PubMed Health⌕ Search

Biomedical subjects

O Tochikubo

Publications and source records attributed to O Tochikubo.

At least 19 recordsLinked to original sources
PubMed1996

Effects of insufficient sleep on blood pressure monitored by a new multibiomedical recorder.

Blood pressure varies in relation to factors such as physical activity, body position, ambient temperature, and autonomic nervous system activity. Therefore, we have developed a portable multibiomedical (PMB) recorder that monitors five parameters: indirect blood pressure, physical activity, body position, ambient temperature, and RR interval of the electrocardiogram. In the present study, we applied the PMB recorder over a 24-hour period to study the effect of insufficient sleep on blood pressure in subjects doing extensive overtime work. The parameters listed above were measured by the PMB recorder throughout a normal workday (mean period of sleep, 8 hours) and throughout a day with insufficient sleep (mean period of sleep, 3.6 hours) in 18 male technical workers aged 23 to 48 years old. Blood pressure (mean systolic/diastolic pressure +/- SD) significantly increased the day after a sleep-insufficient night (129 +/- 8/79 +/- 6 mm Hg) compared with the day after a normal night (123 +/- 8/76 +/- 7 mm Hg, P<.05). However, ambient temperature, mean number of steps per minute, and percentage of time spent in a standing position showed no significant difference between these days. Spectral analysis of RR intervals showed that the ratio of the low-frequency component on the RR power spectrum (0.05 to 0.15 Hz) to the high-frequency component (0.15 to 0.40 Hz) was higher on the sleep-insufficient day (2.17 +/- 0.37 versus 1.81 +/- 0.37), as was the urinary excretion of norepinephrine (P<.05). Heart rate was significantly higher on the sleep-insufficient day (81 +/- ll versus 76 +/- 8 beats per minute), after the data of two subjects with abnormal levels of physical activity were excluded (P<.Ol). These data suggest that lack of sleep may increase sympathetic nervous system activity on the following day, leading to increased blood pressure. The PMB recorder was useful for precisely evaluating the relationship between blood pressure and environmental factors.

Adult↗
PubMed1995

Circadian variation in baroreflex sensitivity evaluated by beat-to-beat hemodynamic change in patients with essential hypertension.

The mechanisms underlying the higher incidence of cardiovascular events in the morning were investigated by studying the circadian variation in hemodynamics and baroreflex sensitivity (BRS) in 20 untreated inpatients with essential hypertension. Direct blood pressure (BP) and heart rate (HR) were recorded using telemetry. Cardiac output (CO) was measured by the dye dilution method. Beat-to-beat stroke volume (SV) and total peripheral vascular resistance (TPR) were obtained using the pulse contour method. The coefficient of regression between HR and systolic BP (SBP) change (delta HR/delta SBP = Ahr) was calculated for in 5 consecutive heart beats during which BP decreased spontaneously and linearly (r > 0.9). Similarly, the delta SV/delta SBP (= Asv) and delta TPR/delta SBP (= Atpr) were also measured, and the negative values of these coefficients (-Ahr, -Asv and -Atpr) were calculated. Comparisons between morning (6-11 a.m.) and evening (4-9 p.m.) values showed no significant difference in mean BP (122 vs 127 mmHg) and HR (72 vs 73 bpm). However, CO (3.7 vs 4.2 l/min), -Ahr (0.28 vs 0.43 bpm/mmHg) and -Asv (-1.5 vs 1.4 ml/mmHg) were lower in the morning than in the evening (p < 0.01). In contrast, TPR (40 vs 34 mmHg/l/min) and -Atpr (1.2 vs -1.4 min/l) were higher in the morning than in the evening (p < 0.01). These findings suggest that lower -Ahr and -Asv and higher TPR and -Atpr may cause stress to the cardiovascular system in the morning in patients with essential hypertension.

Adult↗
PubMed1995

[A new protein titrator tape for self-assessment by outpatients with proteinuria].

