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Biomedical subjects

M Nishinaga

Publications and source records attributed to M Nishinaga.

42 records · Page 3Linked to original sources
PubMed1992

Diurnal blood pressure variations and silent cerebrovascular damage in elderly patients with hypertension.

OBJECTIVE: To examine the effect of diurnal blood pressure changes upon cerebrovascular damage in elderly patients with hypertension. DESIGN: Fifty-four asymptomatic hypertensive and 34 normotensive elderly subjects underwent both 24-h non-invasive ambulatory blood pressure monitoring and brain magnetic resonance imaging. METHODS. Diurnal variation was defined as a difference of greater than or equal to 10 mmHg between mean awake and asleep systolic blood pressure. Hypertensives were thus classified as dippers or non-dippers. Low intense foci (lacunae) and advanced periventricular hyperintensity were identified as silent cerebrovascular damage. RESULTS: In the hypertensive group, lacunae were correlated more closely with mean asleep systolic blood pressure than with mean awake systolic blood pressure. Age, awake blood pressure, predicted whole blood viscosity, lipid profiles or quantity of sleep did not differ between the hypertensive dippers or non-dippers. The non-dippers, however, showed significantly higher grades of cerebrovascular damage as well as cardiac hypertrophy by electrocardiography than the dippers, whose results were similar to those of normotensives in this regard. CONCLUSIONS: An absent or lower nocturnal blood pressure fall in elderly hypertensives is associated with silent cerebrovascular damage. In contrast, the presence of a nocturnal fall could prevent the development of hypertensive vascular damage.

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PubMed1991

Factors associated with silent multiple lacunar lesions on magnetic resonance imaging in asymptomatic elderly hypertensive patients.

1. Factors associated with advanced cerebrovascular damage incidentally seen on brain magnetic resonance imaging (MRI) were investigated in a population of 34 normotensive and 54 hypertensive asymptomatic elderly individuals (69 +/- 5 years). 2. Four or more 'lacunar' lesions per subject were considered to be advanced changes, based on the distribution in normotensive subjects and were found in 11 (20%) out of 54 hypertensive subjects. 3. Compared with the remaining 43 hypertensive patients with fewer or no lacunae, the proportion of subjects over 70 years of age who had electrocardiographic (ECG) evidence of left ventricular hypertrophy (LVH) was significantly higher in this group of hypertensive patients. Patients with multi-lacunar lesions also showed significantly higher 'office' and average ambulatory, in particular, blood pressure during sleep and less nocturnal blood pressure fall, than those with fewer or no lacunae. Furthermore, they showed a higher predicted whole blood viscosity and a lower high density lipoprotein (HDL)-cholesterol. The predictive values of LVH on ECG for the presence of multi-lacunar lesions in hypertensive patients were substantially high (70-90%). 4. The data suggest that silent advanced cerebrovascular damages on MRI are not rare among asymptomatic elderly hypertensive patients and are associated with various cerebrovascular risk factors. A useful marker for their identification appears to be ECG-LVH.

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PubMed1991

Anticoagulant heparin-like glycosaminoglycans on endothelial cell surface.

Atherosclerosis is associated with an accumulation of proteoglycans. Proteoglycans and/or glycosaminoglycans, in particular heparan sulfate, produced by endothelial cells are thought to play important roles in diverse vascular functions. Of particular note is that they possess anticoagulant functions, i.e., heparin-like antithrombin cofactor activity. Incubation of antithrombin III with endothelial cell cultures resulted in a specific, saturable binding of this protease inhibitor presumably to the endothelial cell surface. In addition, thrombin inactivation by antithrombin III was accelerated on the endothelial surface, providing strong evidence that heparan sulfate on the surface of endothelial cells exerts a heparin-like activity. beta-D-xyloside or cytokine treatments altered the synthesis of heparan sulfate on the endothelial cell surface, resulting in decreased anti-thrombin III binding and diminished heparin-like anticoagulant activity of endothelial cells. The modulation of endothelial heparin-like compounds by these pharmacologic or physiologic agents may have pathophysiologic implications in thrombosis as well as atherogenesis.

Animals↗
PubMed1991

[Normal and abnormal aging of cardiovascular system].

Studies of normal aging in the cardiovascular system in humans are affected by the study population. Besides intrinsic biological aging, extrinsic factors including overt or latent cardiovascular diseases as well as life style variables such as physical activity, diet, alcohol and smoking may influence the age-related changes of cardiovascular function. We have recruited "normal" elderly subjects from community-dwelling volunteers by extensive health screening procedures including treadmill maximum exercise tests. Some of their cardiovascular functions, such as various cardiovascular regulatory functions, were altered compared to normal young subjects, while others such as resting hemodynamics were not. Interrelationships among various autonomic functions in the elderly were not recognized. Although general effects of life styles on circulatory regulatory functions were not clearly indicated, variables such as sodium intake or body mass index appeared to affect some of the sympathetic nervous functions. Furthermore, hypertension in the elderly had much less impact on cardiovascular functions than is generally expected, based on the results from young or middle-aged subjects. To identify factors which either modify (accelerate) or do not affect the aging of the cardiovascular functions is important not only to achieve a good aging process but also to establish therapeutic goals in elderly subjects.

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PubMedDate not supplied

Predicting the severity of coronary lesions by the continuous recording method of exercise two-dimensional echocardiography.

We estimated the severity of coronary artery disease by the continuous-recording method of exercise two-dimensional echocardiography (Ex.2DE) in 56 patients with angiographically significant coronary artery stenosis ( > 50% diameter narrowing) who had undergone both Ex.2DE and coronary angiography. Patients were divided into two groups on the basis of findings of coronary angiography: group 1 had 50% to 89% stenosis (n = 24) and group 2 had 90% or greater stenosis (n = 32). The sensitivity and specificity of Ex.2DE for the detection of ischemic segments were 82% and 88%, respectively in the overall patient population. The sensitivity was 67% in group 1 and 94% in group 2. Hyperkinesis occurred at the beginning of exercise in 21 (88%) of 24 patients in group 1 and 15 (47%) of 32 patients in group 2 (p < 0.05). Our findings demonstrated that patients who did not show hyperkinesis at the beginning of exercise had more severe coronary artery disease. Careful observation of serial wall motion during exercise by the continuous-recording method may provide important information about myocardial ischemia.

Adult↗