Shimamoto Kazuaki, Kita Toru, Mabuchi Hiroshi, Matsuzaki Masunori, Matsuzawa Yuji, Nakaya Noriaki, Oikawa Shinichi, Saito Yasushi, Sasaki Jun, Itakura Hiroshige
Sapporo Medical University School of Medicine, Sapporo, Japan.
Hypertens Res. 2007 Feb;30(2):119-23. doi: 10.1291/hypres.30.119.
Hyperlipidemia, hypertension, and diabetes mellitus (DM) are well-established risk factors for cardiovascular disease. We analyzed the cardiovascular events in hyperlipidemic patients with or without DM who were administered open-labeled simvastatin in groups stratified by blood pressure level using data from the Japan Lipid Intervention Trial (J-LIT). Hyperlipidemic patients with DM (n=6,288) had significantly more cardiovascular events than those without DM (n=33,933). The incidence rates of total cardiovascular events in the Non-DM and DM groups were 15.40 and 25.76 per 1,000 patients for the 6-year period, respectively. The relative risk of total cardiovascular events in the DM vs. the Non-DM group was 1.68, and the relative risk was significantly higher in the DM than in the Non-DM group. The relative risks of total cardiovascular events were significantly higher in DM and Non-DM patients whose systolic blood pressure (SBP) was greater than or equal to 130 mmHg compared to that of Non-DM patients whose SBP was less than 130 mmHg, and in DM and Non-DM patients whose diastolic blood pressure (DBP) was greater than or equal to 80 mmHg compared to that of Non-DM patients whose DBP was less than 80 mmHg. In all groups stratified by SBP and DBP, relative risks of total cardiovascular events were higher in DM patients than in Non-DM patients. For patients with hypercholesterolemia and DM, blood pressure should be strictly controlled in order to prevent both coronary events and stroke. These results are in good agreement with the JNC 7 and the ESH/ESC guidelines for DM patients, which recommended that the SBP and DBP be less than 130 and 80 mmHg, respectively.
高脂血症、高血压和糖尿病（DM）是公认的心血管疾病危险因素。我们使用日本脂质干预试验（J-LIT）的数据，分析了接受开放标签辛伐他汀治疗的合并或不合并DM的高脂血症患者按血压水平分层的心血管事件。合并DM的高脂血症患者（n = 6,288）的心血管事件明显多于不合并DM的患者（n = 33,933）。在6年期间，非DM组和DM组的总心血管事件发生率分别为每1000例患者15.40例和25.76例。DM组与非DM组总心血管事件的相对风险为1.68，DM组的相对风险显著高于非DM组。与收缩压（SBP）低于130 mmHg的非DM患者相比，SBP大于或等于130 mmHg的DM和非DM患者的总心血管事件相对风险显著更高；与舒张压（DBP）低于80 mmHg的非DM患者相比，DBP大于或等于80 mmHg的DM和非DM患者的总心血管事件相对风险显著更高。在所有按SBP和DBP分层的组中，DM患者的总心血管事件相对风险高于非DM患者。对于高胆固醇血症合并DM的患者，应严格控制血压以预防冠心病事件和中风。这些结果与JNC 7以及ESH/ESC针对DM患者的指南高度一致，后者建议SBP和DBP分别低于130 mmHg和80 mmHg。
