Biomedical subjects

T Omae

Publications and source records attributed to T Omae.

At least 55 records · Page 3Linked to original sources

PubMed1996

Different effects of alcohol and salt on 24-hour blood pressure and heart rate in hypertensive patients.

To compare the influences of alcohol and salt intake on 24-h blood pressure (BP), we studied short-term effects of repeated alcohol ingestion and dietary salt intake in hypertensive patients. Thirty-two Japanese men with mild to moderate essential hypertension (54 +/- 1 years old, mean +/- SE) were examined. Sixteen patients were given alcohol (1 ml/kg) with dinner for 7 d after a 7-d control period with an isocaloric beverage. Another group consisting of 16 age- and weight-matched patients consumed a low-sodium diet (25 mmol/d) for 7 d, followed by a high-sodium diet (250 mmol/d) for 7 d. Twenty-four-hour BP was measured at the end of each period. Average 24-h BP in the alcohol period (137 +/- 4/83 +/- 2 mmHg) was similar to that in the control period (138 +/- 4/84 +/- 2 mmHg). However, BP in the alcohol period was significantly lower in the evening, but significantly higher in the morning than that in the control period. Heart rate increased for several hours after alcohol ingestion, resulting in a significant increase in 24-h heart rate (67 +/- 2 vs. 64 +/- 2 beats/min). Average 24-h BP was higher in the high salt period (144 +/- 4/89 +/- 4 mmHg) than in the low salt period (135 +/- 3/85 +/- 3 mmHg, p < 0.05). The pressor effect of high salt intake was sustained throughout the day and was associated with a decrease in 24-h heart rate (60 +/- 2 vs. 66 +/- 2 beats/min). In conclusion, short-term repeated intake of alcohol may have little effect on average 24-h BP while it causes an evening fall and a morning rise in BP, and high salt intake raises BP throughout the day. Alcohol consumption increases and salt loading decreases 24-h heart rate.

Adult↗

PubMed1996

Current status of antihypertensive therapy for elderly patients in Japan.

To assess how elderly Japanese hypertensive patients are treated by specialists, we conducted a cross-sectional survey. A total of 1,163 outpatients aged 50 years or older were studied. Hypertension was diagnosed in 939 of these patients, and 827 were receiving drug therapy. The average blood pressure during therapy was 143 +/- 16/81 +/- 10 mmHg. In patients aged 70 years or older, systolic blood pressure during antihypertensive therapy was significantly higher (p < 0.01) and diastolic blood pressure was significantly lower (p < 0.01) than the corresponding values in those aged 50 to 59 years or 60 to 69 years. The calculated mean blood pressures were similar in the different age groups. The rate of monotherapy in the patients aged 70 years or older was 58.8%, which was significantly higher (p < 0.01) than the rates of monotherapy in the other age groups. Calcium channel blockers were prescribed in about 80% of patients, irrespective of age or comorbidity. Of the patients receiving calcium channel blockers, 43.5% were treated with monotherapy. This rate significantly (p < 0.01) increased with advancing age. Diastolic blood pressures were significantly lower (p < 0.05) in patients with stroke and in those with ischemic heart disease, diabetes mellitus, or dyslipidemia, as compared with patients with no comorbidity. Among patients aged 70 years or older, the difference in systolic blood pressure between those with ischemic heart disease and those with no comorbidity was not significant. Blood pressure in elderly hypertensive patients was reduced to a level similar to that in younger patients. The target blood pressure was influenced by the presence of comorbidity. Furthermore, specialists showed a high preference for the use of calcium channel blockers in the management of hypertension.

Activities of Daily Living↗

PubMed1996

Antihypertensive therapy reduces increased plasma levels of adrenomedullin and brain natriuretic peptide concomitant with regression of left ventricular hypertrophy in a patient with malignant hypertension.

