Haruhito Kawashimo

Risk factors for the development of hypertension: a 6-year longitudinal study of middle-aged Japanese men.

Objective To identify the factors related to the development of hypertension on the basis of annual health examinations at the workplace. Setting A cohort of Japanese male office workers who were reexamined for six successive years after their initial examinations in 1990. Subjects The study cohort comprised 1089 hypertension-free subjects aged 30–54 years. Six-year follow-ups were completed for 934 subjects (85.8%) Results An analysis using the Kaplan–Meier method showed that the incidence of hypertension above the borderline level increased significantly with increasing age, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol level, uric acid level, total protein level, hematocrit level, and alcohol intake. This increase was significant for systolic blood pressure, diastolic blood pressure, and hematocrit level. The highest cumulative incidences both of hypertension above the borderline level and of definite hypertension were observed among those with 85–89 mmHg diastolic blood pressure, and the second highest among those with 130–139 mmHg systolic blood pressure. Multivariate analysis using the Cox proportional hazards model indicated that age, systolic blood pressure, diastolic blood pressure, and alcohol intake were independent factors associated with the incidence of hypertension above the borderline level. Systolic blood pressure, diastolic blood pressure, and hematocrit level proved to be independently predictive of hypertension, and alcohol intake was of borderline significance as a risk factor for hypertension. Conclusion High normal blood pressure is the strongest predictor for the development of hypertension among middle-aged Japanese men. In addition, high alcohol intake and high hematocrit level may be contributory factors.

Alcohol Consumption and Risk for Increased Aortic Pulse Wave Velocity in Middle-Aged Japanese Men

A 9-year longitudinal study was performed to prospectively examine the association of alcohol consumption with development of increased aortic pulse wave velocity (PWV) in 1,358 Japanese men aged 35 to 59 years with a PWV less than 8.0 m/sec and without antihypertensive medication. Three hundred fifty-nine men developed increased aortic PWV of 8.0 m/sec or more during 10,598 person-years follow-up. After controlling for potential predictors of aortic PWV, the relative risk for increased aortic PWV compared with that in nondrinkers was 1.05 (95% confidence interval [CI], 0.70 to 1.58) for those who drank 0.1 to 22.9 g/day of ethanol, 1.58 (95% CI, 0.89 to 1.91) for those who drank 23.0 to 45.9 g/day of ethanol, 1.77 (95% CI, 1.24 to 2.53) for those who drank 46.0 to 68.9 g/day of ethanol, and 1.81 (95% CI, 1.23 to 2.66) for those who drank 69.0 or more g/day of ethanol (p for trend < 0.00 1). The relative risk for increased aortic PWV in current drinkers vs nondrinkers was stronger among men with a body mass index (BMI) less than 24.2 kg/m2 and nonsmokers than among men with a BMI 24.2 kg/m2 or more and current smokers, respectively. These results suggest that alcohol consumption is closely associated with risk for increased aortic PWV in middle-aged Japanese men.

Risk factors for the incidence of aortic stiffness by serial aortic pulse wave velocity measurement in middle-aged Japanese men.

To examine the risk factors related to the incidence of aortic stiffness, 1,045 Japanese men aged 40 to 54 years with aortic pulse wave velocity (PWV) of less than 8.0 m/sec were followed up for seven years with annual examinations, with an average period of observation of 6.3 years with standard deviation of 1.56 years. Subjects who showed 8.0 m/sec and over of PWV during follow-up surveys were defined as incidental cases of aortic stiffness. Kaplan-Meier analysis showed that die incidence of aortic stiffness increased significantly with increases in age, body mass index, and total cholesterol and low-density lipoprotein (LDL) cholesterol levels. The incidence of aortic stiffness was significantly higher among those who had or currently smoked than among those who never smoked. From multivariate analysis using Cox proportional hazards model, the incidence of aortic stiffness showed a significant dose-response relationship for age, PWV, total cholesterol and LDL cholesterol levels and smoking habits. These results indicate that increased levels of total cholesterol and LDL cholesterol and smoking habits may constitute contributing factors for the development of aortic stiffness in middle-aged Japanese men.