[Long-term trends in blood pressure observed in rural and urban populations].
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Biomedical subjects
Publications and source records attributed to M Kiyama.
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The relation between dietary calcium and blood pressure was examined in 1,928 men, ages 40-69 years, from five geographic and two occupational populations in Japan. Dietary calcium intake was estimated using 24-hour dietary recall in systematic samples of participants of population-based cardiovascular surveys from 1983 to 1987. The means of daily calcium intake of the study populations ranged from 449 to 695 mg, approximately 300 mg lower than the recommended US dietary calcium intake. Linear regression analyses were used to examine the relation between dietary calcium and blood pressure within each population, controlling for age, body mass index, alcohol consumption, and sodium intake. Total calcium intake was inversely associated with the systolic blood pressure level in each population, and the pooled estimate of the regression coefficients for millimeters of mercury of blood pressure per 100-mg increase in calcium intake was -0.54 (95% confidence interval -0.89 to -0.19). The inverse association between calcium intake and diastolic blood pressure was less consistent, and the pooled estimate did not reach statistical significance (-0.10, 95% confidence interval -0.34-0.14). Inverse associations existed for both dairy and nondairy food sources of calcium when analyzed separately, and the association was significant only for dairy calcium. Although a causal relation between dietary calcium and blood pressure cannot be established, these results suggest a possible public health implication in Japan of increasing calcium intake for the prevention and control of hypertension, where average dietary calcium intake is low.
The relation of body fat distribution and body mass with haemoglobin A1c, blood pressure and blood lipids were examined in 874 men aged 40 to 59 not taking medication for diabetes mellitus and who worked for an urban company in Japan. Body fat distribution was measured by the waist hip circumference ratio. Body mass was estimated by Quetelet index. Haemoglobin A1c was measured from casual venous blood samples by high-pressure liquid chromatography. Measurement of haemoglobin A1c was validated by a 75 g oral glucose tolerance test conducted in a 7% sample. There was a dose-response relation between waist-hip ratio and haemoglobin A1c concentration while the relation between body mass index and haemoglobin A1c was not evident. Using linear regression to control for age, serum total cholesterol, usual alcohol consumption, cigarette smoking and body mass index, the positive association between waist-hip ratio and haemoglobin A1c remained significant (p = 0.02). This was not true for the positive association between body mass index and haemoglobin A1c (p = 0.32). Both waist-hip ratio and body mass index were positively associated with blood pressure and serum total cholesterol, and inversely associated with HDL-cholesterol. The associations of waist-hip ratio with blood pressure and blood lipids were significant after controlling for body mass index. Therefore, the waist-hip ratio is a correlate of both glucose abnormalities and known coronary risk factors in urban Japanese men even when body mass is controlled for.
A community-based education program was conducted for persons found to be hypercholesterolemic by screening during cardiovascular surveys, in an urban population, to evaluate the feasibility and effect of the program in primary prevention of coronary heart disease. The subjects were men and women aged 40-64 living in the suburbs of Osaka whose serum total cholesterol was between 240 and 299 mg/dl in both the 1988 and the 1989 surveys. Persons with hypothyroidism, those taking medication for hypercholesterolemia or hypertension, and with a history of stroke and coronary heart disease were excluded. Of the 111 persons who were eligible, 104 persons were recruited for the program on March, 1989. The 104 persons were randomly assigned to either an intensive education group (n = 51) or a usual education group (n = 53). For the intensive education group, seven education classes were held from April to November, 1989. Lectures, practice sessions, interviews, and spot cholesterol measurements were conducted in a local community center. The usual education group received a letter with results from the 1989 survey and dietary instruction in April 1989 and an education class in September 1989. Mean serum cholesterol in the intensive education group showed a 10.0 mg/dl greater reduction in September 1989 and a 9.0 mg/dl greater reduction in March 1990 than in the usual education group (p less than 0.05) while mean HDL-cholesterol did not change in either groups. The intensive education group reported a larger decrease in the dietary frequency of chicken egg, poultry skin and small fishes, foods which are rich in saturated fat and cholesterol. The frequency of fatty meat, butter and fish eggs was low in both groups and did not differ between the two groups after the one-year program. These results indicate that a population-based education program is feasible and effective in reducing serum total cholesterol of hypercholesterolemic persons.
To investigate the proportion by type of stroke in communities, a stroke surveillance was conducted in three rural populations between 1979 and 1987. Among 411 stroke patients aged 40 and over determined by the modified Millikan's stroke criteria, the type of stroke was analyzed using computed tomography (CT) criteria for 273 patients who were examined by CT. 1. Incidence rates of stroke determined by the modified Millikan's criteria did not vary among the three populations in all age-sex groups except for men aged 60-69. 2. The proportion of stroke patients who had CT examinations was 84-88% for men and women aged 40-69 in the three communities. 3. According to the CT criteria, the proportion by type of stroke in patients aged 40-69 in the three communities was 32% for cerebral hemorrhage, 16% for subarachnoid hemorrhage, 42% for cerebral infarction and 10% for unspecified stroke without CT abnormalities. Among the total with cerebral infarction, the proportion with cerebral infarction in penetrating artery regions, mostly lacunar infarction, was 65% and that of infarction in cortical artery regions, mostly thromboembolic infarction, was 35% for patients aged 40-69. 4. Cerebral infarction in cortical artery regions was classified further into embolic, thrombotic and unspecified types based on CT findings, the presence of embolic origin, and symptoms at the onset. The proportion of these three types of infarction were similar in patients aged 40-69. Compared with hospital-based studies in Japan, the present population-based study showed a higher proportion of cerebral infarction and infarction in penetrating artery regions. This study also indicated that the proportion of cerebral hemorrhage and infarction in penetrating artery regions was higher and that of infarction in cortical artery regions lower in Japanese than in Caucasians.
A chemical robot capable of performing enzymatic reactions and extraction processes of DNA has been developed. The basic functions of this robot include handling of plastic tubes with caps, micropipetting, mixing, microcentrifuging and incubating. As a result, almost all of the pre-electrophoresis steps can be carried out. In addition, because these processes are automated, the working time of each process can be reduced. The reproducibility of the automated operation is equivalent to that of a skilled operator.
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The atherosclerotic lesions of the coronary arteries and basal cerebral arteries in the circle of Willis were examined in the bodies of decreased men ages 30 and over who had been admitted to a local hospital in northeast Japan during 1966 to 1974 (243 men) and 1975 to 1984 (602 men). The autopsy rates during the two periods were 86% and 89%, respectively. The extent of atherosclerosis was determined blindly by one pathologist using a grading method of cross-sectional stenosis scoring for coronary arteries and Baker's method for basal cerebral arteries. The age-adjusted mean scores for atherosclerosis in the coronary arteries and basal cerebral arteries were 30% and 42% lower, respectively, in the 1975 to 1984 period than in the 1966 to 1974 period (p less than 0.001). There was also a fall in age-adjusted blood pressure levels at admission: 10 mm Hg for systolic and 4 mm Hg for diastolic blood pressure (p less than 0.001). The opposite trend was seen in mean serum cholesterol: a rise from 171 mg/dl to 177 mg/dl (p = 0.018). Linear regression analysis indicated that blood pressure was positively associated with both atherosclerosis scores, controlling for age and serum cholesterol in both time periods (p less than 0.001). The association of serum cholesterol with the atherosclerosis scores was positive in both periods and statistically significant in 1975 to 1984. Similar findings were obtained when the analyses were conducted for cardiovascular disease (myocardial infarction and stroke) and for noncardiovascular disease, separately.(ABSTRACT TRUNCATED AT 250 WORDS)