We investigated the potential role of increased plasma adrenomedullin and brain natriuretic peptide (BNP) levels in a patient with malignant hypertension. A 51-year-old man was admitted to our hospital with a chief complaint of visual disturbance. His blood pressure was 270/160 mmHg on admission. Papillary edema associated with retinal bleeding was observed. Echocardiography revealed marked concentric left ventricular hypertrophy with mild systolic dysfunction. Plasma levels of adrenomedullin and BNP were markedly elevated. Antihypertensive therapy reduced the plasma levels of adrenomedullin in association with a concomitant decrease in blood pressure. The plasma level of BNP also decreased and regression of left ventricular hypertrophy and normalization of left ventricular systolic function were observed. Our findings suggest that adrenomedullin may be involved in the defense mechanism against further elevations in blood pressure in patients with hypertension and that the plasma level of BNP may reflect left ventricular systolic dysfunction, left ventricular hypertrophy, or both, in patients with severe hypertension.

Adrenomedullin↗

PubMed1996

Effects of dietary salt and angiotensin-converting enzyme inhibitor on ATP-driven Ca pump and Na/Ca exchange in aortic rings of Dahl rats.

We examined effects of dietary salt and cilazapril on ATP-driven Ca pump and Na/Ca exchange system in arterial smooth muscle of Dahl salt-sensitive (DS) rats. Twenty-four DS rats were assigned to 4 groups. H- and H+ rats were fed a high-salt diet. L- and L+ rats were fed a low-salt diet. H+ and L+ were administered cilazapril. Aortic rings were superfused with physiological saline, and isometric tension was measured. Relaxation rates of low-Na(+)-induced contractions were promoted by the removal of external Ca. Cilazapril significantly decreased blood pressure in both the high- and low-salt diet groups. Salt loading reduced relaxation rates in 1.2 mmol/l Na+, and enhanced the increase in relaxation rates from 1.2 mmol/l to normal Na+. A negative correlation was observed between Ca extrusion by the Ca pump and blood pressure, and a positive correlation was observed between Ca extrusion by Na/Ca exchange and blood pressure. The results suggest that the decrease of Ca2+ extrusion by the ATP-driven Ca pump resulting from a high-salt diet might lead to an elevation in the concentration of cellular Ca2+.

Adenosine Triphosphate↗

PubMed1996

Pressor and depressor hormones during alcohol-induced blood pressure reduction in hypertensive patients.

Alcohol acutely causes vasodilation and hypotension in Orientals. To study the mechanisms responsible for the alcohol-induced blood pressure (BP) reduction, we examined levels of various vasoactive hormones after a single intake of alcohol in twelve Japanese men with mild hypertension. On the alcohol intake day, they consumed 1 ml/kg of alcohol with an evening meal, while on the control day they took an isocaloric control drink. BP and vasoactive hormone levels were determined before and 2 h after intake of the alcohol or the control drink. BP after alcohol ingestion was significantly lower than that before drinking or on the control day. This alcohol-induced hypotension was associated with significant increases in heart rate, plasma catecholamines and plasma renin activity (PRA). The changes in heart rate and plasma noradrenaline were inversely related to the changes in BP. Plasma levels of vasopressin and insulin were lower in the alcohol period than in the control period, but these changes were not correlated with the changes in BP. Levels of aldosterone, cortisol, atrial natriuretic peptide, prostaglandin (PG) E2, 6-keto-PGF1 alpha, beta-endorphin, and cyclic GMP were not significantly different between the alcohol and the control periods. These results suggest that changes in pressor hormones may not contribute to the acute hypotensive effect of alcohol, and that the sympathetic nervous system is activated by the BP reduction. The levels of the depressor hormones measured also appear to play no role in alcohol-induced hypotension.

Adult↗

PubMed1995

Increased plasma levels of adrenomedullin in patients with heart failure.

