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Yokohama-shi, Japan

Kageyama S.,Jikei University School of Medicine | Ueda S.,University of Ryukyus | Mochizuki K.,Mochizuki Clinic | Miyakawa M.,Miyakawa Clinic | And 5 more authors.
Hypertension Research | Year: 2012

There are limited clinical trials examining the efficacy of antihypertensive drug combinations aimed at preventing cardiovascular events. Therefore, we designed a randomized controlled trial using amlodipine as the base drug of a multi-drug regimen, the Optimal Combination of Effective ANtihypertensives (OCEAN) Study, to determine the drug combination that is most efficacious in the prevention of cardiovascular events, such as stroke. The OCEAN Study is a collaborative study between Japan and China, enrolling 20 000 patients and following them for 3 to 4 years. A pilot study was conducted before the full-scale study to confirm the feasibility of the protocol and that the study groups and infrastructures could function properly. A total of 279 Japanese patients were enrolled from 57 participating medical institutions between June and December 2004. Two hundred and sixty-six patients (mean age: 65.9 years) were treated with amlodipine alone. One hundred and fifty-four of these patients (57.9%) did not reach the treatment targets (140/90 mm Hg for the elderly and patients with cerebrovascular disease, 130/80 mm Hg for those with diabetes mellitus, chronic kidney disease or prior myocardial infarction) and a second agent was added. They were randomly allocated into three different treatment groups using a diuretic, a Β-blocker or an angiotensin-converting enzyme inhibitor/angiotensin II receptor antagonist. The pilot study showed that the protocol was appropriate, and the inclusion of patients with slightly higher blood pressures was necessary to increase the randomization rate. It also confirmed that we organized properly functioning study groups and infrastructures. © 2012 The Japanese Society of Hypertension All rights reserved. Source


Obara T.,Tohoku University | Ohkubo T.,Tohoku University | Fukunaga H.,Tohoku University | Kobayashi M.,Tohoku University | And 8 more authors.
Hypertension Research | Year: 2010

The Japanese Society of Hypertension published guidelines for home blood pressure (HBP) measurement in 2003 and for the management of hypertension in 2004. The objective of this study was to investigate the status of physicians practice and awareness of HBP measurement based on the Japanese guidelines and compare the status between immediately after and 4 years after publication of the guidelines. A questionnaire survey regarding HBP was conducted among physicians who attended educational seminars on hypertension in 2004-05 and in 2007-08. This questionnaire was distributed, completed, and collected just before the start of the seminars. Of the 1966 and 2995 respondents to the 2004-05 and 2007-08 surveys, respectively, 90.2 and 94.6% recommended HBP measurement to their patients. The majority of physicians recommended use of the upper-arm cuff device, and recommendation of the number of measurements, documentation and evaluation of the measured values varied widely among physicians, both in 2004-05 and in 2007-08. About 10% of physicians showed sufficient understanding of the optimal methods for HBP measurement based on Japanese guidelines both in 2004-05 and in 2007-08. Only 21.6 and 23.9% of physicians correctly recognized the reference values of hypertension based on HBP measurement (systolic/diastolic, 135/85 mm Hg) in 2004-05 and in 2007-08, respectively. Although most Japanese physicians recognized the importance of HBP measurement, many had inadequate knowledge of HBP measurement, both in 2004-05 and in 2007-08. More aggressive promotion of HBP measurement among physicians is warranted. © 2010 The Japanese Society of Hypertension All rights reserved. Source


Kobayashi M.,Tohoku University | Obara T.,Tohoku University | Ohkubo T.,Tohoku University | Fukunaga H.,Tohoku University | And 8 more authors.
Hypertension Research | Year: 2010

The optimal procedure for casual-clinic blood pressure (CBP) measurement is outlined in the 2004 Japanese guidelines. We investigated the status of physicians practices and their awareness of CBP measurement immediately and 4 years after the publication of the guidelines using a questionnaire regarding CBP. This survey was conducted among physicians who attended educational seminars on hypertension in 2004-2005 and in 2007-2008; the questionnaire was distributed, completed and collected just before the start of the seminars. Of the 1966 respondents to the 2004-2005 survey and the 2995 respondents to the 2007-2008 survey, the proportion of physicians who answered that CBP was more important than self-measured BP at home (home BP) was less than 10% in both surveys. The proportion of physicians who used a mercury sphygmomanometer (68.1-75.5%) was higher than those who used an automatic and electronic sphygmomanometer (20.7-29.0%) in both surveys. However, the use of an automatic and electronic sphygmomanometer slightly increased from 20.7% in 2004-2005 to 29.0% in 2007-2008. Physicians who were younger or working in a hospital were less likely to measure CBP using the conditions of the guidelines. Approximately 50% of physicians correctly recognized the reference values of hypertension based on CBP measurement (systolic/diastolic, 140/90 mm Hg) in both surveys. The status of physicians practice and awareness of CBP measurement varied by physicians age, specialty and work place and those situations did not change over 4 years, underlying the importance of clarifying factors inherent in these situations. © 2010 The Japanese Society of Hypertension All rights reserved. Source


Satoh M.,Tohoku University | Kato N.,Kato Clinic of Internal Medicine | Hosaka M.,Tohoku University | Elnagar N.,Tohoku University | And 15 more authors.
Clinical and Experimental Hypertension | Year: 2014

Background: An electronic system for salt intake assessment using a 24-h dietary recall method has been developed in Japan. We evaluated the validity of this salt intake system for assessing salt intake. Methods: We prospectively obtained data on estimated salt intake using 24-hour urinary sodium excretion (24-hUNaCl) and salt intake by the salt intake assessment system from 203 consecutive outpatients with essential hypertension (age: 67.8o±o10.7 years; 53.7% men). Results: Mean values were 9.7o±o2.9og/day for 24-hUNaCl and 9.1o±o2.9og/day for the salt intake assessment system before corrections. The salt intake estimated by the present system was significantly correlated with 24-hUNaCl (ro=o0.66, po Source

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