Hypertension and cerebrovascular disease - the Japanese experience

Omae, Teruo; Ueda, Kazuo

doi:10.1097/00004872-198805000-00002

Cited by 37 publications

(22 citation statements)

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“…36,37 However, based on the results of the multiple logistic analysis, the effect of hypertension on the occurrence of stroke (Table 4) was much stronger than any other variables. 38 In the present study, low serum cholesterol was not significantly associated with an increased occurrence of cerebral hemorrhage in women. The adjusted odds ratio for cerebral hemorrhage in women was larger than 1.00 except for the highest quartile of cholesterol level, and the odds ratio of the highest quartile was not significant.…”

Section: Study Limitationscontrasting

confidence: 53%

Low Serum Cholesterol as a Risk Factor for Hemorrhagic Stroke in Men

et al. 1999

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Section: Study Limitationscontrasting

confidence: 53%

Low Serum Cholesterol as a Risk Factor for Hemorrhagic Stroke in Men

et al. 1999

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“…The relative risk of stroke in hypertensive subjects decreases with age, although the absolute risk for stroke is high in elderly hypertensive subjects. 1,19 In the Hisayama Study, the relative risk for stroke mortality was 10-fold higher in hypertensive subjects aged Ͻ60 years than normotensive subjects of similar age, but it was 3-fold higher in hypertensive subjects aged Ն60 years. 19 The mean age of our patients was 71 years, which was higher than that in other studies investigating the risk of higher BP for stroke.…”

Section: Discussionmentioning

confidence: 98%

“…[5][6][7][8][9] Detection and treatment of hypertension are routinely performed, and the age-adjusted mortality risk for stroke has decreased markedly in many countries, including Japan. 1,2,11 However, the efficiency of hypertension treatment still seems insufficient. According to the 1991-1994 US National Health and Nutrition Examination Survey, the percentages for treatment and control (Ͻ140/ 90 mm Hg) of hypertension were 54% and 27%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Hypertension is the most powerful risk factor of stroke, and higher levels of systolic and diastolic blood pressure (BP) have been associated with an increased incidence of ischemic and hemorrhagic stroke in people of all ages and both sexes. [1][2][3][4][5] Many intervention studies have demonstrated that antihypertensive therapy effectively reduces morbidity and mortality of stroke in hypertensive subjects, including elderly patients with isolated systolic hypertension. [5][6][7][8][9] Therefore, there is no doubt that control of hypertension is particularly important for the prevention of stroke.…”

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confidence: 99%

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Risk of Stroke in Relation to Level of Blood Pressure and Other Risk Factors in Treated Hypertensive Patients

Makino

Kawano

Minami

et al. 2000

Stroke

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Background and Purpose-Treatment of hypertension effectively reduces the risk of stroke. However, many treated patients still have high blood pressure (BP), other cardiovascular risk factors, and complications. The risk of stroke in treated hypertensive patients is not well understood. Methods-We analyzed the level of BP over 1 year before the onset of stroke and other cardiovascular risk factors in treated hypertensive patients in a case-control study. The study population included 126 hypertensive patients (74 men; mean age, 70.9 years) with first strokes during 1988 -1993 who had been treated for Ͼ1 year before stroke onset (stroke group). As a control group, we selected 126 sex-and age-matched hypertensive patients who were treated during the same period and were free from stroke. Results-Mean 12-month BP was not significantly different between stroke and control groups, although systolic BP was 2. Mean pulse pressure was also significantly higher in the stroke group than the control group in patients aged Ͻ70 years but not in older patients. In the stroke group, the level of BP within 1 month before stroke onset did not differ from the mean value over the 12-month period. Patients with brain hemorrhage had higher diastolic BP than those with other subtypes. The stroke group had higher plasma glucose, lower HDL cholesterol, and higher frequencies of diabetes mellitus, proteinuria, atrial fibrillation (29.4% versus 4.0%), and use of antiplatelet (31.0% versus 11.1%) and anticoagulant (10.3% versus 1.6%) agents than the control group. Conclusions-The onset of stroke in treated hypertensive patients was related to a higher level of BP in subjects Ͻ70 years old, although this relationship was not obvious in older patients. The risk of stroke in these patients was associated with the presence of metabolic risk factors and cardiovascular complications. Office BP did not change significantly 1 month before the onset of stroke. (Stroke. 2000;31:48-52.)

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“…1,2 Although the treatment of hypertension has dramatically reduced the incidence of mortality from stroke in many countries, 3 stroke incidence has recently increased in several geographical locations. 4 The earlier reduction in stroke mortality was mainly related to a decrease in the incidence of cerebral haemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Circadian blood pressure and heart rate characteristics in haemorrhagic vs ischaemic stroke in Chinese people

Jiang

Liu

et al. 2009

J Hum Hypertens

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To compare the circadian variation of blood pressure (BP) between patients with intra-cerebral haemorrhage (ICH) and with cerebral infarction (CI), around-the-clock BP measurements were obtained from 89 hypertensive patients with ICH, from 63 patients with CI and from 16 normotensive volunteers. The single and populationmean cosinor yielded individual and group estimates of the MESOR (Midline Estimating Statistic Of Rhythm, a rhythm-adjusted mean value), circadian double amplitude and acrophase (measures of extent and timing of predictable daily change). Comparison shows that without any difference in BP MESOR, the circadian amplitude of systolic (S) BP was larger in ICH than CI patients (Po0.001), and both groups differed from the healthy volunteers in BP MESOR and pulse pressure (Po0.001) and in the circadian amplitude of SBP (Po0.005). The smaller population circadian amplitude of diastolic (D) BP of the ICH group (P ¼ 0.042) is likely related to a larger scatter of individual circadian acrophases in this group as compared with that in the other two groups, an inference supported by a smaller day-night ratio of DBP for ICH vs CI patients (P ¼ 0.007). Heart rate (HR) variability, gauged by the standard deviation (SD), was decreased in both patient groups as compared with that in healthy controls, more so among ICH than CI patients (P ¼ 0.025). Thus, patients with ICH had a higher incidence of abnormal circadian characteristics of BP than patients with CI, the major differences relating to a larger circadian amplitude of SBP, a smaller HR-SD, and a larger incidence of odd circadian acrophases of DBP.

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Hypertension and cerebrovascular disease - the Japanese experience

Cited by 37 publications

References 0 publications

Low Serum Cholesterol as a Risk Factor for Hemorrhagic Stroke in Men

Low Serum Cholesterol as a Risk Factor for Hemorrhagic Stroke in Men

Risk of Stroke in Relation to Level of Blood Pressure and Other Risk Factors in Treated Hypertensive Patients

Circadian blood pressure and heart rate characteristics in haemorrhagic vs ischaemic stroke in Chinese people

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