Biomedical subjects

H Iso

Publications and source records attributed to H Iso.

At least 55 records · Page 3Linked to original sources

PubMed1996

Polymorphism of the apolipoprotein B gene and blood lipid concentrations in Japanese and Caucasian population samples.

To examine whether a racial difference in apolipoprotein B (Apo B) gene polymorphism between Japanese and American Caucasians corresponds with the lower blood cholesterol concentrations in Japanese than in Americans, we examined the EcoRI polymorphism of the Apo B gene for 271 nonsmoking men and women aged 47-69 years in two population-based samples: rural Japanese living in Akita and Caucasians living in Minneapolis-St. Paul, Minnesota, USA. Mean values of serum cholesterol concentrations were significantly lower in Japanese than in Caucasians for both men and women (difference = 25-26 mg/dl). An allele-specific polymerase chain reaction was conducted to examine the Eco RI cutting site at the 12669 cDNA position of the Apo B gene. The allele R2 (absence of the cutting site) has been associated with lower cholesterol concentrations in two previous studies. The frequency of the R2 allele was 6% for Japanese and 17% for Caucasians (P < 0.001), and this race difference in allele frequency was identical for men and women. After controlling for age, body mass index, alcohol intake, and for women, menopausal status and hormone replacement therapy, the adjusted mean (SE) cholesterol level among Japanese was 204 (3) mg/dl for genotype R1R1 and 185 (7) mg/dl for genotype R1R2 or R2R2 combined (P = 0.01). The respective mean values among Caucasians were 224(5) mg/dl and 232(7) mg/dl (P = 0.36). The polymorphism had a similar effect on total cholesterol concentrations for both men and women. The observed lower prevalence of the R2 allele in Japanese than in Caucasians indicates that this variation in the Apo B gene does not explain the racial difference in blood cholesterol concentrations.

Aged↗

PubMed1996

Lipoprotein(a) and its correlates in Japanese and U.S. population samples.

To examine whether serum levels of lipoprotein(a) [Lp(a)], a potential coronary risk factor, are higher in Caucasian-Americans than in Japanese, a circumstance that would correspond to the higher mortality from coronary heart disease in the United States than in Japan, we analyzed serum Lp(a) levels in 300 nonsmoking men and women aged 47-69 years. Participants were drawn from two population-based samples: rural Japanese living in Akita and Caucasians living in Minneapolis-St. Paul, MN. Geometric mean and median serum Lp(a) concentrations were higher (P < 0.05) in Japanese than in Caucasians for both men (difference in geometric mean = 3.2 mg/dL) and women (difference = 5.3 mg/dL). There was however, no racial difference in the proportion of elevated Lp(a) concentrations (i.e., > or = 30 mg/dL) in either sex. Alcohol intake was inversely correlated with Lp(a) levels in Japanese men, who had a high average alcohol intake, but not in other sex and racial groups. Serum Lp(a) was nonsignificantly but consistently correlated with plasma fibrinogen and LDL-cholesterol for all sex and racial groups. With adjustment for alcohol intake, LDL-cholesterol, and plasma fibrinogen, the Japanese-Caucasian difference in geometric mean Lp(a) values was even larger for men and was not changed for women. Results of the present study do not support the hypothesis that racial differences in Lp(a) concentrations contribute to the higher mortality rate from coronary heart disease in the United States than in Japan.

Aged↗

PubMed1996

Plasma fibrinogen and its correlates in urban Japanese men.

BACKGROUND: The intention of the study was to examine determinants of plasma fibrinogen concentrations in Japanese men. METHODS: A cross-sectional study was conducted in 1991 among 995 male employees aged 40-59 years in two urban companies. RESULTS: The overall mean value (standard deviation) of plasma fibrinogen concentration was 257 (57) mg/dl. There was a strong dose-response relationship between cigarette smoking and plasma fibrinogen concentration. Plasma fibrinogen was positively associated with age and serum total cholesterol, and inversely associated with ethanol intake, dietary intake of sea foods such as squid, octopus or shrimp. Intake of other major protein and lipid resources such as meat, eggs and milk, or intake of vegetables was not related to plasma fibrinogen. An effect of dietary intake of sea foods on plasma fibrinogen was small but significant after controlling for the other covariates; an 80 g/week larger intake of sea foods was associated with a 3.9 mg/dl (95% confidence interval: 0.5, 7.3) lower fibrinogen concentration. CONCLUSIONS: This study confirms the relation of known coronary risk factors to plasma fibrinogen in Japanese men, and suggests that dietary intake of sea foods affects plasma fibrinogen concentrations.