OBJECTIVES: To investigate the role of adrenomedullin in the pathophysiology of heart failure, we measured plasma levels of adrenomedullin in patients with heart failure. BACKGROUND: Adrenomedullin is a potent hypotensive peptide newly discovered in pheochromocytoma tissue by monitoring its elevating activity on platelet adenosine 3',5'-cyclic monophosphate (cAMP). A significant level of adrenomedullin has been identified in human plasma. These findings suggest the possibility of adrenomedullin as a new circulating hormone that participates in the regulation of the cardiovascular system. METHODS: Venous blood samples at rest were obtained from patients with heart failure in New York Heart Association functional classes I (n = 15), II (n = 25), III (n = 16) and i.v. (n = 10) and from normal subjects (n = 27). Plasma adrenomedullin levels were determined by our newly developed radioimmunoassay. Other humoral factor levels measured simultaneously included norepinephrine, atrial natriuretic peptide, brain natriuretic peptide, plasma renin activity, aldosterone and cAMP. Left ventricular ejection fraction was measured by echocardiography. In eight patients with severe heart failure, plasma adrenomedullin levels were measured before and after treatment. RESULTS: The mean (+/- SD) plasma level of adrenomedullin in control subjects was 2.52 +/- 0.75 pmol/liter. Plasma levels of adrenomedullin in patients with heart failure were unaffected in those in functional class I (2.85 +/- 0.62 pmol/liter) but tended to be increased in those in class II (3.54 +/- 0.82 pmol/liter) and were significantly increased in those in classes III and i.v. (4.78 +/- 1.218 and 8.74 +/- 3.43 pmol/liter, respectively). There was a significant correlation between plasma levels of adrenomedullin and norepinephrine (r = 0.618, p < 0.001), atrial natriuretic peptide (r = 0.696, p < 0.001) and brain natriuretic peptide (r = 0.692, p < 0.001). Left ventricular ejection fraction inversely correlated with plasma adrenomedullin levels (r = 0.485, p < 0.001). Plasma adrenomedullin levels significantly decreased after treatment (from 7.40 +/- 3.40 to 3.98 +/- 1.00 pmol/liter, p < 0.05). CONCLUSIONS: These results suggest that plasma level of adrenomedullin are elevated in heart failure and that an increased plasma volume and an activated sympathetic nervous system in this condition may be related to its synthesis or secretion. Given that adrenomedullin exerts potent cardiovascular effects, increased adrenomedullin may be involved in the defense mechanism against further peripheral vascular resistance elevation in heart failure.

Adrenomedullin↗

PubMed1995

Improvement of insulin sensitivity for glucose metabolism with the long-acting Ca-channel blocker amlodipine in essential hypertensive subjects.

To clarify whether the long-acting calcium-channel blocker amlodipine restores insulin insensitivity in essential hypertension, insulin sensitivity tests were performed at the physiological steady-state insulin level (45 to 55 microU/mL) before and after amlodipine (2.5 to 7.5 mg/d) administration for 2 to 4 months in borderline and mild essential hypertensive subjects. Instead of somatostatin, Sandostatin (Sandoz, Basel, Switzerland) was used for the determination of steady-state plasma glucose (SSPG) in the same way as previously described. SSPG, which was initially high (212.9 +/- 18.0 mg/dL, mean +/- SE), was significantly reduced to 169.8 +/- 14.7 after amlodipine treatment. Responses of ketone bodies during the test at 30 minutes, which reflect the insulin effect on lipolysis in adipose tissue and hepatic fatty acid oxidation, also improved after amlodipine treatment. Norepinephrine, noted to be mildly elevated after amlodipine treatment, decreased during the sensitivity test at 2 hours probably due to the sedative effect, without any change in the fractional extraction of Na. This indicates that the physiological level of insulin does not activate sympathetic nerve activity or stimulate Na reabsorption. The long-acting calcium-channel blocker amlodipine has significantly improved the initially decreased insulin sensitivity for glucose metabolism at least partially in borderline or mild essential hypertension.

Amlodipine↗

PubMed1995

Role of systolic blood pressure in determining prognosis of hemodialyzed patients.

