Prognosis and outcome of elderly hypertensives in a Japanese community: results from a long-term prospective study

Ueda, Kazuo; Omae, Teruo; Hasuo, Yutaka; Kiyohara, Yutaka; Fujii, I; Wada, Junichi; Kato, Ikunoshin; Kawano, Hideo; Shinkawa, Atushi; Ômura, Takao; Fujishima, Masatoshi

doi:10.1097/00004872-198812000-00006

Cited by 33 publications

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“…15,23,24 Epidemiological studies further documented that hypertension is a risk factor for atherosclerosis in the general population. 25 Hypertension progresses to atherosclerosis by accelerating shear stress and lipid permeability of the arterial wall, and increasing the extracellular matrix. 26,27 In the chronic uremic patients in the present study, high systolic blood pressure and smoking made as much of a contribution to carotid atherosclerosis as tHcy.…”

Section: Discussionmentioning

confidence: 99%

Association Between Plasma Homocysteine Concentration and Carotid Atherosclerosis in Hemodialysis Patients

Sakurabayashi¹,

Fujimoto

Takaesu³

et al. 1999

Jpn Circ J

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Ultrasonography to Calculate Carotid Maximum IMTB-mode ultrasonography of the extracranial carotid artery was performed with a high-resolution, real-time scanner equipped with a 7.5-MHz imaging transducer (SSD 650 CL, Aloka, Tokyo, Japan). One trained physician, who was blinded with regard to the subjects' clinical Jpn Circ J 1999; 63: 692 -696 (Received March 19, 1999; revised manuscript received June 2, 1999; accepted June 10, 1999 Accelerated atherosclerosis is a major risk for uremic patients undergoing long-term hemodialysis. Because hyperhomocysteinemia may influence this condition, 168 such patients were examined for a possible association between plasma total homocysteine concentration (tHcy) and conventional cardiovascular risk factors. Generalized atherosclerosis was indicated by excessive intimal-medial wall thickness (IMT) of the extracranial carotid artery as measured by B-mode ultrasonography. The results documented tHcy in these patients of 33.0±16.9 mol/L, a significantly higher amount than that of healthy subjects (11.0±3.1 mol/L, p<0.0001). The patients' carotid maximum IMT was 1.79±1.16 mm. In multiple regression analyses with forward elimination procedure, carotid maximum IMT was clearly related to age (r=0.417, p<0.0001), systolic blood pressure (r=0.262, p=0.0043), smoking (r=0.177, p=0.0076), duration of hemodialysis (r=0.083, p=0.0045), and tHcy (r=0.195, p=0.0021). These 5 factors accounted for 36.0% of the variation in carotid maximum IMT. Factors determined as unrelated were male gender, diastolic blood pressure, body mass index, total and HDL cholesterol, triglyceride, lipoprotein(a), uric acid, calcium, inorganic phosphate, and parathyroid hormone. Therefore hyperhomocysteinemia, along with advanced age, systolic hypertension and smoking aggravates atherosclerosis in chronic uremic patients. (Jpn Circ J 1999; 63: 692 -696)

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Section: Discussionmentioning

confidence: 99%

Association Between Plasma Homocysteine Concentration and Carotid Atherosclerosis in Hemodialysis Patients

Sakurabayashi¹,

Fujimoto

Takaesu³

et al. 1999

Jpn Circ J

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“…Because our study was conducted more than one decade after the Hisayama Study, 18 the different results of the two studies may be partly explained by the fact that the prevalence of obesity has rapidly increased due to the westernization of the Japanese lifestyle, including dietary habits, 22 which has brought on other coronary heart disease risk factors associated with insulin resistance syndrome such as hypertension, dyslipidemia, diabetes mellitus and hyperuricemia. 22 Liu et al 23 demonstrated that body mass index was significantly associated with hypertension, diabetes mellitus, and hypercholesterolemia in the Japanese population.…”

Section: Prehypertension and Coronary Atherosclerosismentioning

confidence: 98%

Role of Prehypertension in the Development of Coronary Atherosclerosis in Japan

Washio

Shoji

Yoshimasu

et al. 2004

Journal of Epidemiology

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BACKGROUND: Hypertension is an important risk factor of coronary heart disease. A new guidelines for hypertension prevention and management in The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure in the United States recommended lifestyle modification or medical treatment for subjects with prehypertension. However, whether prehypertension increases the risk of coronary atherosclerosis in the Japanese population is still unknown. METHODS: A cross-sectional study in a clinical setting was conducted. The subjects were 705 patients (417 males and 288 females) aged 30 years and older who underwent a first-time coronary angiography for suspected or known coronary heart disease at 5 major cardiology departments in the Fukuoka metropolitan area between September 1996 and August 1997. RESULTS: Compared to subjects with normal blood pressure, those with prehypertension had an increased risk of coronary atherosclerosis even after adjusting for other factors. CONCLUSION: Prehypertension may be an important clinical entity which requires treatment in the Japanese population.

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“…The QRS amplitude, however, tended to decreased in the H-0 group, which is a physiological change accompanying aging, as it was also seen in the control group. 12 The analysis of the annual ECG changes revealed that the QRS amplitude in the H-1 and H-2 groups was higher than in the control group. Interestingly, the H-0 group, in particular, showed significant differences from the control group in many findings and showed worsening of the ECG findings with time, although the BP levels were clinically within the normal range.…”

Section: Discussionmentioning

confidence: 95%

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

Nakayasu

Nakaya

Oki

et al. 2004

Circ J

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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-...

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Prognosis and outcome of elderly hypertensives in a Japanese community: results from a long-term prospective study

Cited by 33 publications

References 0 publications

Association Between Plasma Homocysteine Concentration and Carotid Atherosclerosis in Hemodialysis Patients

Association Between Plasma Homocysteine Concentration and Carotid Atherosclerosis in Hemodialysis Patients

Role of Prehypertension in the Development of Coronary Atherosclerosis in Japan

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

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