Showing papers by "Hirohito Metoki published in 2013"
TL;DR: In a general population, new indices of blood pressure variability derived from the self-measured home blood pressure did not incrementally predict outcome over and beyond mean SBP.
Abstract: Blood pressure variability based on office measurement predicts outcome in selected patients. We explored whether novel indices of blood pressure variability derived from the self-measured home blood pressure predicted outcome in a general population. We monitored mortality and stroke in 2421 Ohasama residents (Iwate Prefecture, Japan). At enrollment (1988-1995), participants (mean age, 58.6 years; 60.9% women; 27.1% treated) measured their blood pressure at home, using an oscillometric device. In multivariable-adjusted Cox models, we assessed the independent predictive value of the within-subject mean systolic blood pressure (SBP) and corresponding variability as estimated by variability independent of the mean, difference between maximum and minimum blood pressure, and average real variability. Over 12.0 years (median), 412 participants died, 139 of cardiovascular causes, and 223 had a stroke. In models including morning SBP, variability independent of the mean and average real variability (median, 26 readings) predicted total and cardiovascular mortality in all of the participants (P≤0.044); variability independent of the mean predicted cardiovascular mortality in treated (P=0.014) but not in untreated (P=0.23) participants; and morning maximum and minimum blood pressure did not predict any end point (P≥0.085). In models already including evening SBP, only variability independent of the mean predicted cardiovascular mortality in all and in untreated participants (P≤0.046). The R(2) statistics, a measure for the incremental risk explained by adding blood pressure variability to models already including SBP and covariables, ranged from <0.01% to 0.88%. In a general population, new indices of blood pressure variability derived from home blood pressure did not incrementally predict outcome over and beyond mean SBP.
116 citations
24 Mar 2013
TL;DR: The terminology, definition and classification of pregnancy induced hypertension (PIH) by the Japan Society for the Study of Hypertension in Pregnancy (JSSHP) are presented.
Abstract: In this report, we present the terminology, definition and classification of pregnancy induced hypertension (PIH) by the Japan Society for the Study of Hypertension in Pregnancy (JSSHP). PIH is classified as gestational hypertension (GH), preeclampsia (PE), superimposed preeclampsia (S-PE) or eclampsia (E). Subclassifications by symptoms (severity and gestational age at onset) are also shown. Hypertension Research In Pregnancy
110 citations
01 Jan 2013
TL;DR: The terminology, definition and classification of pregnancy induced hypertension (PIH) by the Japan Society for the Study of Hypertension in Pregnancy (JSSHP) is presented in this paper.
Abstract: In this report, we present the terminology, definition and classification of pregnancy induced hypertension (PIH) by the Japan Society for the Study of Hypertension in Pregnancy (JSSHP). PIH is classified as gestational hypertension (GH), preeclampsia (PE), superimposed preeclampsia (S-PE) or eclampsia (E). Subclassifications by symptoms (severity and gestational age at onset) are also shown. Hypertension Research In Pregnancy
99 citations
TL;DR: Night-time BP is a better predictor of CKD development than daytime BP in the general population and is considered useful for evaluating the risk of progression to CKD.
Abstract: Objective:Ambulatory blood pressure (BP) is reportedly associated with target organ damage. However, whether ambulatory BP carries prognostic significance for the development of chronic kidney disease (CKD) has not been confirmed.Method:We measured ambulatory BP in 843 participants without CKD at ba
41 citations
Katholieke Universiteit Leuven1, Osaka University2, Tohoku University3, Collège de France4, Saitama Medical University5, Kagoshima University6, Kanazawa Medical University7, Dokkyo University8, Nihon University9, Ehime University10, Kyushu University11, Sapporo Medical University12, Hiroshima University13, University of Miyazaki14, Kawasaki Medical School15, Juntendo University16, Morinomiya University of Medical Sciences17
TL;DR: SNPs in PICALM, TANC2, NUMA1 and APCDD1 were found to be associated with CCB responses and those in ABCC9 and YIPF1 wereFindings indicate that phenotyping by home blood pressure measurement might be a step towards the personalized treatment of hypertension.
