Hypertension in Rural Area: Its Pathognostics and Control / 日本農村医学会雑誌

ABSTRACT

As regards hypertension in rural areas, many studies have so far been conducted in Japan by members of the Japanese Association of Rural Medicine and other medical societies. The findings have greatly contributed to the lowering of the incidence of cerebrovascular diseases. However, due to their still high incidence and problematic complications, they as yet remain to be one of the most serious health problems of rural people. On November 24, 1983, the author in had an opportunity to attend the 8th Congress of the Korean Association of Rural Medicine Seoul and had the honor of delivering lectures on the hypertension in Japanese rural areas. This paper was prepared in regard to the following four major aspects primarily on the basis of the relevent recent reports filed with the Japanese Association of Rural Medicine.<BR>1 Epidemiology of Cerebrovascular Diseases and Hypertension. In terms of the mortality rate from cerebrovascular diseases, Niigata Prefecture ranks among the 10 top regions in Japan. This fact had led many medical scientists to believe that the incidence rate of the hypertensives in rural areas in the northern prefecture must be high. Actually, however, it was found to be low when compared with the national average registered in a nationwide survey of nutrition. The fact that replacing cerebral hemorrhage cerebral infarction has emerged as a primary cause of the deaths from cerebrovascular diseases in Japanese rural areas, suggests that it is necessary to probe into the factors that may lie in the process of transition from hypertension to cerebral Infarction, with emphasis on their possible link with the lifestyles and other environmental factors in rural settings.<BR>2. Association between Hypertension and Lifestyles in Rural Areas. Aside from genetic predisposition, high salt intake is the most important factor contributing to the incidence of hypertension. Salt consumption should be reduced along with improvement of dietary habits. Especially important is proper intake of protein.<BR>3. Hypertension Control and Clinical Tests. Before everything else, regular checkups on blood pressure are necessary for bringing hypertension under control. Among evaluating test results, electrocardiographic findings should be given a preferential status. Apperance ofe high R with strain pattern and atrial fibrillation should be taken special note of as a problem indicative of the onset of cerebral infarction. These findings suggest the occurence of heart failure in the development of cerebral infarction.<BR>4, Ischemic Heart Disease among Rural Inhabitants. More Japanese-Americans who have emigrated from Hiroshima Prefecture than their relatives living in the rural areas of the prefecture were found to be suffering from hypertension, obesity, hyperlimpemia and abnormal glucose tolerance. And ischemic changes on ECG were more evident among these Americans of Japanese descent than the people in Hiroshima. Such findings suggest that the traditional daily fare of the rural communities in Hiroshima contains something that can prevent ischemic heart disease.<BR>In conclusion, to bring hypertension under control in the agrarian society in Japan, strong willpower to that end is required at both individual and community levels.<BR>Encouragement should also be given to farmers so as to have their blood pressure measured and receive ECG tests on a regular basis. On the otherhand, Japan's traditional dietary patterns are considered worth reviewing with a view to further reducing cerebrovascular disease incidence rate and preventing ischemic heart disease whose incidence is anticipated to go up in the future