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Advanced cerebrovascular damage in diabetic white-coat hypertension
AJH–May 2004 –VOL. 17, NO. 5, PART 2
POSTERS: Cerebrovascular Disease/Stroke
61A
P-79 ADVANCED CEREBROVASCULAR DAMAGE IN DIABETIC WHITE-COAT HYPERTENSION Kazuo Eguchi, Kazuomi Kario, Satoshi Hoshide, Masato Morinari, Joji Ishikawa, Kazuyuki Shimada. Department of Cardiology, Jichi Medical School, Tochigi-ken, Japan. Background: The significance of white-coat hypertension in diabetes mellitus has not previously been investigated. Methods: We performed 24hr ambulatory BP monitoring and brain MRI in 360 asymptomatic hypertensives with/without diabetes (mean age: 67.4years). Patients were classified into 4 groups: sustained hypertension with diabetes (SHT⫹DM, n⫽117), without diabetes (SHT, n⫽140) and white-coat hypertension with diabetes (WCHT⫹DM, n⫽42), without diabetes (WCHT, n⫽61). Results: There were no differences in the prevalence of SCI (WCHT⫹DM 64.3% vs. SHT 61.4%) and multiple SCIs (WCHT⫹DM 40.5 vs. SHT 40.7%). However, the prevalence of multiple SCIs was higher in the WCHT⫹DM than in the WCHT group (WCHT⫹DM 40.5% vs. WCHT 21.3%, p⬍0.05).
Conclusion: Silent multiple cerebral infarcts in the diabetic masked hypertension was advanced to a degree similar to sustained hypertensives. Key Words: Diabetic Masked Hypertension, Stroke Risk, Silent Cerebral Infarct
P-81 DIFFERENT IMPACT ON THE ASSOCIATION BETWEEN HYPERTENSION AND STROKE AMONG OBESE AND NON-OBESE JAPANESE Shizukiyo Ishikawa, Kazuomi Kario, Kazunori Kayaba, Kazuyuki Shimada, Eiji Kajii. Department of Community and Family Medicine, Jichi Medical School, Minamikawachi, Tochigi, Japan; Department of Cardiology, Jichi Medical School, Minamikawachi, Tochigi, Japan.
Conclusion: Silent cerebral damage is advanced in diabetic white-coat hypertension and its degree is similar to that in sustained hypertension without diabetes. Key Words: Silent Cerebral Infarct, White-Coat Hypertension, Diabetes Mellitus
P-80 DIABETIC MASKED HYPERTENSION: RISK FOR STROKE IN JAPANESE Kazuo Eguchi, Kazuomi Kario, Masato Morinari, Kazuyuki Shimada. Department of Cardiology, Jichi Medical School, Tochigi-ken, Japan. Background: We investigated the impact of masked hypertension on silent cerebral infarcts (SCI) in hypertensives with/without diabetes. Method: We performed 24-hr ABP monitoring and brain MRI in 404 asymptomatic patients with hypertension with/without diabetes or with diabetes alone (mean age: 67.1 years). The subjects were stratified into the masked hypertension (Masked HT) group, sustained hypertension (SHT) group, normotensive (NT) group: and white-coat hypertension (WCHT) group. Results: The Masked HT group had a significantly higher prevalence of multiple SCI (ⱖ3 SCIs per person) than the NT group (38.7 vs. 21.5%, p⫽0.04; see Figure). The prevalence of SCI and multiple SCI were comparable between the Masked HT group and the SHT group. © 2004 by the American Journal of Hypertension, Ltd. Published by Elsevier Inc.
Objectives: Hypertension and obesity are independent risk factors for cardiovascular diseases and mortality, but the interaction of these factors is unclear. The purpose of this study is to examine the association between hypertension and stroke among obese and non-obese Japanese. Methods: We conducted a population-based cohort study, which comprised 12 areas in Japan. The subjects were 4,237 males and 6,685 females at the baseline examination in 1992-1995, which showed data of blood pressure and body mass index (BMI), and determined no history of cerebral infarction or myocardial infarction using a questionnaire. Hypertension was categorized by blood pressure ⱖ140/90 mmHg. BMI ⱖ25 kg/m2 was categorized as obese and BMI ⬍25 kg/m2 as non-obese in both sexes. Results: Mean ages were 55.0 ⫾11.9 years for males and 55.3 ⫾11.1 years for females. During the follow-up period (mean: 7.8 years), stroke events occurred in 152 males and 127 females. The hazard ratios of hypertension for stroke were 3.2 (1.2– 8.7) in obese males, 1.9 (95% CI: 1.3–2.8) in non-obese males, 1.7 (0.8 –3.5) in obese females, and 2.5 (1.7–3.9) in non-obese females, respectively, after adjustment for age, total cholesterol, smoking and drinking status, using Cox’s proportional hazard model. Conclusion: Hypertension had a higher risk for stroke in obese males than non-obese males, but for females, hypertension increased the risk in non-obese females, whereas no significant association was seen in obese females. The hazard ratios of hypertension for stroke among obese and nonobese Japanese Obese Hazard ratio Males Females
Non-HT HT HTNon-HT HT
1.0 3.2 1.0 1.7
Non-Obese 95%CI 1.2–8.7 0.8–3.5
Hazard ratio 1.0 1.9 1.0 2.5
95%CI 1.3–2.8 1.7–3.9
Hazard ratios were adjustment for age, total cholesterol, smoking and drinking status, using Cox’s proportional hazard model.
