Relationship Between Blood Pressure Category and Incidence of Stroke and Myocardial Infarction in an Urban Japanese Population With and Without Chronic Kidney Disease

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Abstract
Background and Purpose—Chronic kidney disease (CKD) is increasingly recognized as an independent risk factor for stroke and myocardial infarction (MI). Few studies, however, have examined the relationship between blood pressure (BP) category and these diseases in subjects with and without CKD. Methods—We studied 5494 Japanese individuals (ages 30 to 79, without stroke or MI at baseline) who completed a baseline survey and received follow-up through December 2005. The glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease study equation modified by the Japanese coefficient. CKD was defined as an estimated GFR <60 mL/min/1.73m2. BP categories were defined by the European Society of Hypertension and European Society of Cardiology 2007 criteria. Results—In 64 395 person-years of follow-up, we documented 346 incidences of cardiovascular diseases (CVD; 213 strokes and 133 MI events). Compared with the GFR (≥90 mL/min/1.73m2) group, the hazard ratios (95% confidential inte...