Hypertension Research
Online ISSN : 1348-4214
Print ISSN : 0916-9636
ISSN-L : 0916-9636
22 巻, 4 号
選択された号の論文の8件中1~8を表示しています
  • 1999 Revised Version
    Kunio Hiwada, Toshio Ogihara, Masayuki Matsumoto, Hiroaki Matsuoka, Sh ...
    1999 年 22 巻 4 号 p. 231-259
    発行日: 1999年
    公開日: 2006/08/10
    ジャーナル フリー
  • Yutaka Imai, Takayoshi Ohkubo, Ichiro Tsuji, Atsushi Hozawa, Kenichi N ...
    1999 年 22 巻 4 号 p. 261-272
    発行日: 1999年
    公開日: 2006/08/10
    ジャーナル フリー
    To examine the relationships between casual, ambulatory and home blood pressure measurements in the general population, these measurements were obtained in 1, 695 of 3, 744 subjects aged 20yr or older in Ohasama, Japan. Of these 1, 695 subjects, 1, 207 measured their home blood pressure more than 14 times in each of the morning and evening (881 untreated subjects including normotensives and untreated hypertensives, 56.4±11.5yr of age; 326 treated subjects, 66.0±9.2 yr of age). We analyzed data in these 1, 207 subjects, examining the distribution of each measurement, the relationships among measurements, and the factors affecting the blood pressure differences among the measurements. For systolic pressure, the casual measurement was the highest among the methods examined. The daytime ambulatory measurement was significantly higher than morning and evening home measurements. Morning home measurements were significantly higher than those in the evening. For diastolic pressure, however, the morning home measurement was the highest among the methods examined. Short-term pressure variability (standard deviation and variation coefficient of ambulatory measurements) was greater than long-term pressure variability (standard deviation and variation coefficient of home measurements). The pressure variability in treated subjects was greater than that in untreated subjects. The correlation between casual pressure and the other pressures was not as strong (r<0.567). Among the relationships between ambulatory and home measurements, the strongest correlation was observed between the 24-h ambulatory measurement and the morning home measurement (r=0.738) in untreated subjects. The morning home measurement was highly correlated with the evening home measurement (r>0.814). The differences among the methods examined were affected by blood pressure level and age. It should be noted that in elderly and treated subjects, blood pressure measurement using one method does not necessarily correlate with that obtained using the other methods. This information is useful for the estimation of the value of one type of blood pressure measurement from values obtained with other methods. (Hypertens Res 1999; 22: 261-272)
  • Toshiro Matsui, Kei Tamaya, Kiyoshi Matsumoto, Yutaka Osajima, Keiko U ...
    1999 年 22 巻 4 号 p. 273-277
    発行日: 1999年
    公開日: 2006/08/10
    ジャーナル フリー
    The plasma concentrations of angiotensin (Ang) I, Ang II, and their metabolites (Ang (3-8), (4-8), (5-8), and (3-4)) following in vitro ACE inhibitory activity were examined in young male normotensive (NT) (n=7), and mild hypertensive (HT) volunteers (n=6). There were no differences in supine plasma levels of Ang I, Ang II, and Ang (5-8) between the NT and HT groups: Ang I, 304±43fmol/ml vs. 293 ±15fmol/ml; Ang II, 32±6fmol/ml vs. 43±10fmol/ml; Ang (5-8), 176±22fmol/ml vs. 133±32 fmol/ml. In addition, there were no significant differences between groups in any of these Ang levels when measured after standing for 60min. However, the HT group showed significantly reduced supine and upright plasma Ang (3-8) and Ang (3-4) levels as compared to the NT group. In particular, the supine plasma level of Ang (3-4) (71±13fmol/ml-plasma) in the HT group was significantly (1/3-fold) lower than that in the NT group (197±35fmol/ml-plasma). An inverse correlation between the plasma level of Ang (3-4) and the upright systolic blood pressure (r=-0.627, p<0.02, n=13) was observed, indicating that the metabolism of Ang (3-4) might have been associated with the change in blood pressure. (Hypertens Res 1999; 22: 273-277)
  • Noriyuki Okada, Masahito Imanishi, Katsunobu Yoshioka, Yoshio Konishi, ...