Adult↗

PubMed1996

Community-based education classes for hypertension control. A 1.5-year randomized controlled trial.

Community-based hypertension control is important for primary prevention of cardiovascular disease. In this study, untreated men and women aged 35 to 69 years were randomly assigned to an intervention (n=56) or control (n=55) group in a 1.5-year community-based education program. Subjects had no evidence of hypertensive end-organ defects and had screening blood pressures of 140 to 179 mm Hg systolic and/or 90 to 109 mm Hg diastolic, with no difference in mean blood pressure between groups (148 to 150 mm Hg for mean systolic and 83 to 84 mm Hg for mean diastolic pressures). The intervention group took four education classes in the first 6 months and four classes during the next year, and the control group took two classes. Health education focused on reduced dietary sodium and increased milk intake, brisk walking, and, if necessary, reduction of alcohol and sugar intakes. Antihypertensive medication was started less often in the intervention than in the control group at 1.5 years (9% versus 24%, P <.05). Mean systolic pressure was 5 to 6 mm Hg less in the intervention than in the control group at both 6 months and 1.5 years (P <.05), with or without inclusion of those subjects who began antihypertensive medication. Diastolic pressure and body mass index did not change significantly between groups. Urinary sodium excretion declined in the intervention but not in the control group (differences between groups: P=.04 at 6 months and P=.07 at 1.5 years). According to a behavioral questionnaire, sodium reduction and milk increase were greater in the intervention than the control group (sodium: P <.01 at 6 months and P=.08 at 1.5 years; milk: P <.001 at 6 months and P <.01 at 1.5 years). Mean ethanol intake was reduced in the intervention but not the control group (P=.04 at 1.5 years). This community-based hypertension control program was effective in reducing systolic pressure levels by nonpharmacological means during the first 6 months and maintaining the reduction for 1.5 years.

Aged↗

PubMed1996

Epidemiology of cerebrovascular disease: stroke epidemic in Japan.

Japan had the highest mortality from stroke among developed countries in 1960, but experienced rapid changes in diet and other lifestyles with economic growth between the 1960s and the 1980s, which provided an unique opportunity to observe a natural experiment of changes in risk factors and stroke. Blood pressure levels declined due to improvements of drug treatment for hypertension and to dietary improvements such as sodium reduction. An increase in mean values of ethanol intake and body mass index did not correspond with a decline of blood pressure levels. Serum total cholesterol increased with an increased intake of meat, egg, milk and dairy products. Age-adjusted mortality rate of stroke declined 70% between 1960 and 1990. The changes of diet, blood pressure levels and stroke were more evident in rural populations than in urban populations. Risk factors of stroke has been investigated prospectively, and hypertension was found to be the most important risk factor. A low blood cholesterol was associated with the increased risk of intracerebral hemorrhage, which has been confirmed in several Japanese populations, Japanese Americans and Caucasian Americans. Thus, a rise in serum cholesterol suggested to contribute in part to a decline in intracerebral hemorrhage. Risk factors for cerebral infarction include age, atrial fibrillation and hypertensive endorgan effects such as resting electrocardiogram and fundscopic examination. A community-based hypertension control program for stroke prevention has been evaluated; a larger decline in stroke incidence in the intervention community (69%) than in the reference community (49%, the difference: p < 0.001). Effective community programs stimulated the formation of the 1982 national act on health and medical care in which every municipal government is required to conduct health screenings and education for residents aged 40 and over to prevent cardiovascular diseases.

Cerebrovascular Disorders↗

PubMed1996

A case-reference study on plasma fibrinogen concentrations and coronary atherosclerosis in Japanese.