ł- have invented a new dipstick (protein titrator tape) for measuring the volume of protein excreted in the 24-hour urine. The principle of the method is based on the protein error of indicators with the modification of a conventional dipstick test. The dipstick consists of two thick filter papers, containing differently adjusted pH indicators of tetrabromphenol blue, making it possible to detect a wide range of protein concentrations in the urine using a standard color chart that includes twenty color blocks. Two hundred and ninety outpatients had their urine samples assessed with this method as well as with the pyrogallol red test as a comparative study for quantitative measurement of protein concentrations. The new-type dipstick method exhibited good correlation with the results of the pyrogallol red test, especially in the range of protein concentrations from 50 mg/dl to 400 mg/dl, showing the linear equation of "y (Pyrogallol red) = 10.5 + 0.99 x (Dipstick) (r = 0.91, P < 0.01)". Although there was good correlation with the pyrogallol red test at higher concentrations from 400 mg/dl to 1,000 mg/dl, the dipstick method tended to exhibit lower concentrations than those indicated by the counterpart method. The rate of consistency between observers was quite high. This new-type dipstick method will offer a reliable method for patients or their family to assess their protein excretion in the urine every 24 hours at home using a portable urine sampling device.

Adult↗
PubMed1994

Critical PQ interval for the appearance of diastolic mitral regurgitation and optimal PQ interval in patients implanted with DDD pacemakers.

Diastolic mitral regurgitation (MR) may be induced by prolonging atrioventricular (AV) delay, and a significant negative correlation has been described between the critical PQ interval for the appearance of diastolic MR and pulmonary capillary wedge pressure (PCWP) in patients with DDD pacemakers. We report the relationship between the critical PQ interval for the appearance of diastolic MR and the optimal PQ interval in 11 patients (69.1 +/- 12.6 years). Cardiac output (CO) and PCWP were measured by Swan-Ganz catheter and transmitral blood flow was recorded by pulsed-Doppler echocardiography. AV delay was prolonged stepwise by 0.025 seconds starting from 0.065 seconds. The pacing rate was fixed at 70 beats/min. CO was highest when the PQ interval was 0.18 +/- 0.04 seconds. There was a significant positive correlation between the critical PQ interval for the appearance of diastolic MR and the PQ interval at which CO was the highest (r = 0.91, P < 0.01). The PQ interval at which CO was the highest was 0.02 +/- 0.02 seconds shorter than the critical PQ interval for the appearance of diastolic MR (P < 0.05). When the PQ interval was increased by 0.025 seconds from the critical PQ interval for the appearance of diastolic MR, CO decreased from 4.3 +/- 0.6 L/min to 4.1 +/- 0.6 L/min and PCWP increased from 7.5 +/- 6.4 mmHg to 8.5 +/- 7.3 mmHg (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Systemic hemodynamics during sleep in young or middle-aged and elderly patients with essential hypertension.

Age-related changes in cardiovascular regulatory mechanisms may affect blood pressure homeostasis during sleep and in the daytime. This study compared systemic hemodynamics during the daytime and sleep between 12 young or middle-aged patients (young, 42.1 +/- 13.9 years old, mean +/- SD, less than 56 years old) and 12 elderly patients with essential hypertension (old, 65.3 +/- 2.8, 60 to 70 years old). They were all hospitalized and placed on a diet containing approximately 7 g sodium chloride per day. Intra-arterial blood pressure and electrocardiogram were recorded for 24 hours, and electroencephalogram and electroophthalmogram were recorded during the night with a telemetric method. Cardiac output was measured with patients in the supine position by the cuvette method during the daytime and stage 3 or 4 sleep at night. The averaged 24-hour blood pressure was similar in the two groups (140 +/- 2 [SEM]/85 +/- 3 mm Hg in the young group and 144 +/- 4/81 +/- 2 mm Hg in the old group). The reduction in mean blood pressure during sleep was also comparable in both groups (-18 +/- 2 in the young group and -20 +/- 2 mm Hg in the old group). Cardiac index was smaller in the old group than the young group during both the daytime and sleep (daytime, 2.3 +/- 0.1 versus 3.2 +/- 0.2 [L/min]/m2, P < .01; sleep, 2.1 +/- 0.1 versus 2.6 +/- 0.2 [L/min]/m2, P < .01). The reduction in cardiac index during sleep was greater in the young than the old group (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Improvement of multiple coronary risk factors in obese hypertensives by reduction of intra-abdominal visceral fat.

