Objectives
This study aimed to clarify the relationship between the white blood cell (WBC) count and hypertension in the general Japanese population.
Methods
We conducted a population-based retrospective cohort study using annual health check-up data of residents of Iki City, Nagasaki Prefecture, Japan. A total of 2935 participants without hypertension at baseline were included in the present analysis. WBC counts were classified as tertile 1 (<4700/μL), tertile 2 (4700–5999/μL), and tertile 3 (≥6000/μL). The outcome was incident hypertension (blood pressure ≥140 mmHg). Multivariable-adjusted hazard ratios and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazards model.
Result
During an average follow-up of 4.5 years, 908 participants developed hypertension. The incidence (per 100 person-years) of hypertension increased with an elevation in the WBC count (6.3 in tertile 1, 7.0 in tertile 2, and 7.4 in tertile 3). This association was significant, even after adjustment for other risk factors, including age, sex, current smoking habits, current alcohol intake, exercise habits, obesity, elevated blood pressure, diabetes mellitus, and dyslipidemia. The hazard ratios were 1.07 for tertile 2 (95% CI 0.90–1.26) and 1.27 for tertile 3 (95% CI 1.06–1.51) compared with the reference group of tertile 1 (p = 0.009).
Conclusion
The WBC count was associated with future development of hypertension in the general Japanese population.
Background
This large‐scale observational study on negative events in a real‐world setting investigated Japanese patients with atrial fibrillation who were not on anticoagulants. This study aims to evaluate the incidence of ischemic stroke and bleeding events (intracranial hemorrhage, gastrointestinal bleeding, others) based on
CHA
2
DS
2‐
VAS
c scores in Japanese patients with atrial fibrillation who were not anticoagulated.
Methods and Results
We used health checkups and insurance claim data from a Japanese insurance organization. Altogether, 9733 atrial fibrillation patients were not prescribed anticoagulation during their follow‐up periods. Patients’ risk levels were defined by their
CHA
2
DS
2‐
VAS
c scores (range 0–≥3): Men with scores of 0, 1, or ≥2 and women with scores of 1, 2, or ≥3 were considered at low, intermediate, or high risk, respectively. Cox proportional hazards model was used to assess the association between the
CHA
2
DS
2‐
VAS
c‐determined risk and the incidence of ischemic stroke and intracranial, gastrointestinal, and other bleeding. The mean 2.5‐year follow‐up revealed 143 ischemic strokes and 332 bleeding events. Annual event rates were 0.58% for ischemic stroke and 1.17% for total bleeding events. Annual incidence of ischemic stroke increased with elevated predicted risks based on
CHA
2
DS
2‐
VAS
c scores: 0.18% for low‐risk, 0.44% intermediate‐risk, and 1.29% high‐risk groups (
P
<0.001 for trend). Annual incidences of total bleeding also increased with elevated predicted risks: 0.51% for low‐risk, 1.28% intermediate‐risk, and 2.02% high‐risk groups (
P
<0.001 for trend).
Conclusions
Risks of ischemic stroke and bleeding events were high, particularly among those with high
CHA
2
DS
2‐
VAS
c scores.
Introduction: Both body mass index (BMI) and waist circumference (WC) are associated with diabetes risk, and the difference between them in predictive ability for diabetes is still contentious. We conducted a population-based study to investigate and compare the association of them with diabetes by sex. Methods: This study included a total of 4754 subjects aged 40-80 years with no diabetes at baseline between 2008 and 2017. Using multivariate Cox proportional hazards models, we calculated hazard ratios for diabetes according to tertiles of BMI or WC. Harrell's C statistics was applied to assess and compare the predictive ability of the models using BMI and WC. Results: Both BMI and WC showed the significant positive trends with diabetes risk. In men, the extreme tertiles (BMI [ 25.1 kg/m 2 and WC [ 88.0 cm) provided 1.58-fold or 2.04-fold higher risk compared with the first tertiles (\ 22.6 kg/m 2 and \ 81.2 cm). In women, BMI [ 24.4 kg/m 2 showed 3.28-fold higher risk than the first tertile (\ 21.6 kg/m 2 ), whereas WC C 78.2 cm was more than twice as likely to suffer from diabetes as WC \ 78.2 cm. BMI and WC showed a comparative performance in predicting diabetes in both sexes (P value 0.447 in men, and 0.337 in women).
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