独協学園における循環器疾患の健康管理に関する研究(第3報)

―進展要因の追求疫学的検討―

抄録

The serial study on health examination concerning with cardiovascular checks were carried out from 1976 to 1983 on 3, 437 boys in an junior and senior high school in Tokyo metropolitan. Systolic blood pressure (S.B.P) of 140 mmHg and/or more and diastolic blood pressure (D.B.P) of 90 mmHg and/or more were employed as the standards for moderate hypertension. S.B.P of 150 mmHg and/or more and D.B.P of 90 mmHg and/or more were also employed as the standards for hypertension. The results were as follows: 1) The proportion of the pupil diagnosed to hypertension was 8.4% in junior and 11.2% in senior. The junior high school boys of 0.1% and the senior of 1.4% have kept hypertensive blood pressure for three years. A significant difference was recognized between both proportional insidences. 2) Abnormal ECG was found in 19.2% in junior and 26.1% in senior according to the modified Minnesota Code Criteria. Right axis deviation, P-R prolongation, left high voltage, incomplete RBBB were highly found as slightly abnormal ECG, and then sinus tachycardia, junctional ST depression, flat T wave, occasional exrasystole were more found in hypertension group than in normotension. 3) Through screening examination on about 5, 919, 3 times of 1, 973 boys, ECG findings had revealed abnormality in 136 boys, who were examined on their ECG change by the load test of Master's two steps and other physical findings from 1980 to 1982. Eight pupils of 136 had to be controlled in their daily physical activities. However, as the abnormal ECG findings are usually reversible in boys, the control for their physical activity should be renewed at every month with repeated intensive follow up examination. 4) Twelve patients with congenital heart disease (0.35%), two cases with acquired heart disease (0.06%), a case of idiopathic cardiomyopathy (0.03%), twelve cases with the past history of rhuematic fever (0.35%), three cases with the past history of Kawasaki disease (0.09%) were found from 3, 437 boys by this health examination during these eight years. 5) These boys with positive familial history of hypertension, obesity, stressful personality, and less training of physical exercise were suggested to be associated with development of hypertension. According to the follow up study of boys for six years, the juniors whose height had highly increased had relatively high blood pressure, on the other hand, the seniors whose weight had highly increased had shown the hypertensive conditions. 6) The submaximal treadmill test had the burden more sever for cardiovascular of the hypertensives than the normals. It is likely to be the interesting findings that the hypertensive boys who had the training of physical exercise showed the less increased pulse in treadmill test and the more rapid recovery from elevated blood pressure than those without the physical training.