    1999 年 22 巻 4 号 p. 279-284
    発行日: 1999年
    公開日: 2006/08/10
    ジャーナル フリー
    A method for the clinical assessment of glomerular hemodynamics has been published previously. We here examined whether, when using this method, renal creatinine clearance (Ccr) can be substituted for the glomerular filtration rate (GFR). The study subjects comprised 57 inpatients from Osaka City General Hospital: 30 with type 2 diabetes mellitus and 27 with chronic glomerulonephritis. During the 2-wk study, patients received a high-salt diet for 1 wk and a low-salt diet for 1 wk. Urinary sodium excretion and systemic blood pressure were measured daily. The renal plasma flow, Ccr, and plasma total protein concentration were also evaluated simultaneously on the last day of the high-salt diet. The GFR was also calculated from the fractional renal accumulation of 99mTc-diethylenetriaminepentaacetic acid (DTPA). Glomerular hemodynamics, represented by the glomerular capillary hydraulic pressure and the resistance of afferent and efferent arterioles, were calculated using the renal clearance, the plasma total protein concentration, and the pressure-natriuresis relationship. Values for renal hemodynamics with the Ccr-derived GFR were compared with those from the 99mTc-DTPA-derived GFR. Ccr values of 53 to 169ml/min correlated with the 99mTc-DTPA-derived clearance of 39 to 179ml/min (n=57, r=.71, p<.001). Values for the glomerular pressure and the resistances of afferent and efferent arterioles calculated using the Ccr-derived GFR correlated significantly with those calculated using the 99mTc-DTPA-derived GFR (r=.99, p<.001 and r=.99, p<.001, respectively). These results indicate that the Ccr is an accurate representation of the GFR for use in glomerular hemodynamic analysis of the pressure-natriuresis relationship. (Hypertens Res 1999; 22: 279-284)
  • Philippe M. Frossard, John P. Kane, Mary J. Malloy, Abdulbari Bener
    1999 年 22 巻 4 号 p. 285-289
    発行日: 1999年
    公開日: 2006/08/10
    ジャーナル フリー
    As renin is the key enzyme of the renin-angiotensin-aldosterone system, the renin gene (REN) represents a good candidate quantitative trait locus for investigations aimed at uncovering the molecular and genetic influences implicated in the molecular etiology of essential hypertension. Among the various polymorphic markers that are available at the REN gene locus, an MboI dimorphic site located in the ninth intron of the REN gene has previously been shown to be significantly associated with a family history of hypertension in a Japanese population and with direct clinical diagnosis of essential hypertension in a Gulf population. We determined MboI allele and genotype distributions in a sample population of 349 (178 men, 171 women) hyperlipidaemic US Caucasians (mean age 55.4±13.1 yr), comprising 122 hypertensive and 227 normotensive subjects. A statistically significant association was found between alleles on which the MboI site was present [MboI(+)] and clinical diagnosis of hypertension. REN MboI(+) alleles are thus in linkage disequilibrium with genetic influences that contribute to increased individual susceptibility to hypertension of hyperlipidaemic patients (with an associated odds ratio of 2.15, 95% CI: 1.34-3.45). This positive association does not seem to occur through the effect of classical risks factors represented by lipid, lipoprotein and apolipoprotein levels. (Hypertens Res 1999; 22: 285-289)
  • Yutaka Kimura, Hirofumi Tomiyama, Eisuke Nishikawa, Gohki Watanabe, Ko ...
    1999 年 22 巻 4 号 p. 291-295
    発行日: 1999年
    公開日: 2006/08/10
    ジャーナル フリー
    A cross-sectional study was conducted to compare the morphological and functional characteristics of the cardiovascular system among subgroups of hypertension defined by the JNC-VI recommendations. One hundred and sixteen subjects (normotensives and unmedicated hypertensives: 49±10 yr) were classified into 4 groups based on the criteria of JNC-VI: normotensive (NOR: n=38), high-normal blood pressure (HN: n=16), stage 1 hypertensive (SI: n=28), and stage 2 to 3 hypertensive (SII-III: n=34). Ultrasonographic examinations of the heart and carotid artery were performed in all subjects, and the following parameters were obtained: left ventricular mass index (LVMI), relative wall thickness at end-diastole (RWTd), cardiac diastolic function (A/E), common carotid artery diameter (CAD), intimal media thickness of the common carotid artery (IMT), and distensibility of the common carotid artery (Distens). RWTd, A/E, and IMT in SI (RWTd, 0.41±0.07; A/E, 1.21±0.41; IMT, 0.69±0.17mm) and SII-III patients (0.40±0.08, 1.38±0.33, 0.80±0.21mm) were larger than those in NOR patients (0.33±0.03, 0.86±0.21, 0.56±0.10mm) (p<.01). Furthermore, LVMI in SII-III (135.5±35.5g/m2) patients was larger than that in NOR patients (99.4±17.5g/m2) (p<.05). RWTd in HN patients (0.37 ±0.06) was significantly higher than that in NOR patients (p<.05). A/E tended to be larger in HN than in NOR patients (p<0.1). In the normotensives, no significant difference in any of the parameters was detected between those with optimal (n=19) and normal (n=19) blood pressure. Thus, both morphological and functional changes were associated with elevation of blood pressure. Cardiac morphological adaptation and functional impairment were present even in subjects with high-normal blood pressure level, while there were no significant differences between the normal and optimal subsets. (Hypertens Res 1999; 22: 291-295)
  • Yuji Shigematsu, Mareomi Hamada, Go Hiasa, Osamu Sasaki, Tomoaki Ohtsu ...
