Role of hypertension, dyslipidemia and diabetes mellitus in the development of coronary atherosclerosis in Japan.

Masakazu Washio, S. Sasazuki, H. Kodama, Kouichi Yoshimasu, Ying Liu, Keitaro Tanaka, Shoji Tokunaga, Suminori Kono, Hidekazu Arai, Samon Koyanagi, K. Hiyamuta, Y. Doi, T. Kawano, Osamu Nakagaki, K. Takada, T. Nii, Kazuyuki Shirai, M. Ideishi, Kikuo Arakawa, M. Mohri, Akira Takeshita
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引用次数: 40

Abstract

The present study evaluated the effect of hypertension (HT), dyslipidemia and diabetes mellitus (DM) on the development of coronary atherosclerosis in the Japanese population, using a cross-sectional study of 433 patients (254 men and 179 women) aged 30 years or older who underwent coronary angiography for suspected or known coronary heart disease angina at 5 cardiology departments in the Fukuoka area between September 1996 and August 1997. Patients with a disease duration of 6 months or more were excluded. The main outcome measure was angiographically defined coronary artery stenosis and was found to a significant degree in 146 patients (33.7%). HT, DM, low levels of high-density lipoprotein cholesterol (HDL-C) and hypertriglyceridemia remained as significant coronary artery disease (CAD) risk factors even after controlling for age, sex, hospital, smoking, alcohol use, body mass index and leisure time physical activity. However, hypercholesterolemia was not a significant risk factor after adjusting for these variables. After controlling for these variables, DM, low HDL-C and hypertriglyceridemia were significant CAD risk factors for men, but only DM was a significant CAD risk factor in women. These results indicate that in Japan DM, low HDL-C and hypertriglyceridemia may be more important CAD risk factors than hypercholesterolemia.
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高血压、血脂异常和糖尿病在日本冠状动脉粥样硬化发展中的作用。
本研究评估了高血压(HT)、血脂异常和糖尿病(DM)对日本人群冠状动脉粥样硬化发展的影响,对433名30岁及以上的患者(254名男性和179名女性)进行了横断面研究,这些患者于1996年9月至1997年8月在福冈地区的5个心脏病科接受了冠状动脉造影,诊断为疑似或已知的冠心病心绞痛。病程6个月及以上的患者被排除在外。主要结局指标是血管造影确定的冠状动脉狭窄,146例(33.7%)患者发现冠状动脉狭窄程度显著。HT、DM、低水平高密度脂蛋白胆固醇(HDL-C)和高甘油三酯血症仍然是冠状动脉疾病(CAD)的重要危险因素,即使在控制了年龄、性别、医院、吸烟、饮酒、体重指数和闲暇时间体力活动之后。然而,在调整这些变量后,高胆固醇血症并不是显著的危险因素。在控制这些变量后,糖尿病、低HDL-C和高甘油三酯血症是男性显著的CAD危险因素,但只有糖尿病是女性显著的CAD危险因素。这些结果表明,在日本,低HDL-C和高甘油三酯血症可能是比高胆固醇血症更重要的CAD危险因素。
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