Back-ground
A new simple instrument for measurement of both PWV and ABI named form PWV/ABI was produced recently. As part of developing this instrument, we confirmed this medical applicability in measurement of brachial-ankle PWV (baPWV) by the principle of tonometry method in comparison with the older method for aortic PWV (aoPWV). We then measured the left heart-carotid PWV (hc-PWV) by the new instrument and compared it with the IMT of the left common carotid artery epidemiologically and minor reconformation of the instrument was made on the basis of our older data in 1997.
Methods
1) The baPWV value by tonometry method with Jentow-7700 and aoPWV (It femoral-left carotid artery) value by TK-401 pulse pressure sensor were measured in 18 patients.
2) The hcPWV was examined by the form PWV/ABI instrument in 135 male (59.4 years of age) and 301 female (57.1 years of age) inhabitants in Kisei Town, of whom the IMT of the common carotid artery by ultrasound sonography was measured in 117 male and 246 female subjects.
Results
1) The baPWV by tonometry method was positively correlated with the aoPWV. The baPWV before and after cold pressor test had a good positive correlation but in several cases the baPWV values after cold pressor test became much higher than those before it, possibly because of vasoconstriction.
2) The mean hcPWV value in male was higher than that in female but no difference was observed between those in farm and fishing villages. There were good positive correlations among values of hcPWV, hbPWV (heart-rt brachial artery), haPWV (heart-rt ankle) and baPWV. The hcPWV value was correlated with the IMT value (p=0.0005 in male and p=0.0058 in female). Significant correlations were observed between the hcPWV and age, blood pressure and free fatty acid concentration in male and age, blood pressure, LDL-cholesterol, body mass index, hematocrit and fasting plasma glucose levels in the female. Risk factors of IMT were age in male and age, blood pressure, LDL-cholesterol, free fatty acid levels and fibrinogen in female subjects. In the analysis of 41 male and 102 female subjects aged 55-64 years, systolic blood pressure and hematocrit in male and fasting insulin level and hypertension in female for the hcPWV and HDL-cholesterol and free fatty acid for the IMT but nothing in male for the IMT became independent variables by multivariate analysis. The ABI in normal range was correlated only with hcPWV but not with hb-ba-and haPWV.
Conclusion
The baPWV may be an arteriosclerotic marker but can be influenced sometimes by room temparature. The hcPWV was well correlated with the IMT and also with age and blood pressure, and in addition, with the metabolic parameters such as body mass index, LDL-cholesterol and fasting glucose level in the female. The ABI level in normal range seems not to be a marker for atherosclerosis.

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While several guidelines for the treatment of hypertension has been published, the actual achieved levels of blood pressure control in out-patients were unclear. We investigated the achieved control levels of blood pressure from using anti-hypertensive drugs in our special out-patient clinic for hypertension in a cross-section survey. Patients with essential hypertension were enrolled in this study, who had been under medical treatment over three months with, no major complications, and with medical records for 1980, 1985, 1990, 1995 or 2000. A final total of 142 males and 184 females were enrolled in this study. The achieved controlled blood pressure was lower after 1990, especially in 2000. No gender differences were observed in the controlled blood pressure levels. Incidence of use of diuretics was reduced gradually at each point and that of calcium antagonist was increased after 1990. Combined medication of over two kinds of medicines were used after 1995. In females, percentages of diuretics, calcium antagonists and angiotensin II receptor blockers in the treatment were higher than in males. The changes in blood pressure goal and guidelines, changes in anti-hypertensive drugs and combination therapy appear to have a role in achieving lower blood pressure levels seen in this study.

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