The Cardiovascular Risk of White-Coat Hypertension.

Background: The role of white-coat hypertension (WCH) and the white-coat-effect (WCE) in development of cardiovascular disease (CVD) risk remains poorly understood.

Objectives: Using data from the population-based, 11-cohort IDACO (International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes), this study compared daytime ambulatory blood pressure monitoring with conventional blood pressure measurements in 653 untreated subjects with WCH and 653 normotensive control subjects.

Methods: European Society Hypertension guidelines were used as a 5-stage risk score.

(Pro)renin receptor is crucial for Wnt/β-catenin-dependent genesis of pancreatic ductal adenocarcinoma.

Although Wnt/β-catenin signaling is known to be aberrantly activated in PDAC, mutations of CTNNB1, APC or other pathway components are rare in this tumor type, suggesting alternative mechanisms for Wnt/β-catenin activation. Recent studies have implicated the (pro)renin receptor ((P)RR) is related to the Wnt/β-catenin signaling pathway. We therefore investigated the possible role of (P)RR in pancreatic carcinogenesis.

A functional (pro)renin receptor is expressed in human lymphocytes and monocytes.

The renin-angiotensin system (RAS) is involved in inflammation. The signaling via the ANG II type 1 receptor in human lymphocytes and monocytes, which play key roles in pathophysiology of glomerulonephritis (GN), can enhance inflammation. However, the role of the (pro)renin receptor [(P)RR], a component of the RAS, in inflammatory reactions is unknown.

Risk Associated with Pulse Pressure on Out-of-Office Blood Pressure Measurement.

Background: Longitudinal studies have demonstrated that the risk of cardiovascular disease increases with pulse pressure (PP). However, PP remains an elusive cardiovascular risk factor with findings being inconsistent between studies. The 2013 ESH/ESC guideline proposed that PP is useful in stratification and suggested a threshold of 60 mm Hg, which is 10 mm Hg higher compared to that in the 2007 guideline; however, no justification for this increase was provided.

Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations.

Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.

Large artery stiffening as a link between cerebral lacunar infarction and renal albuminuria.

Background: Stiffening of large arteries increases pulsatile pressure and flow stresses, which extend to the microcirculation in vasodilated organs such as the brain and kidneys. Subclinical cerebral lacunar infarction and albuminuria, both of which are early manifestations of microvascular damage, have been shown to be potentially interrelated in hypertension and with aging, but the underlying pathogenesis remains unknown.

Methods: In a population of 351 general adults aged > or =50 years, urinary albumin/creatinine ratio (ACR), pulse wave velocity (PWV), and 24-h ambulatory blood pressure (BP) were measured, and cerebral lacunar lesions were assessed on magnetic resonance imaging (MRI).

Association of microalbuminuria with brachial-ankle pulse wave velocity: the Ohasama study.

Background: Microalbuminuria is recognized as a marker of generalized vascular dysfunction. However, the associations between microalbuminuria and pulse wave velocity (PWV), carotid intima-media thickness (IMT), and ambulatory blood pressure (ABP), respectively, have not been investigated.

Methods: Brachial-ankle PWV (baPWV), IMT, and ABP were determined in 328 individuals (mean age, 65.

Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk.

Current diagnostic thresholds for ambulatory blood pressure (ABP) mainly rely on statistical parameters derived from reference populations. We determined an outcome-driven reference frame for ABP measurement. We performed 24-h ABP monitoring in 5682 participants (mean age 59.

Association between wasted pressure effort and left ventricular hypertrophy in hypertension: influence of arterial wave reflection.

Background: Wave reflection during the systole increases left ventricular (LV) pressure, tension-time index (TTI) and myocardial oxygen requirement. The purpose of this study was to extract that component of extra myocardial oxygen requirement that is due to early systolic wave reflection, define it as wasted effort (DeltaE(w)), and examine its relationship to LV hypertrophy (LVH).

Methods: Radial artery pressure waveforms were recorded using applanation tonometry and central aortic waveforms generated in 98 patients with untreated hypertension.

Monitoring of antihypertensive therapy for reduction in left ventricular mass.

Background: Pressure pulse waveform features may predict treatment-induced regression of left ventricular (LV) mass better than casual brachial blood pressure (BP). We compared predictive power for LV mass reduction between the putative optimal pulse waveform feature (pulse amplification) and the putative optimal brachial cuff measurement (self BP monitoring at home).

Methods: Forty-three patients with hypertension received standard medical treatment for 1 year.

Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk.

Background: Current diagnostic thresholds for ambulatory blood pressure (ABP) mainly rely on statistical parameters derived from reference populations. We determined an outcome-driven reference frame for ABP measurement.

Methods And Results: We performed 24-hour ABP monitoring in 5682 participants (mean age 59.

A novel method for evaluating human carotid artery elasticity: possible detection of early stage atherosclerosis in subjects with type 2 diabetes.

We recently developed a novel method for evaluating the elasticity of arterial walls, the phased tracking method. Herein, we evaluated atherosclerosis of the carotid artery with this method in 242 individuals with type 2 diabetes. In multiple regression analysis of subject status, age, systolic blood pressure and hyperlipidemia were found to be independently associated with carotid artery elasticity values.

Electrocardiographic left ventricular hypertrophy and arterial stiffness: the Ohasama study.