The association of obesity and hypertension is well documented, and the combination is important as a coronary risk factor, but its non-pharmacological management is very difficult. Japanese hypertensive obese subjects (HO, n = 95) selected from 321 non-medicated obese subjects with a body mass index > 25 kg/m2 were characterized by the clinical features of significant diaphragmatic elevation, higher heart rate (HR), fasting blood glucose (FBS), total cholesterol (Tch), uric acid and gamma GTP values and lower vital capacity (VC) compared to those of normotensive-obese subjects (NO, n = 226) (p < 0.01). During a diet therapy program (about 1,200 kcal/day) for HO (n = 55), 25 subjects were treated with a non-drug-dependent pulse-synchronized transpercutaneous electric abdominal muscle stimulator (PEM) (ca. 30,000 muscle contractions/day) for 4 weeks. These subjects showed significant improvement with reduction in body weight (9.4%, 7.4 kg), intra-abdominal visceral fat (VF) CT scan area (29%), abdominal subcutaneous area (10%) at the level of the umbilicus, blood pressure (BP), HR, FBS, gamma GTP, Tch, plasma norepinephrine, plasma renin activity and plasma insulin, an increase of VC and lowering of the diaphragm (p < 0.05). The reductions in weight, BP, FBS and Tch in the diet group (n = 30, 1,200 kcal/day for 4 weeks) were smaller than those in the PEM-diet group (p < 0.05). The Japanese hypertensive obese patients had complications of many other coronary risk factors, and the reduction in weight and VF with PEM-diet therapy seems to be effective for improving these risk factors.

Abdominal Muscles↗
PubMed1994

Circadian variation of haemodynamics in patients with essential hypertension: comparison between early morning and evening.

OBJECTIVE: An increased incidence of cardiovascular accidents in the morning has been reported, but the reason why is not clear. We measured 24-h haemodynamics and focused on its change in the morning. DESIGN: To study the circadian variation of haemodynamics, we recorded 24-h direct blood pressure and electrocardiogram using a telemetry method, in 21 untreated inpatients with essential hypertension, and measured cardiac output using the dye-dilution method in the morning, in the evening and during sleep. We also determined the beat-to-beat cardiac output (using the pulse-contour method), the total peripheral resistance and the ratio of low- to high-frequency components (using power spectral analysis of the R-R interval during 24 h), and made comparisons between morning and evening values. RESULTS: Both systolic and diastolic blood pressure increased rapidly in the early morning. Although the comparison of blood pressure between morning and evening showed no difference, total peripheral resistance and low- to high-frequency ratio were significantly higher in the morning than in the evening, but cardiac output was lower in the morning. CONCLUSIONS: Sympathetic nervous activity and vascular resistance seem to be higher in the morning than in the evening, and these haemodynamic changes may stress the cardiovascular system.

Adult↗
PubMed1993

Relationship between blood pressure and heart rate while awake and asleep in patients with mild essential hypertension.

Blood pressure (BP) and heart rate (HR) (BP waveforms) are affected by external stress during waking and BP is reduced to its lowest level (base BP) during sleep. This study investigated the relationship between BP waveforms while awake and base BP waveforms during sleep. The intra-arterial BPs of 64 inpatients (34 males and 30 females, age: 42 +/- 11, mean +/- SD) with mild essential hypertension were measured for 24 h by the telemetry method. The average ln (SBP/DBP) (m) while awake and the m at base BP (ln: natural logarithm, SBP: systolic BP, DBP: diastolic BP) had approximately the same values in each patient (mean difference: -0.02 +/- 0.07). The product of the RR interval (60/HR) and DBP (RR x DBP) while awake and at base BP had almost the same value (mean difference: -3.2 +/- 10 mmHg.sec). According to the Windkessel model, the RR interval during which blood-flow volume in relation to the m value is at its highest can be inferred as S (em-1)/(em-m-1) (S: systolic time). Using this formula, we developed a formula to estimate base RR from waking m, BP, and RR. Calculations with this estimate formula produced a very slight difference (0.0 +/- 0.1 sec) between estimated and actual values for base RR. For the most part, it was possible to infer the base DBP value from the estimated base RR using RR x DBP while awake (mean difference: -3.7 +/- 7.0 mmHg). These results suggest that the base BP waveform may be the most efficient pattern, and that waking BP waveforms change based on the base BP waveform during sleep.

Adult↗
PubMed1992

Diastolic mitral regurgitation in patients with first-degree atrioventricular block.

