Long-Term Follow-up in Japanese Public Office Workers of the Influence of Blood Pressure on ECG Changes

Abstract

eft ventricular hypertrophy is a serious complication of sustained elevation of blood pressure (BP); the Framingham study demonstrated the increased risk for mortality, incidence of heart failure and occurrence of cardiovascular complications 1 and epidemiologic studies have shown that BP should be controlled to prevent complications. [2][3][4][5] There is little information on the association between changes in BP and development of ventricular hypertrophy from analysis of the serial changes of the electrocardiograms (ECGs) in Japanese volunteers, 6 so we studied the relationship between annual changes in BP and the ECG in order to clarify what factors give early detection of complications, and can predict the outcome of therapy. We also studied the influence of borderline or high normal BP on the ECG to determine the goal of antihypertensive therapy. MethodsThis study included 830 subjects aged 35 years or more (564 men and 266 women, mean: 47.6±8.5 years) who underwent the annual check up of office workers in Tokushima City, Japan. We used data from 1985 to 1995 for this retrospective study. Subjects who did not undergo a medical check up because they had moved offices were excluded from the present study. Prior to participation in the study, all subjects gave their written informed consent Circulation Journal Vol. 68, June 2004 and ethical approval. Although dietary and medical treatment was strongly recommended for the hypertensive subjects, BP could not be controlled in some subjects.Blood pressure was measured from the right forearm once a month using a mercury sphygmomanometer and the averaged BP was used as the representative BP in the fiscal year. The diagnosis of hypertension (HT) was based on the World Health Organization -International Society of Hypertension (WHO/ISH) guideline. 7 The ECG (FX-323, Fukuda Denshi Co, Ltd, Tokyo, Japan) was recorded in a supine position, and the ECG diagnosis was classified according to Minnesota cords, and the terms 'left atrial overloading, ST-T change, rhythm abnormality, right bundle branch block and left ventricular hypertrophy' were used. 8 The average BP from the initial to the final year of the study and age in the final year are shown in Table 1.By occupational category, the subjects were engaged in clerical and managerial work. The control group consisted of healthy persons who did not have signs of HT on the ECG or in the urine in their mass screening data for the past 5-10 years. Sixty-four subjects (7.7%) showed elevated BP in the 1985 mass screening (ie, systolic and diastolic pressures were, respectively, 140 mmHg and/or 90 mmHg or more).The averaged systolic and diastolic BP of each year were investigated retrospectively from the records of the subjects who were then classified according to BP. The Control group (278 cases, 46.9±8.1 years old) had systolic pressure ≤129 mmHg or diastolic pressure ≤84 mmHg. The H-0 group (321 cases, 49.5±5.1 years old) had upper normal BP: average values of systolic and diastolic pressure were 130-140 mmHg and/or 85-...

Plasma antibodies to heat shock protein 60 and heat shock protein 70 are associated with increased risk of electrocardiograph abnormalities in automobile workers exposed to noise

“…Electrocardiography (ECG) is one of the clinical characteristics used for diagnosis of cardiovascular diseases, and specific changes of ECG patterns have emerged as markers for different stages of these diseases (Nakayasu et al 2004;Okin et al 2004). Moreover, enhanced levels of anti-Hsps become detectable in individuals with some cardiovascular diseases, such as atherosclerosis, coronary heart disease, and borderline hypertension (Rauch et al 1995;Pockley et al 2000;Mandal et al 2004).…”