The role of blood pressure in determining the prognosis of hemodialyzed patients was examined in 195 patients who were introduced to hemodialysis. The relationship between blood pressure and survival or death was analyzed. In 46 patients who died within 3 years after the introduction of hemodialysis (nonsurvivors), the age was higher (61 +/- 2 years v 50 +/- 1 years), the occurrence of diabetic nephropathy was higher, and the systolic pressure was higher in both the introduction (178 +/- 4 mm Hg v 167 +/- 2 mm Hg) and maintenance (165 +/- 4 mm Hg v 147 +/- 2 mm Hg) phases than in 132 patients who survived more than 3 years (survivors). On the other hand, there were no significant differences in diastolic pressure during either phase between the two groups of patients. When diabetic nephropathy was excluded, only systolic pressure during the maintenance phase was higher in the nonsurvivors than in the survivors. Therefore, based on systolic pressure during the maintenance phase, patients were divided into two groups, the HT group (> or = 160 mm Hg) and the NT group (< 160 mm Hg), and cumulative survival rates were compared. Whether all patients, only those patients with diabetic nephropathy, or only those patients without diabetic nephropathy were examined, the survival rate was higher in the NT group than in the HT group.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗

PubMed1995

Plasma renin activity in hemodialyzed patients during long-term follow-up.

Plasma renin activity (PRA) and mean arterial pressure (MAP) were determined in 11 patients after the initiation of maintenance hemodialysis for 8 to 10 years. PRA increased significantly from 2.3 +/- 0.5 to 6.5 +/- 1.3 ng/mL/h, whereas MAP was lowered during follow-up, and there was a strong correlation between these two (r = 0.88, P < 0.001). Immediately before initiating hemodialysis, PRA was negatively correlated with the increase in PRA (r = 0.62, P < 0.05) and positively correlated with the reduction in MAP (r = 0.65, P < 0.05). PRA was elevated and MAP was markedly reduced in patients whose PRA was relatively low immediately before initiating hemodialysis, whereas PRA tended to be reduced and MAP was unchanged in patients with higher levels of PRA. These data suggest that renin secretion continues even after disuse atrophy of the kidneys with almost complete deterioration of its excretory function.

Adolescent↗

PubMed1995

Short-term increase in prostaglandin I2 synthesis caused by cicletanine in patients with essential hypertension.

Cicletanine is a new antihypertensive drug that stimulates renal and vascular synthesis of prostaglandin (PG) I2 in experimental animals. However, there is little evidence that cicletanine increases the level of PGI2 in systemic blood of human subjects. To investigate the short-term antihypertensive mechanism of cicletanine, we measured serially the systemic blood pressure, the levels of 6-keto-PGF1 alpha (a stable metabolite of PGI2) and PGE2, and renin activity in plasma after administration of the drug. Nine patients with essential hypertension on a diet without severe sodium restriction took 100 mg of the drug by mouth. Systemic blood pressure was measured hourly for 24 h before and after cicletanine administration. The two PGs of interest were extracted, purified by high pressure liquid chromatography, and measured by radioimmunoassay. Cicletanine decreased blood pressure 3 and 6 h after administration and increased the plasma level of 6-keto-PGF1 alpha. The increase in 6-keto-PGF1 alpha was small but significant (mean +/- SD, from 3.21 +/- 1.26 to 3.88 +/- 1.44 and later 4.15 +/- 1.08 pg/mL by 3 and 6 h after administration; P < .05 and .01, respectively). The level of PGE2 had increased at 3 h after administration but returned to baseline by 6 h. Plasma renin activity was increased only at 24 h after administration. Cicletanine increased systemic PGI2 levels short-term, producing an antihypertensive effect in patients with essential hypertension.

6-Ketoprostaglandin F1 alpha↗

PubMed1995

Surgical management of infective endocarditis associated with cerebral complications. Multi-center retrospective study in Japan.

