- 著者
- Sei TSUNODA Yuhei KAWANO Takeshi HORIO Naoki OKUDA Shuichi TAKISHITA
- 出版者
- The Japanese Society of Hypertension
- 雑誌
- Hypertension Research (ISSN:09169636)
- 巻号頁・発行日
- vol.25, no.2, pp.167-173, 2002 (Released:2002-09-13)
- 参考文献数
- 32
- 被引用文献数
- 59 71
Cross-sectional studies have shown that home blood pressure (BP) correlates with hypertensive target organ damage better than clinic BP. However, there have been few longitudinal studies regarding the predictive value of home BP on the changes in organ damage in treated hypertensive patients. Clinic and home BP over a 12-month period, antihypertensive medication use, echocardiographic and electrocardiographic results, and serum creatinine and urinary protein levels were examined in 209 treated hypertensive patients in 1993. These patients were prospectively followed for 5 years. The patients were divided into 4 subgroups according to hypertension control as follows: good control (<140⁄90 mmHg for clinic BP, <135⁄85 mmHg for home BP), improved, worsened, and poor control. The average clinic BP was 147.0±14.9⁄87.0±7.6 mmHg (mean±SD) in 1993 and 146.0±13.7⁄84.1±7.5 mmHg in 1998. The average home BP was 136.8±10.4⁄84.3±7.6 mmHg in 1993 and 136.1±9.7⁄81.2±7.7 mmHg in 1998. The left ventricular mass index (LVMI) positively correlated with both home systolic BP and clinic systolic BP in 1998 but not in 1993. The correlation tended to be closer for home BP than for clinic BP. LVMI did not change in patients with good or improved home systolic BP, while it increased in those with poor or worsened home systolic BP. The relationship between changes in LVMI and clinic BP was not significant. In conclusion, Home BP was more effective than clinic BP as a predictor of changes in left ventricular hypertrophy in treated hypertensive patients. Home BP should be controlled to below 135⁄85mmHg to prevent cardiac hypertrophy.(Hypertens Res 2002; 25: 167-173)
- 著者
- Kunitoshi ISEKI Saori OSHIRO Masahiko TOZAWA Yoshiharu IKEMIYA Koshiro FUKIYAMA Shuichi TAKISHITA
- 出版者
- 日本高血圧学会
- 雑誌
- Hypertension Research (ISSN:09169636)
- 巻号頁・発行日
- vol.25, no.2, pp.185-190, 2002 (Released:2002-09-13)
- 参考文献数
- 29
- 被引用文献数
- 13 22
The incidence of end-stage renal disease due to diabetes mellitus (DM) is increasing. There have been too few epidemiological studies of the predictors of DM nephropathy, particularly type 2 DM, among a statistically significant population. We studied the prevalence and correlates of DM in a screened cohort in Okinawa, Japan. A total of 9, 914 screenees (6, 163 men and 3, 751 women) over 18 years of age underwent a 1-day health check at the Okinawa General Health Maintenance Association between April 1997 and March 1998. Subjects were considered to have DM if they showed a fasting plasma glucose ≥126 mg⁄dl and hemoglobin A1c ≥7.0%, or if they were receiving treatment for DM. Non-DM subjects were followed-up until March 2000 to see whether or not they developed DM. Relative risk for developing DM was evaluated by Cox proportional hazard analysis after adjusting for confounding variables. A total of 673 screenees (520 men and 153 women) were diagnosed with DM. The prevalence of DM was 67.9 per 1, 000 screenees (84.4 for men and 40.8 for women). A total of 7, 125 non-DM screenees were examined a second time. Among them, 164 screenees (130 men and 34 women) had developed DM during the follow-up period. Over 2 years, the cumulative incidence of DM was 2.3% (2.9% in men and 1.3% in women). The adjusted relative risk (95% confidence interval) for developing DM was highest for proteinuria, or 1.90 (1.14-3.17). The results indicated that the prevalence and incidence of DM were high among this screened cohort in Okinawa, Japan. Subjects with proteinuria may thus be at high risk for developing DM. (Hypertens Res 2002; 25: 185-190)