To examine contribution of plasma fibrinogen concentrations to coronary atherosclerosis in Japanese, a cross-sectional study was conducted from 1991 to 1993 for 169 myocardial infarction cases and 1 : 1 matched references. All cases had one to three coronary vessels with 50 percent or more stenosis. References were chosen out of Osaka residents who had no cardiac event by matching sex and age ((+)-3 years) with cases. Mean (SD) values of plasma fibrinogen concentration were 322 (81) mg/dl in men and 377 (77) mg/dl in women for cases, and were 282 (56) mg/dl in men and 277 (48) mg/dl in women for references; mean plasma fibrinogen was significantly higher in cases than in references for both men and women. Furthermore, mean plasma fibrinogen was progressively higher as the number of stenotic vessels increased for men, and similar trend was seen for women. The case-reference difference remained significant even after adjusting smoking status, hypertension, serum total cholesterol, serum HDL cholesterol. Although plasma fibrinogen concentration was reported lower in Japanese than in American Caucasians, plasma fibrinogen is suggested to be a risk factor for myocardial infarction among Japanese as so among Caucasians.

Adult↗

PubMed1996

[The relation of alcohol intake to constitutional and biochemical variables in Japanese populations].

To investigate associations of alcohol intake to constitutional and biochemical variables, cross-sectional studies of men aged 40-59 years from six geographical and occupational populations with varied lifestyles were conducted in the 1990's. Systolic and diastolic blood pressures, glutamic oxaloacetic transaminase, gamma glutamyl transpeptidase, HDL-cholesterol, and uric acid were linearly associated with alcohol intake in all six populations. Drinkers of 2+ drinks (46 g ethanol or more) per day showed higher levels of triglyceride, glutamic pyruvic transaminase than never-drinkers. In two urban occupational populations, men who mainly drank beer had higher uric acid levels; men mainly drinking sake had higher blood pressures and lower serum total cholesterol; men mainly drinking whiskey had higher obesity indices. These differences in constitutional and biochemical variables related to type of alcoholic beverage consumed may be due to differences in lifestyles such as diet and physical activity.

Adult↗

PubMed1995

Alcohol intake and the risk of cardiovascular disease in middle-aged Japanese men.

BACKGROUND AND PURPOSE: Understanding the effects of alcohol intake on stroke and other cardiovascular diseases is an important issue for public health. METHODS: A 10.5-year prospective study of the relationship between alcohol intake and cardiovascular disease incidence was conducted in 2890 men, aged 40 to 69 years and free of a history of stroke and coronary heart disease, in three rural communities of Japan. RESULTS: One hundred seventy-eight strokes (40 intracerebral hemorrhages, 18 subarachnoid hemorrhages, 104 nonhemorrhagic strokes, and 16 unclassified strokes), 34 coronary heart disease events, and 19 sudden unclassified deaths occurred. Drinkers of > or = 70 g/d ethanol had an approximately 2.5 times higher age-adjusted risk of all stroke than never-drinkers; the excess risk was more evident for hemorrhagic stroke than nonhemorrhagic stroke. When hypertension category, serum total cholesterol level, cigarette smoking, and diabetes mellitus were taken into account, these excess risks were reduced but remained significant for all stroke (2.0; 95% confidence interval, 1.3 to 3.1) and hemorrhagic stroke (3.4; 95% confidence interval, 1.2 to 9.2). A J-shaped relationship was suggested between alcohol intake and risk of nonhemorrhagic stroke; drinkers of < 42 g/d ethanol had a slightly lower risk and heavy drinkers had a higher risk than never-drinkers. Current drinkers had a slightly lower risk of coronary heart disease than never-drinkers, although the risk difference was not statistically significant. The age-adjusted risk of sudden death was 10 times higher in heavy drinkers than never-drinkers, and the excess risk did not change when the covariates were controlled for. Total cardiovascular disease showed a similar pattern as did all stroke. CONCLUSIONS: Heavy drinking appeared to increase the risk of hemorrhagic stroke, in part due to hypertension, and to increase the risk of sudden death, which was probably due to drinking per se. Light or moderate alcohol consumption seemed to protect against nonhemorrhagic stroke and coronary heart disease.

