Efficacy of Early Cardiac Rehabilitation After Cardiac Surgery - Verification Using Japanese Diagnosis Procedure Combination Data.

The current status of cardiac rehabilitation (CR) after cardiac surgery and the introduction of early CR (E-CR) in Japan are not fully understood. In this study, the current status of E-CR and its efficacy were investigated by the Academic Committee of the Japanese Association of Cardiac Rehabilitation. We examined the rate of introduction of E-CR and its effects among 220,122 patients who underwent major cardiac and thoracic vascular surgery, as registered in the Diagnosis Procedure Combination (DPC) classification system, between April 2012 and March 2018.

[Current strategy for management of resistant hypertension].

Inadequate control of blood pressure during antihypertensive treatment remains a major problem in preventive cardiovascular and renal disease. Major causes of resistant hypertension are following: problems in measuring technique, presence of white coat effect, poor adherence of patient, obesity, excessive alcohol intake, sleeping apnea syndrome, excess of body fluid, inappropriate use of hypertensive or anti-antihypertensive drug/supplement, especially their combination, and presence of secondary hypertension. Practitioners have to seek for the causes around their patients' lifestyle, prescription, secondary hypertension, after ruling out pseudo-hypertension or white coat hypertension.

[A case of hemodynamic brain infarction with postprandial hypotension].

A 76-year-old man with left internal carotid artery occlusion developed a progressing right hemiparesis. Brain MRI presented reinfarctions in the left anterior border zone and terminal zone in the left deep white matter. Ambulatory blood pressure monitoring showed a decrease in systolic blood pressure by more than 20 mmHg one hour after starting meals, which is considered as postprandial hypotension.