Abstract
The early detection and treatment of hypertension have been promoted in Japan as important strategies for the prevention of cerebrovascular diseases. However, because the subjective symptom of hypertension are mildpreventive measures may be difficult to implement. Therefore, we studied epidemiologically the relation between the subjective symptoms of hypertention and blood pressure measurements in 1224 elderly persons (421 men and 803 women) who continuously underwent medical examinations for the elderly which have been offered for 7 years from 1987 through 1993 by Kasagake town in Gunma Prefecture, Japan. The average age of subjects in this study was 54.3 years for men and 52.8 years for women. The average incidence rate for subjective symptoms of hypertension was 2.7% for persons aged 49 years or less, 5% for persons aged 50 to 59 years, and 6.3% for persons aged 60 years or more. The symptom that appeared most often in subjects with hypertension was“headache and dullness” (7.8%), followed by“insomnia” (6.4%) ; “numbness in the hands and feet” (6.1%), and“fatigue” (6.1%) . A comparison of the average incidence rate of subjective symptoms in subjects with hypertension and those with normal blood pressure according to age group showed no significant differences in subjects aged 49 years or less, while the incidence rate of a“feeling of strangulation”was significantly higher only in subjects aged 50 to 59 years. In hypertensive subjects aged 60 years or more, the rates of“palpitation, ”“headache or dullness, ”and“fatigue”were significantly higher than in normotensive subjects. We studied the relationship of the regression coefficient of the cumulative incidence rate of high blood pressure and that of subjective symptoms over 7 years in the different age groups. We classified the relationship into three types, A, B, and C. Type A showed a significant difference between the regression coeffcients of the cumulative incidence rate of high blood pressure and that of subjective symptoms. Subjective symptoms included“feeling of strangulation, ”“breathlessness, ”“suffocation at night, ”and“edema with talking and tongue.”Type B did not show a significant difference between the coefficient of cumulative incidence rate of subjective symptoms and that of high blood pressure, and both rates increased almost in parallel. The subjective symptoms were“palpitation, ”“dizziness and dizziness on standing up, ”and“general fatigue”in subjects aged 49 years or less; “headache and dullness”in subjects aged 59 years or less; “numbness in hands and feet”in subjects aged 50 to 59 years; and“insomnia”in subjects aged 40 years or more. Type C showed a significant difference between the coefficient of the cumulative incidence rate of subjective symptoms and that of high blood pressure, and the rate of subjective symptoms was higher than that of high blood pressure in the first observed year. The subjective symptoms were“palpitation, ”“dizziness and dizziness on standing up, ”and“general fatigue”in subjects aged 50 to 59 years; “heada he and dullness”in subjects aged 60 years or more; and“numbness in hands and feet”in subjects aged 59 years or less. Most subjective symptoms changed from type B to type C. however, as age increased, the cumulative incidence rate of subjective symptoms became less than that of high blood pressure. In subjects aged 49 years or less the rate of“palpitation”correlated well with the increase of the cumulative incidence rate of high blood pressure.
