Background-Information has been sparse on the comparison of 4 blood pressure (BP) indexes (systolic BP [SBP], diastolic BP, pulse pressure, and mean BP [MBP]) in relation to long-term incidence of stroke and myocardial infarction, particularly in middle-aged and older Asians. Methods and Results-The Japan Arteriosclerosis Longitudinal Study Group conducted a meta-analysis of 16 cohort studies in Japan. A total of 48 224 men and women 40 to 89 years of age participated at baseline, and 1231 stroke events and 220 myocardial infarction events occurred during an average 8.4-year follow-up. Multivariate-adjusted hazard ratios with a 1-SD higher value for each BP index were determined by Poisson regression. Analyses were also done in 4 age-sex groups. All 4 BP indexes were significantly related to all stroke risk. Stroke risk was most strongly related to MBP and SBP in both sexes and most weakly related to pulse pressure. Both stroke subtypes, ischemic and hemorrhagic, were most strongly related to MBP and SBP in both sexes. In addition, in men and women 70 to 89 years of age, MBP or SBP showed the strongest relation to all stroke risk. Myocardial infarction risk was most strongly related to SBP or MBP in both sexes. For any end points in any age-sex groups, pulse pressure was not the strongest predictor. Conclusions-The long-term incident risk of stroke and myocardial infarction associated with high BP in East Asian populations should be assessed mainly on the basis of SBP. MBP also may be an important predictor, but pulse pressure is a less important predictor for cardiovascular disease risk.

Cilnidipine has a blocking action against N-type calcium channels as well as L-type calcium channels. We studied the effect of morning and bedtime dosing on circadian variation of blood pressure (BP), heart rate (HR), and activity of the autonomic nervous system, using an open randomized crossover study in 13 essential hypertensive patients. An automated device allowed 24-hour monitoring of ambulatory BP and HR and the power spectrum of the R-R interval, at the observation period, the morning dosing regimen, and the bedtime dosing regimen. Morning dosing and bedtime dosing with cilnidipine reduced the average systolic BP over 24 hours, during daytime, and during nighttime. The average HR and the average LF/HF ratio over 24 hours, during daytime, and during nighttime, were similar for the three periods. Both morning and bedtime dosing reduced the maximum systolic BP in the early morning and suppressed the morning rise of BP, which were accompanied by partial inhibition of the increase in LF/HF ratio. Our results show that cilnidipine administered once daily is an efficient antihypertensive drug regardless of the time of dosing, without reflex tachycardia and increase in sympathetic nervous activity, and with partial inhibition of the morning activation of the sympathetic nervous system.

Epidemiological studies indicated that erectile dysfunction (ED) is more frequent and their quality of life (QOL) is deteriorated in patients with essential hypertension as compared with normotensive subjects. Since both ED and hypertension influence QOL, it is not clear which malady has a more serious influence on QOL. We conducted a case control study to investigate incidence and impact of ED on QOL. In 102 patients aged 40 to 59 under treatment for hypertension (Hypertensive group) and in 245 age-matched normal subjects (Control group), QOL and ED were assessed by SF-36 and IIEF5. Criteria for presence of ED is IIEF5 score less than 12. Age adjusted incidence of ED in Hypertension group was higher than that in Control Group (odds ratio 1.7, P < .05). Multivariate logistic regression analysis showed hypertension was related only to a low score in general health, ED was related to low scores in physical, mental health, emotional, vitality, and general health. These data suggest that the influence of ED on QOL is more serious than hypertension in middle age men.

Oral PO is a safe, easy to use and effective antispasmodic for DCBM.

Although serum uric acid (UA) levels are usually lower in females than in males, and the incidence of metabolic syndrome (Mets) is also lower in females, several studies have suggested a closer association between the serum UA levels and the onset of Mets in females than in males [1][2][3]. Interestingly enough, despite the lower incidence of coronary artery disease (CAD) throughout the life in females than in males, it has been shown that the serum UA level contributes to a greater degree to the onset of CAD, its prognosis [4][5][6][7][8], and the progression of coronary atherosclerosis [9,10] in females than in males. Furthermore, post-menopause, increased serum UA levels are strongly associated with the development of atherosclerosis with age [11].

Background and aim: Higher fish consumption has been reported to be associated with a lower incidence of coronary artery disease (CAD). We hypothesized that higher fish intake may be associated with lower serum level of non-high-density lipoprotein cholesterol (non-HDL-C) levels, representing the entire dyslipidemia spectrum, and a healthy lifestyle. Methods and results: This cross-sectional study was conducted in a population of 1270 apparently healthy males over the age of 50 years without lipid-modifying therapy at the Health Planning Center of Nihon University Hospital between April and August 2018. The average number of days of fish intake per week was 2.6 AE 1.4. We performed analysis of variance using fish consumption as a categorical variable (0e1 day, 2e3 days, 4e5 days, or 6e7 days per week). The serum non-HDL-C levels in the 6e7 days fish intake group were significantly lower than those in the 0e1 and 2e3days fish intake groups. Furthermore, with increasing frequency of fish intake per week, the proportion of subjects with cigarette smoking decreased (p Z 0.026), that of subjects engaging in habitual aerobic exercises increased (p Z 0.034), and the sleep duration of the subjects increased (p < 0.0001). Conclusions: These results suggest that a high frequency of fish intake, that is a fish intake of 6e7 days per week, was associated with healthier lifestyle behaviours as well as lower non-HDL-C levels, and thus may represent a component of a healthy lifestyle associated with a lower risk of CAD in Japanese males over the age of 50. Clinical trial registration: UMIN (http://www.umin.ac.jp/). Study ID: UMIN000035899.

SummaryWe investigated the relationships between the ratio of serum n-3 polyunsaturated fatty acids (n-3PUFAs: eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) to n-6PUFA (arachidonic acid [AA]) and the prevalence of coronary artery disease (CAD), and assessed the association of the ratio of serum n-3 to n-6 PUFAs with atherosclerosis-related markers.This study was designed as a hospital-based cross-sectional study of 649 consecutive outpatients who had undergone regular examinations between April 2009 and October 2009. We divided the patients into 5 groups based on the quintiles of the EPA/AA ratio or quintiles of the DHA/AA ratio to determine independent factors for the prevalence of CAD.In multivariate logistic regression analyses after adjustment for coronary risk factors and serum n-3PUFAs levels to minimize confounding factors to the extent possible because the serum levels of EPA and DHA showed a strong correlation (r = 0.812, P < 0.0001), the group with the highest EPA/AA ratio had a lower probability of CAD prevalence (odds ratio: 0.328, 95% confidence interval: 0.113 to 0.956, P = 0.041), but this was not true for the DHA/AA ratio. Multivariate analysis showed an increase in the EPA/AA ratio, but not in the DHA/AA ratio, was associated with effects on atherosclerosis-related markers, especially triglyceride-rich lipoproteins, high-density lipoprotein cholesterol (HDL-C) containing apolipoprotein A-1, and leukocyte count in an anti-atherogenic direction.The results suggest a higher EPA/AA ratio, but not a higher DHA/AA ratio, might be associated with a lower prevalence of CAD and improvements of triglyceride metabolism and HDL metabolism, and systemic inflammation. (Int Heart J 2015; 56: 260-268)

No abstract