Key Words: Hypertension, Stroke, Obesity 0895-7061/04/$30.00
POSTERS: Cerebrovascular Disease/Stroke
61A
P-79 ADVANCED CEREBROVASCULAR DAMAGE IN DIABETIC WHITE-COAT HYPERTENSION Kazuo Eguchi, Kazuomi Kario, Satoshi Hoshide, Masato Morinari, Joji Ishikawa, Kazuyuki Shimada. Department of Cardiology, Jichi Medical School, Tochigi-ken, Japan. Background: The significance of white-coat hypertension in diabetes mellitus has not previously been investigated. Methods: We performed 24hr ambulatory BP monitoring and brain MRI in 360 asymptomatic hypertensives with/without diabetes (mean age: 67.4years). Patients were classified into 4 groups: sustained hypertension with diabetes (SHT⫹DM, n⫽117), without diabetes (SHT, n⫽140) and white-coat hypertension with diabetes (WCHT⫹DM, n⫽42), without diabetes (WCHT, n⫽61). Results: There were no differences in the prevalence of SCI (WCHT⫹DM 64.3% vs. SHT 61.4%) and multiple SCIs (WCHT⫹DM 40.5 vs. SHT 40.7%). However, the prevalence of multiple SCIs was higher in the WCHT⫹DM than in the WCHT group (WCHT⫹DM 40.5% vs. WCHT 21.3%, p⬍0.05).
Conclusion: Silent multiple cerebral infarcts in the diabetic masked hypertension was advanced to a degree similar to sustained hypertensives. Key Words: Diabetic Masked Hypertension, Stroke Risk, Silent Cerebral Infarct
P-81 DIFFERENT IMPACT ON THE ASSOCIATION BETWEEN HYPERTENSION AND STROKE AMONG OBESE AND NON-OBESE JAPANESE Shizukiyo Ishikawa, Kazuomi Kario, Kazunori Kayaba, Kazuyuki Shimada, Eiji Kajii. Department of Community and Family Medicine, Jichi Medical School, Minamikawachi, Tochigi, Japan; Department of Cardiology, Jichi Medical School, Minamikawachi, Tochigi, Japan.
Conclusion: Silent cerebral damage is advanced in diabetic white-coat hypertension and its degree is similar to that in sustained hypertension without diabetes. Key Words: Silent Cerebral Infarct, White-Coat Hypertension, Diabetes Mellitus
P-80 DIABETIC MASKED HYPERTENSION: RISK FOR STROKE IN JAPANESE Kazuo Eguchi, Kazuomi Kario, Masato Morinari, Kazuyuki Shimada. Department of Cardiology, Jichi Medical School, Tochigi-ken, Japan. Background: We investigated the impact of masked hypertension on silent cerebral infarcts (SCI) in hypertensives with/without diabetes. Method: We performed 24-hr ABP monitoring and brain MRI in 404 asymptomatic patients with hypertension with/without diabetes or with diabetes alone (mean age: 67.1 years). The subjects were stratified into the masked hypertension (Masked HT) group, sustained hypertension (SHT) group, normotensive (NT) group: and white-coat hypertension (WCHT) group. Results: The Masked HT group had a significantly higher prevalence of multiple SCI (ⱖ3 SCIs per person) than the NT group (38.7 vs. 21.5%, p⫽0.04; see Figure). The prevalence of SCI and multiple SCI were comparable between the Masked HT group and the SHT group. © 2004 by the American Journal of Hypertension, Ltd. Published by Elsevier Inc.
Objectives: Hypertension and obesity are independent risk factors for cardiovascular diseases and mortality, but the interaction of these factors is unclear. The purpose of this study is to examine the association between hypertension and stroke among obese and non-obese Japanese. Methods: We conducted a population-based cohort study, which comprised 12 areas in Japan. The subjects were 4,237 males and 6,685 females at the baseline examination in 1992-1995, which showed data of blood pressure and body mass index (BMI), and determined no history of cerebral infarction or myocardial infarction using a questionnaire. Hypertension was categorized by blood pressure ⱖ140/90 mmHg. BMI ⱖ25 kg/m2 was categorized as obese and BMI ⬍25 kg/m2 as non-obese in both sexes. Results: Mean ages were 55.0 ⫾11.9 years for males and 55.3 ⫾11.1 years for females. During the follow-up period (mean: 7.8 years), stroke events occurred in 152 males and 127 females. The hazard ratios of hypertension for stroke were 3.2 (1.2– 8.7) in obese males, 1.9 (95% CI: 1.3–2.8) in non-obese males, 1.7 (0.8 –3.5) in obese females, and 2.5 (1.7–3.9) in non-obese females, respectively, after adjustment for age, total cholesterol, smoking and drinking status, using Cox’s proportional hazard model. Conclusion: Hypertension had a higher risk for stroke in obese males than non-obese males, but for females, hypertension increased the risk in non-obese females, whereas no significant association was seen in obese females. The hazard ratios of hypertension for stroke among obese and nonobese Japanese Obese Hazard ratio Males Females
Non-HT HT HTNon-HT HT
1.0 3.2 1.0 1.7
Non-Obese 95%CI 1.2–8.7 0.8–3.5
Hazard ratio 1.0 1.9 1.0 2.5
95%CI 1.3–2.8 1.7–3.9
Hazard ratios were adjustment for age, total cholesterol, smoking and drinking status, using Cox’s proportional hazard model.
Key Words: Hypertension, Stroke, Obesity 0895-7061/04/$30.00