Kawasaki disease with coronary involvement requires long term antithrombotic therapy but because it is an asymptomatic condition. Consistency in taking medication is a problem. We have experienced a case of myocardial infarction occurring due to non-compliance in medication use. As a result a survey was conducted on medication compliance in our 94 outpatients to study non-compliance. The survey was performed by examining outpatient clinical charts and counting the actual days covered by prescriptions in a year.
The survey revealed that 64% of the patients were regular in their hospital visits to pickup prescriptions as scheduled, 14% were covered by prescriptions for 300 days or more but less than 1 year, and 22% were covered less than 300 days. Non-compliance predominated in older children and mildly involved coronary cases.
To improve medication compliance, we have to recognize that medication non-compliance is not infrequent among patients of Kawasaki disease with coronary involvement. More precise disease education for both parents and patients, especially for young children, appears to be necessary.

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[in Japanese]

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Non-pharmacologial management of cardiovascular-disease risk factors utilizing self-assessment programs for salt intake, weight and exercise were studied. In many instances, compound risk factors (HOGUL : H = Hypertension, O = Obesity, G = Glucose intolerance, U=Uratemia, L=Lipidemia) accompany hypertension in obese subjects. Accumulations of intra-abdominal visceral fat aggravate these factors. Therefore reduction of visceralfat is considered a highly important intervention. The ideal management employing a self-assessment program for 4 weeks demonstrated significant reduction of intra-abdominal visceral fat and these risk factors in the obese hypertensives. At the present time, no matter what medication method is used, there is no single preparation that improves all HOGULS significantly. In terms of cost-effectiveness also, it seems advisable to stress a nondrug therapy for controlling cardiovascular risk factors. For these reasons, significant technological improvements in such self-assessment methods for long-term application on outpatients are required.

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A baseline examination of residents over 40 years of age in A-I district of Shibata City, Niigata Prefecture, Japan, was conducted in 1977, for the purpose of finding out probable relationships between dietary factors and stroke or coronary heart disease (CHD). Subjects were 999 males and 1360 females for a response rate of 85% and 93%, respectively. The dietary intake of sodium, potassium, calcium, iron, magnesium, zinc, and copper was assessed using a food frequency questionnaire that we developed, and the results were analyzed for relationships between the intake of various kinds of mineral and blood pressure in a cross-sectional study. A cohort study of dietary mineral intake and incidence of stroke and CHD was also performed over 15.5 years from July 1977 through December 1992.
Relationships between energy-adjusted mineral intake and blood pressure, showed an inverse relationship between blood pressure and potassium and magnesium. There were no significant relationships between stroke incidence and dietary mineral intakes in the cohort study. However, for ischemic heart disease (IHD : myocardial infarction + sudden death), increased intake of potassium, magnesium and iron appeared to be associated with lower IHD incidence. According to the multivariate analysis using Cox' proportional hazard model, cerebro-and cardio-vascular diseases were strongly associated with age and blood pressure. With regard to myocardial infarction incidence, copper intake as well as age and blood pressure somehow had a minor effect. The relationship of dietary minerals to the incidence of stroke and CHD appears to be an indirect relationship mediated by blood pressure.

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