Relationship between achieved blood pressure, dietary habits and cardiovascular disease in hypertensive patients treated with olmesartan: the OMEGA study

Abstract

We investigated the relationship between cardiovascular disease (CVD) and the achieved blood pressure, dietary habits and the presence/absence of metabolic syndrome (MetS) in hypertensive patients treated with olmesartan medoxomil. A prospective cohort study with a 3-year follow-up was conducted in 14 721 olmesartan-naive outpatients (mean age: 64.9 years, 49.6% women) with essential hypertension. The association of CVD with achieved blood pressure, dietary habits and MetS was investigated by Cox proportional hazards analysis. There were 3059 patients (31.8%) with MetS (Japanese criteria) among 9625 evaluable patients. The mean baseline blood pressure was 157.4/88.8 mm Hg, which decreased to 134.0/76.1 mm Hg during treatment (P<0.0001). The annual incidence of CVD was 7.15 per 1000 persons during the study period. When the achieved blood pressure was stratified according to the Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009), the risk of CVD increased significantly along with the severity of hypertension (P<0.0001), especially the risk of stroke. Investigation of dietary habits revealed a significant association between salt intake and the risk of stroke. Higher salt intake was associated with a significantly higher risk of stroke than lower salt intake (hazard ratio, 1.897; 95% confidence interval, 1.003–3.590). Blood pressure was well controlled in both patients with and without MetS, and there was no significant difference in the incidence of events between the two groups. In conclusion, the severity of hypertension (achieved blood pressure) is associated with the incidence of CVD, and the results of this study suggest that tight blood pressure control and salt restriction are important for preventing stroke.

Dynamic prediction model and risk assessment chart for cardiovascular disease based on on-treatment blood pressure and baseline risk factors

“…Using data from the Olmesartan Mega study to determine the relationship between Cardiovascular Endpoints and Blood pressure Goal Achievement (OMEGA) study, 4 a post-marketing study for the angiotensin receptor blocker olmesartan, we previously evaluated the association between achieved BP and CVD with the aim of identifying baseline risk factors. 5 In this analysis, we developed a risk prediction model for CVD using baseline risk factors and the BP reported during the study. At present, few absolute risk assessment charts for hypertensive patients have been developed, and no chart using on-treatment BP is available.…”

The implications of blood pressure targets from the 2018 European Society of Cardiology hypertension guidelines in Asian patients: a systematic review and meta-analysis

“…The comprehensive search identified 15 studies, out of which 4 studies were RCTs, 7 studies were observational, and the remaining 4 studies were post-hoc analyses of RCTs (Table 1). [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] The meta-analysis flow diagram is depicted in Figure 1. In one RCT with dual intervention, patients were randomized to follow strict or standard BP targets and to receive angiotensin converting enzyme inhibitors, angiotensin receptor blockers, or calcium channel blockers.…”

“…Asayama et al 2012 25 Fan et al 2017 26 JATOS 2008 27 Kamishima et al 2019 28 Kario et al 2014 29 Lee et al 2017 30 Lee et al 2018 31 Ogihara et al 2009 32,33 Ogihara et al 2010 34 Teramoto 2012 35 Wan et al 2018 36 Wei et al 2013 37 Yamashita 2013 38 Yamazaki et al 2013 39 Zheng et al 2015 40 The table represents only the study characteristics for which data were available from the majority of reports.…”

Biomarkers for Chronic Kidney Disease Associated with High Salt Intake

“…BP elevation increases the risk of cardiovascular and cerebrovascular morbidity and mortality [ 15 , 16 ]. In addition to its effects on BP, salt intake per se accelerates target organ damages, leading to cardiovascular [ 17 , 18 ] and cerebrovascular [ 19 ] diseases. Renal damage is also induced by a high-salt diet, independent of BP.…”