To establish guidelines for the surgical treatment of patients with infective endocarditis who have cerebrovascular complications, we conducted a detailed retrospective study of 181 of 244 patients with cerebral complications among 2523 surgical cases of infective endocarditis of the Japanese Association of Thoracic Surgery. The results showed that 9.7% of all patients with infective endocarditis had associated cerebral complications: 108 (44.3%) had active native valve endocarditis, 96 (39.3%) had healed native valve endocarditis, and 40 (16.4%) had prosthetic valve endocarditis. The hospital mortality of the patients with cerebral complications was 11.0% in the group as a whole: 13.9% in active native valve endocarditis, 3.1% in healed native valve endocarditis, and 37.5% in prosthetic valve endocarditis. Diseased valves included the following aortic valve in 55.5%, mitral valve 49.8%, tricuspid valve in 1.3%, and pulmonary valve in 1.3%. In 181 patients with cerebral complications, organisms were detected as follows: gram-positive cocci in 133 (73.5% [Streptococcus in 85, Staphylococcus in 32]), gram-negative in 18 (9.9%), fungus in 11 (6.1%), and unknown in 64.6%, cerebral bleeding in 31.5%, cerebral abscess in 2.8%, and meningitis in 1.1%. Hospital mortality rate and an exacerbation rate of cerebral complications, including related death, according to the interval from onset of cerebral infarction to cardiac surgery, were as follows: 66.3% and 45.5% within 24 hours, 31.3% and 43.8% between 2 and 7 days, 16.7% and 16.7% between 8 and 14 days, 10.0% and 10.0% between 15 and 21 days, 26.3% and 10.5% between 22 and 28 days, and 7.0% and 2.3% over 4 weeks later, respectively. A significant correlation existed between the interval and the exacerbation of cerebral complications (tied p = 0.008). Preoperative risk factors affecting exacerbation of cerebral complications were as follows: (1) severity of cerebral complications (p = 0.006), (2) intervals (p = 0.012), and (3) uncontrolled congestive heart failure as indications for cardiac surgery (p = 0.014). One patient underwent a cardiac operation within 24 hours of the onset of cerebral hemorrhage and died of cerebral damage. No exacerbations occurred in 10 patients who underwent their operation between 2 and 28 days. Nevertheless, exacerbations occurred in 19.0% of patients whose operation was done more than 4 weeks later. These data suggest that cardiac operations can be done safely 4 weeks after cerebral infarction, and if the delay is more than 2 weeks, the exacerbation rate will be around 10%. The risk of progression of cerebral damage is still significant 15 days and even 4 weeks after cerebral hemorrhage.

Adult↗

PubMed1995

Risk factors for progression of diabetic nephropathy.

Fifty-four patients with noninsulin-dependent diabetes mellitus, who had established nephropathy, were examined to evaluate the risk factors for the progression of diabetic nephropathy. Time-averaged values of blood pressure, serum total cholesterol and fasting plasma glucose concentrations, and the degree of proteinuria during their follow-up period (4.2 +/- 0.5 years) were calculated. The correlation between these values and the slope of the regression line for the reciprocal of serum creatinine concentration over time, as an index of the speed of the progression of nephropathy, was examined. Age (61 +/- 1 years), mean arterial pressure (109 +/- 1 mm Hg), and the degree of the proteinureia (2.1 +/- 0.1 in dipstick test) were correlated with the slope. Effects of hypercholesterolemia and smoking on the slope were also examined. Mean arterial pressure was correlated with the slope significantly in patients without hypercholesterolemia (p < 0.05) and there was a tendency between these two in smokers (p < 0.06), while was no correlation found in patients with hypercholesterolemia or in nonsmokers. In addition, the relation between the slope and mean arterial pressure was relatively stronger in smokers without hypercholesterolemia than in nonsmokers with hypercholesterolemia. Our data suggest that blood pressure control as well as smoking avoidance may be important in preventing the progression of noninsulin-dependent diabetic nephropathy.

Age Factors↗

PubMed1995

Comparison of first-line antihypertensive drugs by a randomized cross-over method--a preliminary report.