    1999 年 22 巻 4 号 p. 297-301
    発行日: 1999年
    公開日: 2006/08/10
    ジャーナル フリー
    It is well recognized that serum creatinine level provides a quick general assessment of renal function. However, we frequently encounter elderly hypertensive patients with renal involvement whose serum creatinine levels are within normal limits. The aim of this study was thus to determine whether serum creatinine level is a sensitive indicator of renal function in elderly hypertensive patients. Study groups were classified according to age: 82 elderly patients (aged 65 yr or older) and 98 middle-aged patients (aged 40-65 yr) with essential hypertension. To assess hypertensive renal involvement, serum creatinine and serum uric acid levels were measured. We also measured the left ventricular mass (LVM) index by using echocardiography as a marker of hypertensive target organ damage. There was no age-related difference in the LVM index, but the serum creatinine level in elderly hypertensive patients was significantly lower than that in middle-aged hypertensive patients. There was no significant difference in serum uric acid level between the two groups. In addition, the LVM index was correlated with the serum uric acid level (r=0.46, p=0.0001) but not with the serum creatinine level in elderly hypertensive patients. In middle-aged hypertensive patients, the LVM index was related to both serum uric acid level (r=0.41, p=0.007) and serum creatinine level (r=0.43, p=0.003). In conclusion, serum creatinine level may underestimate hypertensive renal involvement in elderly hypertensive patients. In contrast, serum uric acid level may be a sensitive indicator of hypertensive target organ damage irrespective of age. (Hypertens Res 1999; 22: 297-301)
  • Hideaki Nakaya, Hiroyuki Sasamura, Yudai Kitamura, Tetsuro Amemiya, Ko ...
    1999 年 22 巻 4 号 p. 303-312
    発行日: 1999年
    公開日: 2006/08/10
    ジャーナル フリー
    Angiotensin converting enzyme inhibitors (ACEI) are known to inhibit the progression of established renal failure. The aim of this study was to compare the efficacy of an ACEI and an AT1 receptor antagonist (AT1R-Ant) in preventing the development of renal disease, at an early stage of hypertensive nephrosclerosis. SHRSP/Izm rats (n=61) were treated from 10 wk until 22 wk with the ACEI delapril (40mg/kg/d) or the AT1R-Ant candesartan cilexetil (1mg/kg/d). Proteinuria, and structural/ultrastructural changes were assessed at 14 and 22 wk. Treatment with either agent resulted in reductions in blood pressure and cardiovascular hypertrophy. Neither proteinuria nor major renal histological changes were evident at 14 wk. At 22 wk, however, proteinuria accompanied by nephrosclerotic chnges was seen in the untreated SHRSP/Izm. Treatment with either ACEI or AT1R-Ant resulted in similar reductions in proteinuria (untreated, 32.2±7.4; delapril-treated, 5.5±1.2; candesartan-treated, 3.9±0.3 mg/100g/d). Prominent sclerosis of small-to-medium sized renal arteries was seen in the untreated SHRSP/Izm at 22 wk, but was similarly attenuated by the ACEI and AT1R-Ant. The glomerular ultrastructure was comparable between the two groups. No significant changes in renal AT1a or AT1b receptor subtype mRNA expression were seen throughout the course of the study. In contrast, a decrease in AT2 receptor mRNA was seen in the drug-treated groups at 14 wk but not at 22 wk. These results suggest that both ACEI and AT1R-Ant have similar efficacy in attenuating the onset of renal injury in early hypertensive nephrosclerosis, and that treatment with either agent is associated with a transient decrease in AT2 receptor mRNA expression. (Hypertens Res 1999; 22: 303-312)
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