Tadayoshi Ogino

Clinical studies on peripheral hemodynamics in arterial hypertension.

Digital blood pressure and flow were measured in both normal subjects and patients with essential hypertension by means of the apparatus which have been recently devised, and peripheral vascular resistance was calculated according to Poiseuilles law in order to compare them. 1. Digital blood pressure is higher, the digital blood flow is less and the peripheral vascular resistance is stronger in patients with essential hypertension than in normotensives. 2. Hypertensive patients with ischemic heart disease, calcification of the aortic arch, left ventricular hypertrophy and heart size greater than 53% of the cardio-thoracic ratio were higher in the digital pressure, less in the digital flow, and stronger in the peripheral vascular resistance than those without these findings of the heart and the aortic arch. 3. The curve of relationship obtained from many cases of both normotensives and hypertensives between the digital blood flow and the peripheral vascular resistance forms a hyperbola. 4. Peripheral vascular resistance in both normotensives and hypertensives increased gradually with age up to 50-60 years, and decreased slightly thereafter. The resistance was stronger in patients with essential hypertension than in normotensives through all ages.

Venous Pressure and Compliance of the Peripheral Capacitance Vessels

Compliances of the peripheral capacitance vessels decreased gradually in accordance with the increase in pressure of the brachial vein. The relationship between them formed a number of hyperbolic-like curves, the same results as those found in many cases of both normal subjects and patients with congestive heart failure. The decrease of compliance of the peripheral capacitance vessels was not the result of an organic change, but of a functional change of the vessels caused by distention.

Compliance of the Peripheral Capacitance Vessels in Patients With Congestive Heart Failure

A method for measuring compliance of the peripheral capacitance vessels is reported, and the values of compliance in patients with congestive heart failure are compared with those in normal subjects. Peripheral venous compliance and right brachial venous pressure in both patients with congestive heart failure and in normal subjects, when plotted graphically, showed a relationship described by many hyperbolic curves. The mean value of compliance of the peripheral capacitance vessels in patients with congestive heart failure was only half that in normal subjects. This difference was statistically significant (P less than 0.001). After the congestion in the patients with congestive heart failure disappeared following treatment with digitalis and other drugs, the values of compliance became nearly the same as in normal subjects. It seems that the increase of compliance of the peripheral capacitance vessels is not due to an organic change but to a functional change of the vessels caused by distention.

Seasonal Variation in the Daily Urinary Sodium Excretion in Outpatients from the Morioka Region of Northern Japan

Objective Although the daily urinary sodium excretion (UNaV) is considered to provide the most reliable estimate of the daily sodium intake, it may be affected by salt loss due to sweating in summer. However, the seasonal variation in the daily UNaV associated with a normal lifestyle is unknown. Methods This study was performed in 348 outpatients from the Morioka region during three seasons: summer (summer 1), winter, and the following summer (summer 2). The daily UNaV (g salt/day) was estimated by the second morning urine method three times during each season. Seasonal variation was defined as a significant trend across the three seasons together with a significant difference between winter and both summers. Results In women, the daily UNaV was higher in winter (11.8±3.0 g salt/day) than in summer 1 (11.2±2.9 g salt/day) or summer 2 (11.0±2.9 g salt/day). In contrast, there was no marked seasonal variation in men. An analysis stratified by age (4 quartiles) identified seasonal variation in the older 2 quartiles of women (aged ≥68 years). In these women, the mean seasonal difference in the daily UNaV was 0.9 g of salt/day for both winter vs. summer 1 and winter vs. summer 2, while it was 0.1-0.8 g of salt/day in the other groups. Conclusion Seasonal variation in the daily UNaV only occurred in older female patients and was relatively small. This is evidence for restricting salt intake throughout the year and should reassure patients who are anxious about salt loss due to sweating in summer.