Diastolic mitral regurgitation has been observed in patients with DDD pacemakers when the atrioventricular (AV) delay was prolonged. However, diastolic mitral regurgitation associated with first-degree AV block has not been fully studied. We examined transmitral blood flow in 24 patients with first-degree AV block and normal cardiac function (ages 35.3 +/- 17.4 years), and in nine patients with DDD pacemakers and normal cardiac function (ages 73.1 +/- 8.1 years), using pulsed Doppler echocardiography. Diastolic mitral regurgitation was observed in 19 of 24 patients with first-degree AV block. Although PQ interval was shortened from 0.32 +/- 0.06 to 0.20 +/- 0.05 seconds (P < 0.01) after 1 mg atropine sulfate IV, the interval between P wave (ECG) and the beginning of diastolic mitral regurgitation did not change, while the duration of diastolic mitral regurgitation was shortened from 0.15 +/- 0.03 to 0.05 +/- 0.03 seconds (P < 0.01). There was a significant correlation between changes in PQ interval and changes in the duration of diastolic mitral regurgitation (r = 0.92, P < 0.001). Although cardiac output (3.9 +/- 0.05 L/min) and pulmonary capillary wedge pressure (5.1 +/- 1.5 mmHg) were normal in all patients with pacemakers, diastolic mitral regurgitation was observed when the AV delay was prolonged. The critical PQ interval for the appearance of diastolic mitral regurgitation was 0.23 +/- 0.01 seconds. In patients with prolonged PQ intervals, delayed ventricular contraction following atrial contraction may be associated with mitral regurgitation in the presence of a reversed AV pressure gradient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

A study of the effects of manidipine on the diurnal variation of arterial pressure and hemodynamics in patients with essential hypertension.

In order to investigate the effects of manidipine, a newly developed long-acting calcium antagonist, on the diurnal variation of arterial pressure and systemic hemodynamics in patients with essential hypertension, we examined 24-h arterial pressure using a direct arterial pressure monitoring method and cardiac output using the cuvette method before and during manidipine treatment. Once-a-day administration of manidipine at daily doses of 10 to 40 mg decreased systolic and diastolic arterial pressures at almost all measurement points. The arterial pressure reductions were not significantly different between daytime and nighttime. Arterial pressure variability expressed in terms of the standard deviation of values was not affected by manidipine treatment. Thus, it appears that patients treated with manidipine can avoid the excessive decrease in arterial pressure during nighttime that may occur with the use of some other calcium antagonists. Heart rate and its variability were unaffected by manidipine treatment. A hemodynamic study revealed that manidipine did not change cardiac output, but significantly decreased total peripheral vascular resistance at rest. It is concluded that once-a-day administration of manidipine at daily doses of 10 to 40 mg brings about a safe and stable antihypertensive effect over a 24-h period, without affecting the diurnal variation of arterial pressure and heart rate. Dilation of the resistance vessels underlies the antihypertensive effect of the agent.

Adult↗
PubMed1991

Blood pressure during sleep: antihypertensive medication.

To investigate whether excessive reduction of blood pressure (BP) by antihypertensive medications correlates with myocardial infarction, especially during sleep in elderly patients, we used telemetry and cuvette dye-dilution methods to assess the direct BP and the hemodynamics of 68 inpatients with essential hypertension during wakefulness and sleep. There were 25 patients greater than or equal to 60 years old (OH-group) and 43 were less than or equal to 59 years old (YH-group). Of the OH-group, 36% showed high BP during the day, with marked decreases (minimum BP less than 110/70 mm Hg) during sleep. Average cardiac index (CI) of the OH-group was low during wakefulness and extremely low during slow-wave sleep. Changes of mean BP in the OH-group correlated with changes in total peripheral vascular resistance index (TPRI) during sleep, but this correlation was not observed in the YH-group. The antihypertensive effects on nocturnal BP of the various medications was: central adrenergic inhibitors less than or equal to beta blockers with intrinsic sympathomimetic activity less than or equal to alpha (alpha beta) blockers less than or equal to angiotensin-converting enzyme inhibitors less than or equal to calcium antagonists. Because BP and CI were found to be very low and TPRI seems to play an important role in BP regulation in sleeping elderly patients, excessive antihypertensive medication may be harmful to this subgroup. However, because the effects on nocturnal BP differ among various antihypertensive treatments, further research is required on the relation between antihypertensive medication and the hemodynamics of sleeping elderly hypertensive patients.