Age Factors↗

PubMed1995

[Relation of serum fatty acids with serum lipids and blood pressure in women].

We studied the correlation of serum fatty acids, a potential coronary risk factor, with serum lipids and blood pressure. The subjects were women aged 40-69 of four Japanese populations (fishing, coastal farming, inland farming and urban populations) and a Caucasian population in which different dietary habits have been reported. Within populations, the total cholesterol level was not correlated with serum fatty acids. HDL-cholesterol was inversely correlated with saturated fatty acids and monounsaturated fatty acids, and positively correlated with polyunsaturated fatty acids although not significantly so in all populations. LDL-cholesterol was not correlated with saturated fatty acids and mono polyunsaturated fatty acids, but was positively correlated with polyunsaturated fatty acids. Triglyceride was positively correlated with saturated fatty acids and monounsaturated fatty acids, and inversely correlated with polyunsaturated fatty acids for all populations. Blood pressure correlated positively with saturated fatty acids, and inversely with polyunsaturated fatty acids although these associations were not statistically significant.

Adult↗

PubMed1995

Polymorphisms of the beta fibrinogen gene and plasma fibrinogen concentration in Caucasian and Japanese population samples.

We reported previously that plasma fibrinogen was significantly higher in U.S. Caucasians than in Japanese, which may contribute to the higher mortality rate of coronary heart disease in the United States than in Japan. To examine the contribution of genetic variations to the race difference in plasma fibrinogen levels, restriction fragment length polymorphisms (RFLPs) of the beta fibrinogen gene were examined in 293 nonsmoking Caucasians and Japanese men and women aged 47-69 years. Three RFLPs were detected by digestion of genomic DNA using the BclI restriction enzyme, polymerase chain reaction (PCR) products using HaeIII and HindIII. The alleles B2 (4.2 kb, BclI digestion), H2 (957 b, HaeIII) and Hd2 (465 b. HindIII) were associated with higher fibrinogen concentrations in previous studies. Because of a strong linkage disequilibrium between HaeIII and HindIII polymorphisms, the data of HindIII was presented. The frequency of the B2 allele was 22% (95% Cl: 17-27%) for Caucasians and 13% (10-17%) for Japanese (the difference: p < 0.01). The respective frequency of the Hd2 allele was 26% (21-31%) and 12% (8-16%) (p < 0.001). After controlling for age, body mass index, alcohol intake, triglycerides, fish intake, and for women, menopausal status and hormone replacement therapy, the adjusted mean fibrinogen level among Caucasians was 289 mg/dl for genotype B1B1 and 301 mg/dl for genotype B1B2 or B2B2 combined (p = 0.18), and 285 mg/dl for Hd1Hd1 and 306 mg/dl for Hd1Hd2 or Hd2Hd2 combined (p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1995

[Characteristics of participants in community-based rehabilitation programs and their levels of independence in activities of daily living].

To clarify characteristics of participants in community-based rehabilitation programs provided by local municipalities (cities, towns, and villages) and effect of the program on their levels of independence in activities of daily living (ADL), a cross-sectional study was performed on 422 participants in 49 municipalities in Kochi Prefecture. 1. Mean age of participants was 68.3 +/- 9.0, and 77.7% of them were stroke patients. 2. The mean interval between disease onset and program participation was 40.4 months, and the mean duration of program participation was 54.5 months. 3. At the start of rehabilitation programs and at the time of the investigation (December 1993), about 90% of the participants had good levels of independence in ADL (Rank A and over according to the standard of the Ministry of Health and Welfare). 4. The frequency of rehabilitation programs and the presence of occupational therapists were positively associated with the improvement of levels of independence in ADL. In particular, the frequency of rehabilitation programs was associated with improvement of quality of life in self-supporting participants (Rank J2), and the presence of occupational therapists was associated with the improvement of ADL in semi-bed-ridden participants (Rank A). 5. After adjusting for age and sex, using multiple logistic regression analysis, type of diseases (non-stroke), hospital rehabilitation immediately after onset, higher levels of independence in ADL at the start of rehabilitation programs, and higher frequency of rehabilitation programs were significantly associated with improvements in levels of independence in ADL. Shorter interval between disease onset and program participation, and the presence of occupational therapists were also associated with improvements in levels of independence in ADL, although the relation did not reach statistical significance.