Abstract: Background: Patients with mild-to-moderate essential hypertension in the HOMED-BP trial were randomly allocated to first-line treatment with a calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB). Methods: We recruited 265 (93 for CCB, 71 for ACEI and 101 for ARB) patients who completed the genomic study. Home blood pressure was measured for 5 days off-treatment before randomization and for 5 days after 2–4 weeks of randomized drug treatment. Genotyping was performed by 500K DNA microarray chips. The blood pressure responses to the three drugs were analyzed separately as a quantitative trait. For replication of SNPs with p < 10-4, we used the multicenter GEANE study, in which patients were randomized to valsartan or amlodipine. Results: SNPs in PICALM, TANC2, NUMA1 and APCDD1 were found to be associated with CCB responses and those in ABCC9 and YIPF1 were found to be associated with ARB response with replication. Conclusion: Our approach, t...
38 citations
TL;DR: HBP levels during pregnancy were shown not to differ between nulliparous and multiparous women, while CBP levels duringregnancy were higher among nullipARous than among multiparrous women.
31 citations
TL;DR: It is found that breastfeeding has a protective effect against elevated blood pressure even in young children, and subtle, but important, differences were precisely detected by self-measurements performed at home.
Abstract: Breastfeeding leads to lower blood pressure in 7-year-old Japanese children: Tohoku Study of Child Development
29 citations
24 Mar 2013
TL;DR: This paper aims to provide a history of obstetrics and gynecology practice in Japan over a 50-year period and some examples are given of practices in the past and current practices in Japan.
Abstract: 1Department of Obstetrics & Gynecology Nara Medical University, 2Nagoya City West Medical Center, 3Osaka City General Hospital, 4Juntendo University, 5Tohoku University, 6Osaka University, 7Japanese Red Cross Katsushika Maternity Hospital, 8Hokkaido University, 9Saitama Medical University, 10Tokyo Medical University Hachioji Medical Center, 11Ohno Ladies’ Clinic, 12Hamamatsu Medical University, 13Nagoya University, 14Hirosaki University, 15Aichi Medical University
11 citations
TL;DR: Multivariate regression analysis showed that office BP and visit-to-visit heart rate variability were positively associated with visit- to-visits BP variability, whereas body mass index, duration of antihypertensive medication, and taking amlodipine were negatively associated with site BP variability.
Abstract: The factors associated with visit-to-visit variability in blood pressure (BP) measured in the office between the two visits were identified in 1379 treated hypertensive patients (mean age, 66.1 ± 11.0 y; women, 53.8%). Multivariate regression analysis showed that office BP and visit-to-visit heart rate variability were positively associated with visit-to-visit BP variability, whereas body mass index, duration of antihypertensive medication, and taking amlodipine were negatively associated with visit-to-visit BP variability. Further prospective studies are required to clarify the causal relationships between these factors and visit-to-visit BP variability among treated hypertensive patients.
8 citations
TL;DR: Physicians treated hypertensive patients more aggressively and evaluated their patients’ blood pressure control more strictly in 2005–2006 than in 2003, but physicians’ assessment of BP control might be still insufficient and the BP control status of patients with diabetes was still poorer than that of non-diabetes patients even in 2005.
Abstract: We investigate the change of the management of treated hypertensive patients with or without diabetes in Japan using the data in 2003 and the data in 2005-2006. Physicians treated hypertensive patients more aggressively and evaluated their patients' blood pressure (BP) control more strictly in 2005-2006 than in 2003. However, physicians' assessment of BP control might be still insufficient and the BP control status of patients with diabetes was still poorer than that of non-diabetes patients even in 2005-2006. Further investigation for the change of the management of treated hypertensive patients in Japan is needed.
3 citations
24 Mar 2013
TL;DR: This paper aims to provide a history of maternal and child health care in Japan and some of the aspects of care that have changed in the past 50 years.
Abstract: 1Nagoya City West Medical Center, 2Aiiku Hospital, Maternal and Child Health Care Center, 3Ohno Ladies Clinic, 4Matsuda Perinatal Clinic, 5Nara Medical University, 6Tohoku University Graduate School of Medicine, 7Kawasaki Medical School Hospital, 8Osaka City General Hospital, 9Aichi Medical University School, 10Jichi Medical University School of Medicine, 11Department of Pharmacology Nagoya City University