Although a linear relationship between SBP and risk of coronary artery disease or cerebrovascular disease was observed regardless of GTS, this association in HF is little known. We analyzed data from a nationwide claims database from 20to 20on 589,621 individuals. A Cox proportional hazards model identified risks of HF among 5 levels of SBP according to GTS [i.e. normal glucose tolerance (NGT) , prediabetes, diabetes (DM) ]. Incidence of HF per 1,000 person-years was 0.for NGT, 0.18 for prediabetes, and 0.80 for DM. Compared with SBP <1mmHg, hazard ratios (HR) (95% CI) for HF in the 4 higher NGT levels (120-129, 130-139, 140-149, ≥150 mmHg) increased from 1.93 (1.30-2.85) in the second level to 8.66 (5.44-13.39) in the fifth level. For prediabetes or DM, HF risk was significantly increased in the ≥150 mmHg group compared with the ≤1mmHg group. Compared with NGT and SBP ≤1mmHg, prediabetes or DM patients with SBP ≤1mmHg had approximately 2-fold or 5-fold risks of HF, respectively (Table) . Association of SBP with HF differs according to GTS. BP control is essential in those with NGT. The impact of risk factors other than SBP, such as poor glycemic control and physical inactivity, on the development of HF may increase with worsening of glucose status, suggesting that comprehensive management of risk factors other than BP is essential in those with prediabetes and DM to prevent HF.
K.Fujihara: None. M.H.Yamada: None. M.Yamamoto: None. M.Oe: None. T.Osawa: None. M.Iwanaga: None. T.Yamada: None. S.Kodama: None. H.Sone: Research Support; Astellas Pharma Inc., Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Novo Nordisk, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Takeda Pharmaceutical Company Limited.