2015 年 22 巻 1 号 p. 62-75
Aim: The aim of this analysis was to investigate the relationships between dyslipidemia, achieved blood pressure (BP) values and the lipid levels, as well as the control of four cardiovascular risk factors (BP, low-density lipoprotein: LDL cholesterol, hemoglobin A1c: HbA1c and smoking) and the incidence of cardiovascular disease (CVD), in Japanese patients receiving antihypertensive therapy.
Methods: A total of 13,052 patients with no history of CVD were included in this subanalysis of the prospective observational OMEGA study in Japanese hypertensive patients treated with olmesartan. Multivariable Cox regression models were used to evaluate the relationship with the risk of CVD.
Results: The incidence of CVD during the 36-month study period was 5.59/1,000 patient-years among the patients with dyslipidemia (n=6,297) and 5.57/1,000 patient-years among the patients without dyslipidemia (n=6,755), with no significant differences between the two groups. Higher achieved BP values tended to be associated with an increased CVD risk in both the patients with and without dyslipidemia. In addition, the risk of CVD tended to be higher in the patients with an achieved LDL cholesterol level of ≥120 mg/dL than in those with an LDL level of ＜120 mg/dL (trend p=0.0005) and in the patients with an achieved high-density lipoprotein cholesterol level of ＜60 mg/dL than in those with an HDL level of ≥60 mg/dL (trend p=0.0017). Furthermore, the risk of CVD was higher among the patients with fewer controlled risk factors than among those with control of all four risk factors (trend p＜0.0001).
Conclusions: In order to prevent CVD in olmesartan-treated hypertensive patients with no history of CVD, it is important to control both the lipid and BP levels and aim for comprehensive risk factor control.