Document Detail


Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly: the Hisayama study.
MedLine Citation:
PMID:  12578518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is not known whether the treatment recommendations presented in the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure are applicable to the Japanese elderly population. METHODS: We followed up 588 cardiovascular disease-free residents of a Japanese community who were 60 years or older from November 1, 1961, through October 31, 1993. Treated hypertensive patients were excluded from the analysis. During this period, CVD occurred in 179 subjects. The incidences were estimated by the pooling of repeated observations method. RESULTS: The age- and sex-adjusted incidences of cardiovascular disease significantly increased with elevated blood pressure levels. The hazard ratio for stage 3 hypertension was 5.34 (95% confidence interval, 2.66-10.71; P<.001) compared with optimal blood pressure after adjustment for other covariates. Among subjects aged 60 to 79 years, the incidences for stages 1 through 3 hypertension were significantly higher than for those with optimal and normal blood pressure. In comparison, among those 80 years or older, the incidence was significantly higher only in patients with stage 3 hypertension. We further estimated the incidences according to the risk stratification system. In the younger elderly subjects, the incidences increased with rising blood pressure levels in each risk stratum. Similar relationships were not observed among the older elderly subjects. CONCLUSIONS: Our findings demonstrate that the recommendations of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure were potentially applicable to the Japanese elderly subjects 79 years or younger. Based on our findings, however, hypertension might not be a risk factor for cardiovascular disease among very old hypertensive patients with advanced atherosclerosis.
Authors:
Hisatomi Arima; Yumihiro Tanizaki; Yutaka Kiyohara; Takuya Tsuchihashi; Isao Kato; Michiaki Kubo; Keiichi Tanaka; Ken Ohkubo; Hidetoshi Nakamura; Isao Abe; Masatoshi Fujishima; Mitsuo Iida
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of internal medicine     Volume:  163     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-11     Completed Date:  2003-03-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  361-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka City, 812-8582 Japan. harima@intmed2.med.kyushu-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Cardiovascular Diseases / epidemiology*,  etiology*
Coronary Disease / epidemiology,  etiology
Female
Follow-Up Studies
Humans
Hypertension / complications*,  epidemiology,  therapy*
Incidence
Japan / epidemiology
Male
Practice Guidelines as Topic
Reproducibility of Results
Risk Factors
Severity of Illness Index
Sex Factors
Stroke / epidemiology,  etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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