Ambulatory blood pressure of adults in Ohasama, Japan.

Imai, Yutaka; Nagai, Kenichi; Sakuma, Masayoshi; Sakuma, Hiromichi; Nakatsuka, Haruo; Satoh, Hiroshi; Minami, Naoyoshi; Munakata, Masanori; Hashimoto, Junichiro; Yamagishi, Toshio

doi:10.1161/01.hyp.22.6.900

Cited by 173 publications

(124 citation statements)

References 35 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…14 Moreover, the number of individuals with non-dipper pattern BP increases with age. 15 In this study, we found a significant difference in age between the H and the L group; however, multivariate analysis demonstrated that age was not a significant determinant of sleep BP.…”

Section: Influential Factors In Circadian Bp Changescontrasting

confidence: 56%

Relationship between chronic kidney disease and sleep blood pressure in patients with sleep apnea syndrome

et al. 2010

View full text Add to dashboard Cite

Chronic kidney disease (CKD) is common disease in patients with sleep apnea syndrome (SAS), which is considered to be responsible for secondary and nocturnal hypertension. In this study, we assessed blood pressure (BP) changes in SAS patients with CKD. Of 460 Japanese outpatients with suspected SAS who underwent ambulatory BP monitoring within 3 months of overnight polysomnography, 198 patients (172 males and 26 females) who were not receiving treatment with antihypertensives or nitroglycerin were enrolled. The estimated glomerular filtration rate (eGFR) was calculated, and the patients were stratified into the high (H; eGFRX60 ml min À1 per 1.73 m 2 ) or the low (L; eGFRo60 ml min À1 per 1.73 m 2 ) group. The patients in the L group were significantly older than those in the H group (Po0.001), and body mass index was significantly smaller in the L group than in the H group (P¼0.025). The rate of patients treated with statin (P¼0.030) and the levels of both triglyceride (P¼0.006) and creatinine (Po0.001) differed significantly between the two groups. The sleep data, 24-h BP, awake BP and morning BP showed no significant differences between the two groups. However, sleep systolic and diastolic BPs were significantly higher in the L group (122.5±16.7 mm Hg and 81.1±12.2 mm Hg, respectively) than in the H group (117.1±11.8 mm Hg, P¼0.033; and 76.1±9.5 mm Hg, P¼0.012, respectively). SAS patients with CKD had elevated sleep BP. This result suggests that appropriate treatments for both SAS and CKD prevent sleep BP elevation, which is considered a risk factor for the onset risk of a cardiovascular event. Keywords: ambulatory blood pressure monitoring; circadian blood pressure; estimated glomerular filtration rate; nocturnal hypertension; polysomnography INTRODUCTIONIt is important to consider blood pressure (BP) outside of a clinic setting when treating patients with hypertension, because BP measurements obtained in a clinic setting are not representative of BP outside of the clinic setting. Abnormal changes in circadian BP are considered to increase the risk of cardiovascular event. Patients with nocturnal hypertension or a morning BP surge tend to have a higher incidence of silent cerebrovascular disease 1 and greater intima-media and relative wall thickness compared with normotensive patients. 2 Nocturnal hypertension and morning BP surge are induced by sleep disordered breathing, which can be observed in 22% of Japanese adult males. 3 Typical clinical features of BP changes in patients with sleep disordered breathing and those with sleep apnea syndrome (SAS) are nocturnal hypertension and non-dipper patterns of circadian BP. As the severity of SAS increases, sleep BP is elevated even in a patient whose BP is within the normal range in the clinic. Moreover, the incidence of nocturnal cardiovascular events while sleeping increases in these patients. [4][5][6] Chronic kidney disease (CKD) seems to be tightly linked with nocturnal hypertension and morning BP surge. 7 CKD poses a high risk for the onset of cardiovascu...

show abstract

Section: Influential Factors In Circadian Bp Changescontrasting

confidence: 56%

Relationship between chronic kidney disease and sleep blood pressure in patients with sleep apnea syndrome

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Conventional BP was measured by trained observers with a mercury sphygmomanometer, 13,14,[17][18][19][20] or with validated auscultatory 21,22 (USM-700F, UEDA Electronic Works, Tokyo, Japan) 15 or oscillometric (OMRON HEM-705CP, Omron Corporation, Tokyo, Japan) 16 devices, using the appropriate cuff size, with participants in the sitting [13][14][15][16][17]19,20 or supine 14 position. Conventional BP was the average of two consecutive readings obtained either at the person's home, 14,16,17,19,20 or at an examination center.…”

Section: Measurementsmentioning

confidence: 99%

Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations

Sehestedt

Hansen

et al. 2011

Hypertens Res

View full text Add to dashboard Cite

It remains unknown whether diabetes and high blood pressure (BP) are simply additive risk factors for cardiovascular outcome or whether they act synergistically and potentiate one another. We performed 24-h ambulatory BP monitoring in 8494 subjects (mean age, 54.6 years; 47.0% women; 6.9% diabetic patients) enrolled in prospective population studies in 10 countries. In multivariable-adjusted Cox regression, we assessed the additive as opposed to the synergistic effects of BP and diabetes in relation to a composite cardiovascular endpoint by testing the significance of appropriate interaction terms. During 10.6 years (median follow-up), 1066 participants had a cardiovascular complication. Diabetes mellitus as well as the 24-h ambulatory BP were independent and powerful predictors of the composite cardiovascular endpoint. However, there was no synergistic interaction between diabetes and 24-h, daytime, or nighttime, systolic or diastolic ambulatory BP (P for interaction, 0.07pPp0.97). The only exception was a borderline synergistic effect between diabetes and daytime diastolic BP in relation to the composite cardiovascular endpoint (P¼0.04). In diabetic patients, with normotension as the reference group, the adjusted hazard ratios for the cardiovascular endpoint were 1.35 (95% confidence interval (CI), 0.87-2.11) for white-coat hypertension, 1.78 (95% CI, 1.22-2.60) for masked hypertension and 2.44 (95% CI, 1.92-3.11) for sustained hypertension. The hazard ratios for non-diabetic subjects were not different from those of diabetic patients (P-values for interaction, 0.09pPp0.72).In conclusion, in a large international population-based database, both diabetes mellitus and BP contributed equally to the risk of cardiovascular complications without evidence for a synergistic effect.

show abstract

“…To our knowledge, such reference values were derived only from the Ohasama Study in Japan. 14,15 Based on this study, it is suggested that an ambulatory BP у135/80 mm Hg is defined as hypertension. The lowest relative hazard is observed with a 24-h ambulatory BP level of 111-117 mm Hg systolic and Ͻ68 mm Hg diastolic.…”

Section: Discussionmentioning

confidence: 93%

Differential effects of antihypertensive drugs with differing pharmacological properties on the basal ambulatory blood pressure

1998

Self Cite

View full text Add to dashboard Cite

Ambulatory blood pressure of adults in Ohasama, Japan.

Abstract: We performed a cross-sectional study in a small town in northern Japan to evaluate the distribution, reference values, and daily variation in ambulatory blood pressure. A total of 705 subjects (

Cited by 173 publications

References 35 publications

Relationship between chronic kidney disease and sleep blood pressure in patients with sleep apnea syndrome

Relationship between chronic kidney disease and sleep blood pressure in patients with sleep apnea syndrome

Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations

Differential effects of antihypertensive drugs with differing pharmacological properties on the basal ambulatory blood pressure

Contact Info

Product

Resources

About