the risk of CVD, stroke, and coronary heart disease (CHD) using data from 7,643 participants (30–84 years) registered in the Suita Study. Within 113,838 person-years (16.6 median years of follow-up), 690 participants developed CVD (411 cases of stroke and 279 cases of CHD). Compared to normal BP (Systolic BP (SBP) < 120 and diastolic BP (DBP) < 80 mmHg), elevated BP (SBP 130–139 and/or DBP 80–89 mmHg) and hypertension (SBP ≥ 140 and/or DBP ≥ 90 mmHg) were associated with a higher risk of CVD, stroke, and CHD. High-normal BP (SBP 120–129 and DBP < 80 mmHg) was associated with a higher risk of CVD and CHD. In conclusion, CVD preventive interventions should begin at lower BP levels than those applied in the 2019 JSH guidelines.

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Data availability

Data are available upon reasonable request.

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Acknowledgements

We would like to thank the Suita Medical Association, the members of Suita City Health Center, the staff of the Preventive Cardiology and Preventive Healthcare Departments, and all cohort members.

Funding

This study was supported by Grants-in-Aid for Scientific Research in Japan (B, No. 16H05252), the Intramural Research Fund for cardiovascular diseases of the National Cerebral and Cardiovascular Center (20-4-9), the Japan Health Research Promotion Bureau (JH) (2019-(1)-1), the Japan Science and Technology Agency (JPMJPF2018), the Health and Labour Sciences Research Grants of the Ministry of Health, Labour and Welfare of Japan (20FA1002), and the Meiji Yasuda Research Institute and Life Insurance Company.

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Authors and Affiliations

  1. Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan

    Ahmed Arafa, Rena Kashima & Yoshihiro Kokubo

  2. Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

    Ahmed Arafa

  3. Department of Cardiovascular Pathophysiology and Therapeutics, Graduate School of Medicine, Osaka University, Suita, Japan

    Rena Kashima

Authors
  1. Ahmed Arafa
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  2. Rena Kashima
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  3. Yoshihiro Kokubo
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Contributions

AA wrote the main manuscript and performed the analysis. RK and YK were involved in the study design and data interpretation. All authors critically revised and commented on drafts before approving the final manuscript.

Corresponding author

Correspondence to Ahmed Arafa.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

The Institutional Review Board of the National Cerebral and Cardiovascular Center, Osaka, Japan approved the study protocol (R21024). This study was conducted according to the principles of the Declaration of Helsinki.

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Arafa, A., Kashima, R. & Kokubo, Y. New 2019 JSH guidelines and the risk of incident cardiovascular disease: The Suita Study. Hypertens Res 46, 583–588 (2023). https://doi.org/10.1038/s41440-022-01142-5

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