The importance of hypertension in the development of cardiovascular complications in the elderly (age> 65 years) was examined in subjects who utilized the Kirigaoka-Danchi clinic in Kita-ku, Tokyo, for yearly health checks continuously from 1991 to 1995. Study subjects included 163 controls, whose blood pressure (BP) was <160/90mmHg, and 111 hypertensives, who were on antihypertensive agents. The hypertensives were further classified as well-controlled (systolic BP < 160mmHg : n = 89) or uncontrolled (systolic BP > 160mmHg : n=22) patients. As a result, control subjects exhibited a slight increase in BP over the period while hypertensives did not. The percentage of subjects whose urinary protein was positive increased in the period from 1991 to 1995 in both control and hypertensive groups. However, the percentage was significantly higher in hypertensives in 1995. A similar tendency was found in the percentage of subjects who had electrocardiographic abnormalities and who had abnormal findings of fundi. Especially, in uncontrolled hypertensives, were these findings apparent. Therefore, from these results, it appears that hypertension may accelerate the development of cardiovascular complications.

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Salt intake in Japan as reported in the National Nutrition Survey decreased consistently from the start point of the survey, but began to increase after 1987. To investigate the reason for the increase, the trends in food intake and all nutrients intakes other than vitamins, were compared, taking into account a revision of tables of food composition in 1988 (which changed from a table of food composition by weight average to the standard tables of food composition in Japan-fourth revised edition), and to a revision to the food classification system in 1990, namely separation of 'other seasonings' from 'other food'. The trends for food intake and for each nutrient intake, with the exception of sodium intake, showed similar patterns rapid increase in 1988 and rapid decrease in 1990 corresponding to the changes in 'other seasonings'.
Sodium intake from 'other food' in 1988 and 1989 was corrected by adjusting using the average ratios of sodium : food intake and sodium : intake of each nutrient for 'other food' including 'other seasonings' from 1990 to 1994. Sodium intake from total food amended using the adjusted sodium intake of 'other food', increased rapidly in 1988 and reached a plateau.
It is concluded that this rapid increase is not a real increase but an apparent increase that was caused by the change of the method for estimating amounts of nutrients, due to the change of the tables of food composition or changes of the classification system of foods.

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[in Japanese]

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We examined the relationship between diabetes mellitus (DM) and ischemic heart disease (IHD) deaths in a case-control study. There were 1, 857 deaths aged 40 to 74 years old in Oita City with a population of 419, 000, in the period 1992-93. A total of 354 deaths were heart disease and IHD related deaths as recorded on death certificates. A total of 100 IHD deaths were reevaluated through the MONICA criteria from this data. Cases were 88 IHD deaths, which were investigated for past histories of DM, hypertension (HT) and hyperlipidemia (HL). Controls were randomly selected, matched by age (within 2 years) and sex, from a population of 1, 003 subjects who participated in annual health check -ups (this amounted to 60% of all residents over 40 years old) in C Village near Oita City, where cases were studied for prevalence of DM. The adjusted odds ratio of DM for IHD deaths was 5.1 (95% confidence interval : 2.6-9.9) analyzed by a conditional logistic regression model with 3 variables of DM, HT and HL. This odds ratio was higher than that of HT and HL. About 70% of these cases were deaths within 24 hours from the onset of symptoms. This data suggests that DM represents a greatly significant risk factor for severe heart attacks which lead to IHD deaths.

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[in Japanese]

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