Activities of Daily Living↗

PubMed1994

Serum total cholesterol and mortality in a Japanese population.

Although the relation between serum total cholesterol and coronary heart disease is well established, the relation with mortality from non-coronary disease is controversial. Inverse relations of serum cholesterol with hemorrhagic stroke and cancer have stimulated the examination of cholesterol-non-coronary mortality associations. The population surveyed is 12,187 men and women aged 40-69 years living in Yao City, a suburb of Osaka, who undertook baseline examinations between 1975 and 1984 and had no history of stroke and coronary heart disease at baseline. The subjects were followed on average 8.9 years until the end of 1988 using systematic mortality surveillance. During the follow-up, there were 343 deaths, comprising 170 cancer deaths (International Classification of Death 9th edition: ICD-9, 140-239), 21 coronary heart disease deaths (ICD-9, 410-414), 67 other cardiovascular deaths (ICD-9, 390-458 excluding 410-414), and 85 non-cardiovascular, non-cancer deaths. There was a significant inverse association of serum cholesterol with total and cancer mortality for men, and no significant association for women. The cholesterol-disease association, although not significant, was positive for coronary heart disease and other cardiovascular disease deaths, and inverse for non-cardiovascular, non-cancer deaths in both sexes. The inverse association of serum cholesterol with total and cancer mortality for men remained significant after controlling for age, job classification, hypertension category, usual alcohol intake, cigarette smoking, and relative weight index.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Left ventricular mass and subsequent blood pressure changes among middle-aged men in rural and urban Japanese populations.

BACKGROUND: It has been suggested that echocardiographically determined left ventricular mass (LVM) is useful in the prediction of hypertension. To examine the relation between LVM and subsequent blood pressure (BP) change, a 6- to 8-year follow-up was conducted in adult Japanese men. METHODS AND RESULTS: LVM was determined by M-mode echocardiography using the American Society of Echocardiography formula among 354 normotensive men aged 30 to 59 years from a rural community (n = 193) and from urban companies (n = 161) in Japan between 1979 and 1983. BP was remeasured 6 to 8 years after baseline in 148 rural men (77%) and 127 urban men (79%). For men whose BP was remeasured, the mean +/- SD LVM index (LVM/body surface area [g/m2]) at baseline was 117 +/- 22 in rural men and 99 +/- 15 in urban men (the difference, P < .001). For both populations, LVM index was positively associated with age and physical activity but not with body mass index. Associations of LVM index with usual alcohol intake and initial BPs were generally weak. According to linear regression analyses after controlling for these covariates at baseline, a 20-g/m2 greater LVM index at baseline was associated with a 5 mm Hg increase in systolic and a 4 mm Hg increase in diastolic BP during the subsequent 6 to 8 years for urban men. A 1-mm greater average ventricular wall thickness was associated with a similar BP increase. For rural men, positive associations of LVM index with BP increase existed but were weak. The weaker association between LVM index and BP increase in rural compared with urban men was probably the result of effects of higher physical activity, leading to a larger left ventricular internal dimension. The increase in systolic and diastolic BPs over the 6 to 8 years of observation was significantly related to baseline LVM index in rural and urban men with a smaller internal dimension (rural men, < or = 49 mm; urban men, < or = 47 mm) but not in those with larger dimensions. CONCLUSIONS: An increased LVM index predicts subsequent BP increase in middle-aged normotensive men in the presence of a normal or small internal dimension.

Adult↗

PubMed1994

High-density lipoprotein cholesterol and premature coronary heart disease in urban Japanese men.

