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. 2025 Feb;48(2):632-639.
doi: 10.1038/s41440-024-01902-5. Epub 2024 Sep 19.

Achievement of guideline-recommended target blood pressure is associated with reducing the risk of hemorrhagic and ischemic stroke in Japanese coronary artery disease patients -the CLIDAS study

Yusuke Oba  1 , Tomoyuki Kabutoya  2 , Takahide Kohro  3 , Yasushi Imai  4 , Kazuomi Kario  1 , Hisahiko Sato  5 , Kotaro Nochioka  6 , Masaharu Nakayama  7 , Naoyuki Akashi  8 , Hideo Fujita  8 , Yoshiko Mizuno  9   10 , Arihiro Kiyosue  11 , Takamasa Iwai  12 , Yoshihiro Miyamoto  13 , Yasuhiro Nakano  14 , Masanobu Ishii  15   16 , Taishi Nakamura  16 , Kenichi Tsujita  15 , Tetsuya Matoba  14 , Ryozo Nagai  17 ; CLIDAS research group
Affiliations

Achievement of guideline-recommended target blood pressure is associated with reducing the risk of hemorrhagic and ischemic stroke in Japanese coronary artery disease patients -the CLIDAS study

Yusuke Oba et al. Hypertens Res. 2025 Feb.

Abstract

The Japanese Society of Hypertension have established a blood pressure (BP) target of 130/80 mmHg for patients with coronary artery disease (CAD). We evaluated the data of 8793 CAD patients in the Clinical Deep Data Accumulation System database who underwent cardiac catheterization at six university hospitals and the National Cerebral and Cardiovascular Center (average age 70 ± 11 years, 78% male, 43% with acute coronary syndrome [ACS]). Patients were divided into two groups based on whether or not they achieved the guideline-recommended BP of <130/80 mmHg. We analyzed the relationship between BP classification and major adverse cardiac and cerebral event (MACCE) separately in two groups: those with ACS and those with chronic coronary syndrome (CCS). During an average follow-up period of 33 months, 710 MACCEs occurred. A BP below 130/80 mmHg was associated with fewer MACCEs in both the overall (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-1.00, p = 0.048) and the ACS group (HR 0.67, 95%CI 0.51-0.88, p = 0.003). In particular, stroke events were also lower among those with a BP below 130/80 mmHg in both the overall (HR 0.69, 95%CI 0.53-0.90, p = 0.006) and ACS groups (HR 0.44, 95%CI 0.30-0.67, p < 0.001). In conclusion, the achievement of BP guidelines was associated with improved outcomes in CAD patients, particularly in reducing stroke risk among those with ACS.

Keywords: Blood pressure; Coronary artery disease; Guideline; Stroke.

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Conflict of interest statement

Compliance with ethical standards. Conflict of interest: T. Kabutoya. received scholarship funds from Abbott Medical. KK received research grants and honoraria from Sanwa Kagaku Kenkyusho. HS reports stock or stock options in Precision. HF received consulting fees from Mehergen Group Holdings; and honoraria from Novartis Pharma and Otsuka Pharmaceutical. AK received honoraria from AstraZeneca, Eli Lilly, and Sumitomo Pharma. KT received research grants from PPD-Shin Nippon Biomedical Laboratories and Alexion Pharmaceuticals; and scholarship funds from Abbott Medical, Bayer, Boehringer Ingelheim, Daiichi Sankyo, ITI, Ono Pharmaceutical, Otsuka Pharmaceutical, and Takeda Pharmaceutical; affiliation with the endowed department from Abbott Medical, Boston Scientific, Cardinal Health, Fides-ONE, Fukuda Denshi, GM Medical, ITI, Japan Lifeline, Kaneka Medix, Medical Appliance, Medtronic, Nipro, and Terumo; and honoraria from Abbott Medical, Amgen, AstraZeneca, Bayer, Daiichi Sankyo, Medtronic, Kowa, Novartis Pharma, Otsuka Pharmaceutical, Pfizer, and Janssen Pharmaceutical. TM received research grants from Amgen and honoraria from Abbott Medical and Bayer. All other authors have no conflicts of interest to declare. IRB Information: This study was approved by the ethics committee of the Jichi Medical University School of Medicine (approval number: 14–113).

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