Adult↗
PubMed1991

A study of the effects of delapril, a new angiotensin converting enzyme inhibitor, on the diurnal variation of arterial pressure in patients with essential hypertension using indirect and direct arterial pressure monitoring methods.

In order to investigate the effect of delapril, a new angiotensin converting enzyme inhibitor, on the diurnal variation of arterial pressure in patients with essential hypertension, this study examined 24 h arterial pressure using an indirect or a direct monitoring system. When the effect of twice-a-day administration of delapril at daily doses of 30 to 90 mg was examined using the indirect monitoring system in 12 outpatients, delapril decreased systolic and diastolic arterial pressures significantly only at limited points during the day. However, each of the averaged 24 h daytime and nighttime arterial pressures showed significant reductions. The 24 h intraarterial pressure monitoring demonstrated that delapril decreased systolic and diastolic arterial pressure at most of the measurement points. The arterial pressure reductions during daytime and nighttime were not significantly different, that is, there was no excessive reduction in nighttime arterial pressure. Heart rate and its variability were virtually unaffected by the delapril treatment in either monitoring study. No adverse reactions were observed in the indirect or direct monitoring studies. Thus, it is concluded that twice-a-day administration of delapril at daily doses of 30 to 90 mg brings about a safe and stable antihypertensive effect, without affecting the diurnal variation of arterial pressure.

Administration, Oral↗
PubMed1991

Reduced baroreflex changes in muscle sympathetic nerve activity during blood pressure elevation in essential hypertension.

To determine whether the baroreflex control of sympathetic nerve activity is altered in patients with essential hypertension, muscle sympathetic nerve activity (MSNA) was recorded microneurographically from the tibial nerves of 23 normotensive subjects and 23 patients with essential hypertension. When phenylephrine (2 micrograms/kg) was injected intravenously, although the pressor response of mean arterial blood pressure (MAP) was significantly enhanced in the hypertensives as compared with the normotensives, the reflex decrease in MSNA was significantly smaller in the hypertensives. Furthermore, the baroreflex slope for MSNA, used as an index of baroreflex sensitivity and calculated by relating the change in MSNA to the change in MAP, was significantly less in the hypertensives. Following the injection of nitroglycerin (2 micrograms/kg), there were no significant differences between the normotensives and hypertensives in the depressor response, the reflex increase in MSNA or the baroreflex slope for MSNA. These observations suggest that the baroreflex change in sympathetic nerve activity is reduced during phenylephrine-induced blood pressure elevation but not during nitroglycerin-induced hypotension in the hypertensives, and that the blunted response of sympathetic nerve activity occurring during hypertension in these hypertensive patients may underlie the maintenance of high blood pressure in essential hypertension.

Adult↗
PubMed1991

Augmented sympathetic nerve activity in response to stressors in young borderline hypertensive men.

To determine whether there may be an abnormality in sympathetic nerve activity in response to physical and psychological stressors, we microneurologically recorded muscle sympathetic nerve activity in 11 normotensive and 9 borderline hypertensive, age-matched men. Supine blood pressure, plasma levels of epinephrine and norepinephrine and muscle sympathetic nerve activity were measured before and during a cold pressor test or a mental arithmetic test. The resting basal values of muscle sympathetic nerve activity, blood pressure and plasma epinephrine were significantly higher in the borderline hypertensives than in the normotensives (P less than 0.05). Plasma norepinephrine levels tended to be higher in the borderline hypertensives than in the normotensives but not to a significant extent (P less than 0.10). The cold test produced significantly exaggerated pressor and muscle sympathetic nerve responses (P less than 0.05) with a trend towards an increase in plasma norepinephrine (P less than 0.10) in the borderline hypertensives as compared with normotensives. The mental arithmetic test produced significantly enhanced pressor and plasma epinephrine responses in the borderline hypertensives as compared with the normotensives (P less than 0.05). During the mental arithmetic test the muscle sympathetic nerve activity decreased significantly in the normotensives (P less than 0.05) but not in the borderline hypertensives. These findings indicate that in people with borderline hypertension an abnormality exists in sympathetic nerve activity at rest and in response to stressors.

Adult↗