BACKGROUND: The objective of this study was to examine the relation of high-density lipoprotein cholesterol (HDL-C) to coronary heart disease in Japanese men whose serum total cholesterol is low by Western standards. METHODS AND RESULTS: A prospective, observational study based on 7.7 years of follow-up for incidence of coronary heart disease and stroke was conducted. The subjects were 6408 middle-aged male workers aged 40 to 59 years at baseline in urban companies in Osaka, Japan, whose mean serum total cholesterol was 5.10 mmol/L. Mean HDL-C adjusted for age, total cholesterol, systolic blood pressure, alcohol intake, cigarette smoking, and body mass index was 1.27 to 1.28 mmol/L for men who developed coronary heart disease (n = 46) or definite myocardial infarction (n = 21) compared with 1.46 mmol/L for those free of cardiovascular disease (n = 6256; difference, P < .01). There was no significant difference in mean HDL-C between stroke cases (n = 33) and those free of cardiovascular disease. The incidence rates of coronary heart disease and definite myocardial infarction, adjusted for the other risk factors, were three to four times higher in the lowest HDL-C quartile (< 1.24 mmol/L) than the highest quartile (> or = 1.66 mmol/L), and there was a significant dose response for definite myocardial infarction. Serum total cholesterol was positively and significantly associated with coronary heart disease incidence. Furthermore, the inverse association for HDL-C was apparent among men with total cholesterol < 5.69 mmol/L (mean total cholesterol, 4.76 mmol/L) and men with total cholesterol > or = 5.69 mmol/L (mean total cholesterol, 6.26 mmol/L). CONCLUSIONS: Coronary heart disease incidence is inversely related to HDL-C in urban Japanese middle-aged men, whose mean total cholesterol (5.10 mmol/L) is relatively low.

Adult↗

PubMed1994

A comparison of lesions in small intracerebral arteries among Japanese men in Hawaii and Japan.

BACKGROUND AND PURPOSE: This report examines the hypothesis that the higher risk of stroke among Japanese men in Japan compared with those in Hawaii is related to pathology in small intracerebral arteries by comparing the prevalence of such lesions in autopsied participants from two cohorts of Japanese men in Japan and Hawaii. METHODS: Existing histological sections from the left basal ganglia from 232 men from Japan and 175 men of Japanese ancestry in Hawaii were examined for selected abnormalities in arteries between 100 and 300 microns in diameter by three pathologists. The presence of lacunar infarcts was also noted, and information about cerebral infarcts, cerebral hemorrhages, and atherosclerosis in the circle of Willis was available for the Hawaii group. RESULTS: Lacunar infarcts and all small intracerebral artery lesions except medial fibrosis were more common at every age in Japan than in Hawaii. By cause of death, all lesions were three or more times more prevalent among men who died of stroke than of noncardiovascular causes in both areas. In the Hawaii group, the small intracerebral artery lesions were significantly associated with autopsy evidence of cerebral and lacunar infarcts, and with atherosclerosis in the large arteries of the circle of Willis. Among a large number of risk factors measured at the baseline examination in Hawaii, only high blood pressure and reported usual Asian diet were significantly associated with one or more measures of small intracerebral artery lesions. CONCLUSIONS: An overview of the accumulated data indicated that small intracerebral artery pathology plays an important role in the high risk of stroke in Japanese men in Japan compared with those in Hawaii. These studies support the idea that hypertension is a necessary factor in the causal pathway, but also indicate that some other factors are involved. Some aspect of an Asian diet continues to be of importance for future research.

Age Factors↗

PubMed1994

[A randomized controlled trail of intensive and usual community-based education for blood pressure control].