The present study was undertaken to compare the effects of first-line antihypertensive drugs in Japanese patients. Four antihypertensive drugs were studied: trichlormethiazide (TCT), nifedipine retard (NIF), atenolol (ATN), and enalapril malate (ENP). Thirty-eight patients (16 men and 22 women; age, 53.3 +/- 8.8 years, mean +/- SD) were enrolled in the study. After a control period of 2 to 4 weeks, the four drugs were administered according to a randomized, cross-over design, the duration of each treatment period being 8 to 12 weeks. The initial dose of each drug was increased until blood pressure (BP) fell to less than 150/90 mmHg. The maximum doses of TCT, NIF, ATN, and ENP were 4, 40, 50, and 20 mg/day, respectively. The protocol was completed in 25 of the 38 patients. The BPs (SBP/DBP) at the end of each period were 168 +/- 3 (mean +/- SEM)/105 +/- 1 (control), 149 +/- 4/ 98 +/- 2 (TCT), 138 +/- 3/89 +/- 2 (NIF), 151 +/- 4/94 +/- 2 (ATN), and 152 +/- 4/97 +/- 2 mmHg (ENP). The BP during NIF treatment was significantly lower than during the other treatments. This finding suggests that the calcium antagonist had a greater hypotensive effect than the other first-line antihypertensive drugs studied. The subjects seem to more closely resemble black rather than white populations with respect to their response to antihypertensive treatment.

Adult↗

PubMed1995

Changes in plasma endothelin-1 concentration during blood volume depletion and expansion: role of the cardiopulmonary baroreflex.

To study the relationship between blood volume and the plasma level of endothelin-1 (ET-1), we examined the effects of blood volume depletion and expansion on the plasma ET-1 level in the rat. Anesthetized Wistar rats were subjected to hemorrhage (7 ml/kg), blood transfusion (7 ml/kg), or sham treatment. The same blood volume depletion and expansion were performed in other groups of rats, after bilateral cervical vagotomy or administration of intravenous atropine, to examine the role of the cardiopulmonary baroreflex. Hemorrhage produced mild decreases in the central venous pressure and arterial blood pressure, and an increase in the heart rate. Blood transfusion caused the opposite responses. The plasma ET-1 level was significantly higher in the volume-depleted rats (4.7 +/- 0.4 pg/ml, mean +/- SE, p < 0.05 vs. control), and was lower in the volume-expanded rats (2.6 +/- 0.2 pg/ml, p < 0.05) than in the control group (3.5 +/- 0.3 pg/ml). In the vagotomized rats, the blood volume depletion decreased and the volume expansion increased the central venous pressure and the arterial pressure, but they did not change the heart rate or the plasma ET-1 level. Vagal efferent inhibition with atropine did not affect the volume-induced changes in the plasma ET-1 level. These results indicate that the plasma level of ET-1 increases with blood volume depletion, and decreases with volume expansion. The cardiopulmonary baroreflex may play an important role in the regulation of plasma ET-1 levels when the blood volume is altered.

Animals↗

PubMed1995

Patient-hospital relationship and quality of life in elderly patients with hypertension.

To investigate the influence of the patient-hospital relationship on the quality of life (QOL) and on medication compliance in elderly patients with hypertension, we developed a comprehensive scale for assessing the patient-hospital relationship. In the first phase, an original questionnaire consisting of 40 items was designed under five fields for global assessment of the concept. We administered this questionnaire to 715 patients with cardiovascular diseases. Variations in the scores were evaluated by factor analysis. Three factors that comprised the majority of variance were derived by principal components analysis and varimax transformation. These orthogonal factors were considered to reflect "convenience of outpatient clinic", "satisfaction with clinical staff", and "communication with physician". We adopted three items under each of the three domains. Using this instrument, we assessed the patient-hospital relationship in 402 elderly outpatients with hypertension at 8 clinical centers. QOL and medication compliance were simultaneously assessed. A linear regression analysis revealed a significant positive correlation between patient-hospital relationship and QOL scores (r = 0.403, p < 0.0001), which means that patient-hospital relationship explained up to 16% of the total variability in scores on the Overall Quality of Life scale. The medication compliance was also better in patients with higher scores on the Patient-Hospital Relationship scale. These results indicate that the patient-hospital relationship is one of the substantial factors determining QOL and medication compliance in elderly patients with hypertension.

