Impact of elevated blood pressure on mortality from all causes, cardiovascular diseases, heart disease and stroke among Japanese

Purpose: To clarify the relationship between blood pressure and mortality from stroke, heart disease, cardiovascular diseases and all causes of death among representative population of Japanese and to estimate category specific excess mortality from stroke due to SBP.Methods: In 1994, 14 year-follow-up cohort study was conducted among participants of national survey on cardiovascular diseases in 1980, randomly selected from Japanese population.Restults: Total observed person years were 54714 for men and 71481 for women. During follow-up 1327 deaths was observed and underlying causes of deaths were identified for 99.5% of deaths using national vital statistics data. Both SBP and DBP were significantly related to mortality from strokes, cardiovascular diseases and all causes of death for both sexes (p<0.001). Heart disease mortality was significantly related to SBP and DBP among men (p<0.05) while not among women.Increased mortality rate from stroke was observed with high blood pressure for all ages. Estimated excess mortality was 67% for men and 46% for women and chiefly observed among moderate hypertensives (27 % for men and 15% for women).Conclusion: High blood pressure was a risk factor for mortality from all causes as well as those from cardiovascular diseases, stroke and heart disease among Japanese. Since major part of excess mortality was due to mild hypertension, population strategy to reduce blood pressure should be encouraged.