A 1.5 year community-based hypertension education program was conducted and evaluated for the feasibility and effectiveness as a program for primary prevention of cardiovascular disease. The subjects were determined to be hypertensive from cardiovascular examinations and composed of 104 untreated men and women aged 35-69 whose blood pressure levels were between 140 and 179 mmHg for systolic and/or between 90 and 109 mmHg for diastolic and who had no evidence of hypertensive end organ effects in the 1990 examination. They were randomly assigned to either an intensive education (IE) group (n = 53) or a usual education (UE) group (n = 51) and invited to education classes six months later. The IE consisted of four education classes in the first six months and another 4 classes in the next 12 months. For the UE, one class in the first 6 months and another class in the next 12 months were held. Health education was focused on reduction of sodium intake, a 30 minutes of walking, and if necessary, reduction of alcohol and sugar intake. Mean (SD) values of systolic blood pressure at the start of the education program were 144.8 (11.7) mmHg in IE and 144.5 (12.2) mmHg in UE. The respective diastolic means (SD) were 80.6 (7.8) mmHg and 80.3 (8.6) mmHg. The proportion of persons who started to receive antihypertensive medication was 8-9% in both groups at six months, and 13% in IE and 29% in UE at 1.5 years. IE showed a 6 mmHg greater reduction in mean systolic blood pressure than UE at both six months and 1.5 years. No significant difference was found in diastolic blood pressure levels over time between the two groups. Dietary improvements related to reduction of salt intake were more evident in IE than in UE. There was no significant changes in means and distributions of relative weight index and alcohol intake in either group. Subgroup analysis according to antihypertensive medication use indicated that reduction of systolic blood pressure levels was significantly larger in IE than in UE for both no medication and medication subgroups at 6 months and 1.5 years. While it was difficult to evaluate an effect of the program at 1.5 years because of the difference in the proportion of medication use between IE and UE, the results at 6 months suggest that this community-based program was effective in reducing systolic blood pressure levels.

Adult↗

PubMed1994

[Family make-up is associated with the admission rate of stroke patients--difference between Kochi and Shimane Prefectures and in a rural community].

Kochi Prefecture had a higher admission rate for patients with cardiovascular disease, particularly for stroke, than Shimane Prefecture which has a similar socio-economic level. Kochi Prefecture had a smaller average number of persons in a household, a lower proportion of three generation households, and a lower proportion of households with six persons or more than Shimane Prefecture. The decline in number of persons in a household was greater in Kochi Prefecture than in Shimane Prefecture from 1960 to 1985, especially between 1970 and 1975. The association between family make-up and hospital discharge one year after stroke was examined in a rural community in Kochi Prefecture. Two hundred forty nine patients aged 40 years and older who were admitted immediately after stroke events were registered between 1969 and 1988, and they were followed for one year. According to family make-up, the subjects were divided into four groups: 1) persons who lived with spouse and daughter-in-law, 2) persons who lived with spouse, 3) persons who lived with daughter-in-law, 4) persons who lived without spouse and daughter-in-law. Although mean age and the proportion of serious cases were not different between group 1 and group 4, the proportion of admitted patients of group 1 was significantly lower than that of group 4. About 60% of group 1 had households with six persons or more. Group 2 had the lowest proportion of admitted patients, but this group was significantly younger than other groups. Within group 3, the proportion of admitted patients was higher in households in which the daughter-in-law had a job than in households in which she did not. These results suggest that the high admission rate in Kochi Prefecture is attributable to households which are short of personnel for home care.

Adult↗

PubMed1993

Antigens of tissue plasminogen activator and plasminogen activator inhibitor 1: correlates in nonsmoking Japanese and Caucasian men and women.

We reported in a 1987 preliminary study that tissue plasminogen activator antigen was significantly higher in American Caucasian men than in Japanese men. To further examine possible differences in fibrinolytic activity between the two races, an expanded study was conducted in a total of 300 nonsmoking men and women aged 47-69 years in two population-based samples: rural Japanese living in Akita and Caucasians living in Minneapolis-St. Paul, MN. Antigens of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1) were measured. Mean t-PA antigen was 2.3 ng/ml higher in Caucasian men than in Japanese men (P < 0.001), but no race difference was seen for women (P = 0.59). Mean PAI-1 was higher in Caucasians than in Japanese for both sexes, and the race difference in mean was 1.8 ng/ml for men (P = 0.07) and 4.4 ng/ml for women (P < 0.001). Both t-PA and PAI-1 were associated positively with body mass index and blood triglycerides for all sex-race groups, and positively with alcohol intake for Japanese and Caucasian men. Compared to Japanese, Caucasians of both sexes had higher levels of body mass index and blood triglycerides, and lower average intake of alcohol among men. Even when adjusted for body mass index, triglycerides, alcohol and other cardiovascular risk factors, the race difference in mean t-PA antigen persisted for men (P < 0.001), as did the difference in mean PAI-1 for men (P = 0.03) and women (P = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