Tanaka S, Hayase A, Hashimoto A, Takagi Y, Kondo S, Hayashi K, Yamamoto M, Iimura O
Second Department of Internal Medicine, Sapporo Medical College, Japan.
J Cardiovasc Pharmacol. 1990;16 Suppl 7:S83-6.
The present study describes the results from the 10-year follow-up data of a prospective epidemiological study for hypertension and cardiovascular diseases in two communities of rural agricultural districts in Hokkaido, Japan. The number of incidences of cerebrovascular accidents (CVAs) in persons who were normotensive, borderline hypertensive (BHT), untreated hypertensive (HT), well-controlled HT [blood pressure (BP) less than 150/90 mm Hg], and poorly controlled HT (BP greater than or equal to 150/90 mm Hg) were 0.46, 3.24, 4.17, 3.49, and 12.76 per 1,000 person-years. respectively: CVAs were markedly high in poorly controlled HT persons. The winter-summer mean BP differences in the first year were significantly and positively correlated with the differences in mean BP between the tenth and the first year, and were significantly higher in the progression to hypertension group than in the nonprogression group in both towns. Multivariate analysis indicated that the winter-summer mean BP difference was a significant variable for indication of progression to hypertension. From these results, we concluded that (a) good control of hypertension could considerably prevent CVA, (b) cold environment may contribute to the progression to hypertension, and (c) winter-summer variation in BP may predict the future course of BP.
本研究描述了一项针对日本北海道两个农村农业区社区的高血压和心血管疾病的前瞻性流行病学研究的10年随访数据结果。血压正常者、临界高血压者（BHT）、未治疗的高血压患者（HT）、血压控制良好的HT患者[血压（BP）低于150/90 mmHg]和血压控制不佳的HT患者（BP大于或等于150/90 mmHg）的脑血管意外（CVA）发病率分别为每1000人年0.46、3.24、4.17、3.49和12.76例。CVA在血压控制不佳的HT患者中明显更高。第一年冬夏平均血压差异与第十年和第一年的平均血压差异显著正相关，且在两个城镇中，进展为高血压组的冬夏平均血压差异显著高于未进展组。多变量分析表明，冬夏平均血压差异是高血压进展的一个显著指标变量。从这些结果中，我们得出结论：（a）良好的高血压控制可以显著预防CVA；（b）寒冷环境可能有助于高血压的进展；（c）血压的冬夏变化可能预测未来血压的变化趋势。
