Association of systolic blood pressure and pulse pressure with carotid intima thickness in elderly Japanese patients.

Many studies have demonstrated that increased carotid intima-media thickness (IMT) is related to future cardiovascular events and is influenced by cardiovascular risk factors such as sex, hypertension, diabetes, and hypercholesterolemia. Although aging is a well-known risk factor for an increase in carotid IMT, few studies have investigated which factors influence carotid IMT in the very elderly. In the present study, we investigated the relationship of pulse pressure (PP), blood pressure (BP), and its variability (six consecutive visits) with carotid IMT among 240 high-risk elderly in whom risk factors were managed clinically (average age was 79 ± 5 years). In the simple correlation, mean systolic BP (SBP) had a positive correlation with IMT and max IMT (P = .012 and P = .045), as did PP (P = .018 and P = .004), but did not diastolic BP or standard deviation of BP and coefficient of variation of BP. In multiple regression analyses, mean SBP and mean PP were each determinants of both IMT and max IMT, when each parameter was added separately to the regression model. We concluded that high SBP and wide PP still have an influence on increased carotid IMT in the very elderly Japanese patients.

The relationship between psychosocial stress, age, BMI, CRP, lifestyle, and the metabolic syndrome in apparently healthy subjects.

The aim of this cross-sectional study was to examine the factors which may be associated with the metabolic syndrome by exploring the relationship between psychosocial stress, age, body mass index (BMI), C-reactive protein (CRP), lifestyle factors, and the components of the metabolic syndrome, such as glycated hemoglobin (HbA1c), fasting blood sugar (FBS), body fat percentage, and triglyceride concentration, among apparently healthy subjects. Psychosocial stress was measured by the use of the inventory to measure psychosocial stress (IMPS). One thousand four hundred and ninety-nine people out of 1,941 public school workers admitted to a hospital for a medical check-up responded to the IMPS, yielding a response rate of 77.2%. A total of 1,201 workers excluding 298 who were taking medication for various diseases were analyzed with the use of hierarchical multiple regression models. It was found that IMPS-measured stress score, age, BMI, and smoking habit were associated with an increase in glycated hemoglobin among men, while alcohol consumption was associated with a decrease in glycated hemoglobin. Stress score, age, BMI, and alcohol consumption were found to be associated with an increase in FBS among men, while smoking and exercise habits were associated with a decrease in FBS. CRP was found to be associated with an increase in body fat percentage among men, though stress score was not associated with an increase in body fat percentage. Stress score, age, and BMI were associated with an increase in triglyceride concentration among women. The findings of the present study seem to be in line with the hypothesis that psychosocial stress plays an important role in developing the metabolic syndrome, which may be associated with inflammatory processes in the vascular wall, resulting in atherosclerosis and cardiovascular disease.

The relationship between IMPS-measured stress score and intraocular pressure among public school workers.

The aim of this study was to examine the relationship between psychosocial stress and intraocular pressure among apparently healthy subjects. Psychosocial stress among 1,461 public school workers (883 men and 578 women) was measured using the inventory to measure psychosocial stress (IMPS) and intraocular pressure was measured using a non-contact tonometer (Topcon CT-90). After controlling for the effects of likely confounding variables such as age, body mass index (BMI), glycosylated hemoglobin, systolic blood pressure, alcohol consumption, smoking status, and exercise, partial correlations and hierarchical multiple regression analysis were performed in order to test the hypothesis that IMPS-measured stress score was associated with intraocular pressure. IMPS-measured stress score was found to correlate positively with intraocular pressure in women after controlling for the effects of confounding variables, whereas this relationship was not found in men. Hierarchical multiple regression analysis indicated that IMPS-measured stress score was positively associated with intraocular pressure in women independent of confounding variables, but not in men. Perturbations of the hypothalamic-pituitary-adrenal (HPA) axis associated with stress are considered to be partly responsible for an increase in intraocular pressure among people suffering from psychosocial stress. Further research is needed to elucidate the relationship between this stress-associated increase in intraocular pressure and open-angle glaucoma.

The relationship between IMPS-measured stress score and biomedical parameters regarding health status among public school workers.

The aim of this study was to examine the relationship between the stress score measured using the Inventory to Measure Psychosocial Stress (IMPS) and biomedical parameters regarding health status among apparently healthy subjects in order to evaluate the validity of the IMPS. Out of the 1,941 public school workers in Kyushu and Okinawa, Japan, who were admitted to a hospital for medical check-ups, 1,499 workers responded to questionnaires which assessed the degree of stress response (i.e., stress score) measured using the IMPS, and the degree of stress tolerance capacity (i.e., stress intolerance score) measured using the Inventory to Measure Stress Tolerance Capacity (IMST). One thousand two-hundred and one workers (684 men and 517 women) were analyzed, excluding 298 subjects who were taking medication for hypertension, hyperuricemia, hyperlipidemia and diabetes, or had a value for glycosylated hemoglobin (HbA1c)>or=6.0 percent. An increase in the stress score was positively associated with an increase in both body fat percentage and glycosylated hemoglobin values among men, while it was positively associated with an increase in plasma triglyceride concentrations among women. The stress score significantly correlated with the value for glycosylated hemoglobin even after controlling for age, body mass index, alcohol consumption, smoking, and exercise among men. An increase in the stress intolerance score was positively associated with an increase in body fat percentage among men, while it was positively associated with an increase in body weight, body mass index, and body fat percentage among women. Our result that the stress score measured using the IMPS was associated with obesity and unfavorable glycemic changes is in congruency with the model that psychosocial stress has a detrimental effect on humans by inducing obesity and insulin resistance, suggesting that the IMPS is a valid means to evaluate psychosocial stress levels among an otherwise healthy population.

Alcohol intake and future incidence of hypertension in a general Japanese population: the Hisayama study.

BACKGROUND: The question remains as to whether light to moderate alcohol intake is associated with an increased risk of hypertension. METHODS: In 1978, a total of 1101 residents (433 men and 668 women) in a subrural community, Hisayama, in Japan, aged 40 years or more, with normal blood pressure, who were free from cardiovascular disease, were enrolled in a 10-year follow-up study. Inquiries regarding regular drinking were made in an interview based on a self-administered questionnaire. RESULTS: During the follow-up, 101 men and 166 women developed hypertension (blood pressure > or =140/90 mm Hg or use of antihypertensive drugs). The age-adjusted incidence of hypertension among current male drinkers increased significantly even with a light intake of alcohol (<23 g of ethanol per day). In women, the incidence was also significantly higher in drinkers than in nondrinkers. In multivariate analysis, alcohol intake, in addition to age and body mass index, remained a significant independent risk factor for hypertension in men, but not in women. In men, all three categories of current drinking were found to be significant risk factors for the development of hypertension after adjustment for age and body mass index [relative risk (RR), 2.00; 95% confidence interval (CI), 1.07-3.76 for light drinking compared with nondrinking; RR, 2.60; 95% CI, 1.50-4.49 for moderate drinking (23-45 g per day); and RR, 2.24; 95% CI, 1.26-3.99 for heavy drinking (> or =46 g/day)]. CONCLUSIONS: Our results suggest that alcohol intake, even light drinking, is a predictor of future hypertension among Japanese men.