Background: Whether arterial stiffness per se contributes to left ventricular hypertrophy (LVH) independently of blood pressure (BP) remains unknown. We examined the relationship between pulse wave velocity (PWV) and LVH in a large population.

Methods: The PWV was measured between the brachial and ankle regions (baPWV) of 798 individuals.

The economic impact of the introduction of home blood pressure measurement for the diagnosis and treatment of hypertension.

Objectives: To investigate the economic consequences resulting from introduction of home blood pressure measurement in diagnosis of hypertension instead of casual clinic blood pressure measurement.

Methods: We constructed a decision tree model using data from the Ohasama study and a Japanese national database. The Ohasama study provided the prognostic value of home blood pressure as compared with clinic blood pressure measurement.

Characteristics of resistant hypertension determined by self-measured blood pressure at home and office blood pressure measurements: the J-HOME study.

Objectives: To diagnose resistant hypertension using self-measured blood pressure (BP) at home and office BP, and to evaluate the characteristics of resistant hypertensive patients.

Methods: The subjects were 528 hypertensive patients taking at least three or more different antihypertensive drugs. Subjects were classified into four groups (controlled hypertension, isolated office resistant hypertension, isolated home resistant hypertension and sustained resistant hypertension) on the basis of the cut-off values of home BP (135/85 mmHg) and office BP (140/90 mmHg).

The current status of home and office blood pressure control among hypertensive patients with diabetes mellitus: the Japan Home Versus Office Blood Pressure Measurement Evaluation (J-HOME) study.

Although self-measured blood pressure (BP) at home (HBP) has become popular in clinical practice, little information is available regarding the proportion of diabetic patients with properly controlled HBP. We evaluated the status of HBP control in diabetic hypertensives. HBP control status was cross-sectionally evaluated among 3400 essential hypertensives taking antihypertensive treatment.

Enhanced radial late systolic pressure augmentation in hypertensive patients with left ventricular hypertrophy.

Background: Wave reflection augments central blood pressure (BP) in late systole, thus increasing cardiac afterload. We examined the relationship between late systolic pressure augmentation in the peripheral radial artery pulse wave and the existence of left ventricular hypertrophy (LVH) in hypertension.

Methods: Brachial BP, radial augmentation index (AI(r)), and carotid-femoral pulse wave velocity (PWV(cf)) were determined in 77 untreated hypertensive patients aged 56 +/- 10 years.

Factors affecting home-measured resting heart rate in the general population: the Ohasama study.

Background: We recently demonstrated that a home-measured resting heart rate (HR) can predict cardiovascular disease mortality, and it is possible that the determinants of home HR are different from casual HR. Therefore, clarifying the determinants of home HR should be useful.

Methods: Home HR was obtained using a self-monitored blood pressure (BP) measuring device.

Efficacy of combination antihypertensive therapy with low-dose indapamide: assessment by blood pressure self-monitoring at home.

We examined the effects of the addition of low-dose indapamide to antihypertensive drugs of other classes, as well as its duration of action, using blood pressure (BP) self-monitoring at home. Seventy-six patients undergoing monotherapy with a calcium channel blocker (CCB), angiotensin converting-enzyme inhibitor (ACEI), or angiotensin AT1-receptor blocker (ARB), but had an average morning home systolic BP (SBP) > or =135 mmHg or diastolic BP (DBP) > or =85 mmHg, were studied. Indapamide (1 mg) was added to their existing treatment once daily for 4 weeks.

Determinants of the second derivative of the finger photoplethysmogram and brachial-ankle pulse-wave velocity: the Ohasama study.

Background: We examined different characteristics of the second derivative of the finger photoplethysmogram (SDPTG) and brachial-ankle pulse wave velocity (BAPWV) for assessing arterial function in a large general population, along with the alteration of SDPTG in hypertension.

Methods: Finger SDPTG and BAPWV were measured in 848 (544 normotensive and 304 untreated hypertensive) subjects 34 to 88 years of age. For assessing SDPTG, we calculated the B:A and D:A ratios and the aging index (AGI), based on the height of the wave components.

Control of blood pressure as measured at home and office, and comparison with physicians' assessment of control among treated hypertensive patients in Japan: First Report of the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) study.

The Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) study was conducted to measure the control of blood pressure (BP) as evaluated by home BP measurement among 3,400 patients with essential hypertension (mean age: 66 years; females: 55%) receiving antihypertensive treatment in primary care settings in Japan. The purpose of this first report was to compare characteristics of BP control as measured at home and in the clinic (office) and define their association with BP control as evaluated by physicians. Mean systolic/diastolic BP (SBP/DBP) values were 140/82 mmHg for home BP and 143/81 mmHg for office BP.

Patient characteristics and factors associated with inter-arm difference of blood pressure measurements in a general population in Ohasama, Japan.

Objectives: To assess whether there is a natural difference in blood pressure (BP) measurements between the right and left arms, and to identify what factors are associated with this difference in a general population.

Methods: The study subjects were 1090 individuals who participated in a medical check-up in Ohasama, Japan. The BP was measured simultaneously in both arms, using an automated device.

Effect of angiotensin-converting enzyme inhibitor perindopril on interneurons in MPTP-treated mice.

We examined the effects of perindopril on the dopaminergic system in mice after 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) treatment. The mice received four intraperitoneal injections of MPTP at 1-h intervals. Administration of perindopril showed dose-dependent neuroprotective effects against striatal dopamine and 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) depletion 3 days after MPTP treatment.