Prognostic Significance of Variability in Ambulatory and Home Blood Pressure from the Ohasama Study
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- Ohkubo Takayoshi
- Departments of Planning for Drug Development and Clinical Evaluation. Tohoku University 21st Century COE Program "Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation", Tohoku University Graduate School of Pharmaceutical Sciences and Medicine.
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Ambulatory and home blood pressure (BP) can be measured over an extended period, thus generating information about BP variability. We have monitored a Japanese general population (Ohasama) for 20 years with respect to morbidity and mortality based on ambulatory and home BP, and have demonstrated the unique prognostic significance of variability in these values. A disturbed nocturnal decline in BP is associated with cerebral infarction and heart diseases, whereas a large morning pressor surge and a large nocturnal decline in BP, which are analogous to a large diurnal increase in BP, are both associated with cerebral hemorrhage. A high BP at various times of the day is associated with different subtypes of cerebrovascular and cardiovascular disease risk. Home BP in the morning and in the evening provide equally useful information for stroke risk, whereas morning hypertension, which is that specifically observed only in the morning, might be a good predictor of stroke, particularly among individuals using anti-hypertensive medication. The BP and heart rate variabilities estimated as standard deviation measured every 30 minutes by ambulatory monitoring are independent predictors. That is, a higher short-term BP variability with a lower short-term heart rate variability leads to a worse cardiovascular prognosis. These variations in BP also bias the diagnosis and treatment of hypertension, which can be managed effectively by considering the phasic, as well as the tonic, component of BP.<br>J Epidemiol 2007; 17: 109-113.
収録刊行物
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- Journal of Epidemiology
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Journal of Epidemiology 17 (4), 109-113, 2007
日本疫学会
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詳細情報 詳細情報について
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- CRID
- 1390282679452278528
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- NII論文ID
- 10025811145
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- NII書誌ID
- AA10952696
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- ISSN
- 13499092
- 09175040
- http://id.crossref.org/issn/09175040
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- 本文言語コード
- en
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- データソース種別
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- JaLC
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- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可