Aged↗

PubMed1995

Glomerular hemodynamics during supraventricular tachycardia.

Supraventricular tachycardia (SVT) was induced in 7 patients by programmed cardiac stimulation via an esophageal lead. Blood pressure, renal function, and hormonal factors were measured before, during, and after SVT. The glomerular filtration rate increased during SVT, while renal blood flow did not change. The parameters of glomerular hemodynamics were calculated according to the method of Gomez. Glomerular pressure was 64 +/- 3 (mean +/- SE) mmHg before SVT, and rose significantly (p < 0.01) to 76 +/- 5 during SVT. This rise in glomerular pressure was associated with a decrease in afferent vascular resistance (from 3355 +/- 610 to 1770 +/- 517 dynes x sec/cm5, p < 0.05) and an increase in efferent vascular resistance (from 3726 +/- 758 to 4814 +/- 780 dynes x sec/cm5, p < 0.05). Since atrial natriuretic peptide (ANP) increased during SVT (from 40 +/- 15 to 208 +/- 72 pg/ml, p < 0.01), these changes in glomerular hemodynamics may be attributed to the physiologic action of ANP. Despite the changes in glomerular hemodynamics during SVT, natriuresis appeared after SVT and not during SVT. This suggests that natriuresis accompanying SVT could not be attributed to the changes in glomerular hemodynamics.

Adult↗

PubMed1995

[Perceived quality of life and social factors in elderly hypertensive patients].

We conducted a cross-sectional study of elderly outpatients with hypertension to examine the relationship between quality of life (QOL) scores and social background factors. The subjects consisted of 516 outpatients (267 females), age of 60 or over, at nine clinics of major hospitals which participated in the National Cardiovascular Center Research Project. The perceived QOL was evaluated by the QOL scale originally based on Japanese patients with cardiovascular diseases. The scale consisted of the following 5 subscales; difficulty due to disease, psychological stability, independence, satisfaction in daily living and vitality. The background factors included family structure, socioeconomic factors and work status, and physical activity of daily living (ADL). After adjusting for age, sex, administered drugs and complicating conditions such as ischemic heart disease and/or apoplexy, a significant odds ratio of a low score of difficulty due to disease, psychological stability, satisfaction in daily living and vitality was found in the impaired physical ADL group with low socioeconomic class, and a significant odds ratio of low score of independence were found in the impaired physical ADL group who had lost jobs due to illness and had no children.

Aged↗

PubMed1995

[Urinary incontinence in elderly patients in the chronic stage of stroke].

One hundred and six elderly patients with chronic stroke who were admitted to Seiai Rehabilitation Hospital were studied regarding urinary incontinence. The average age of the subjects was 74 +/- 8 years old, ranging from 60 to 94 years. Seventy three of the 106 patients (69%) had urinary incontinence which was found in 72% of brain infarction, 61% of brain hemorrhage and 67% of subarachnoid hemorrhage. The prevalence of urinary incontinence in cases of brain stem, thalamic, and putaminal hemorrhage was 80%, 67% and 46%, while that in cases of cortical infarction and infarct of perforating arteries was 84% and 68%, respectively. The rate of urinary incontinence was significantly higher in those aged 75 years or over (p < 0.05), those with poor activities of daily living (ADL, p < 0.005), or with dementia (p < 0.001). Dementia was a complicating factor more frequently in aged patients (p < 0.05) and in those with poor ADL (p < 0.001), although no correlation was seen between age and ADL (p = 0.08). These results indicated the high prevalence of urinary incontinence in elderly inpatients with chronic stroke, which is significantly related to impairment of mental and physical activities.

Activities of Daily Living↗