Abstract
Few epidemiological studies have been conducted on the prevalence, blood pressure trends by age, and basic characteristics of chronic hypotension. Among 13,370 subjects (5,094 men and 8,276 women) examined from 1958 to 1999 in Japan, 92 were identified as chronic hypotensives (11 men and 81 women) whose systolic blood pressure (SBP, mmHg) was lower than 100 mmHg for 8 or more years. Trends of SBP and body mass index (BMI, kg/m2) were determined over a 16-year period in this group of chronic hypotensives and 276 age- and sex-matched controls (33 men and 243 women); during this 16-year period, the chronic hypotensives and controls ranged in age from 19 to 75 years. BMI, heart rate (HR, bpm), body temperature (°C), Hb (g/dl), and creatinine (Cre, mg/dl) were compared between the chronic hypotensives and the controls at the last examination. The chronic hypotensives had a female preponderance (0.2% in men and 1.0% in women, p=0.001), and their SBP and BMI increased little with increasing age. BMI (20.2±3.4), BMI-adjusted SBP (101±19), HR (63±10), body temperature (36.7±0.3), Hb (12.5±1.1), and Cre (0.81±0.13) were lower in the chronic hypotensives than those (22.9±3.4, 126±20, 68±10, 36.8±0.3, 12.9±1.1, and 0.86±0.12, respectively) in controls (p<0.05). The present results clearly show that chronic hypotensives have a female preponderance and low BMI, HR, body temperature, Hb, and Cre in addition to low SBP that does not increase with age.
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Stamler J, Stamler R, Neaton JD : Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. Arch Intern Med 1993; 153: 598–615.
Whelton PK : Epidemiology of hypertension. Lancet 1994; 344: 101–106.
Burt VL, Cutler JA, Higgins M, et al: Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. Hypertension 1995; 26: 60–69.
Pemberton J : Does constitutional hypotension exist? BMJ 1989; 298: 660–662.
De Buyzere M, Clement DL, Duprez D : Chronic low blood pressure: a review. Cardiovasc Drugs Ther 1998; 12: 29–35.
Donner-Banzhoff N, Kreienbrock L, Baum E : Hypotension—does it make sense in family practice? Fam Pract 1994; 11: 368–374.
Dyer AR, Elliott P, Shipley M, Stamler R, Stamler J : Body mass index and associations of sodium and potassium with blood pressure in INTERSALT. Hypertension 1994; 23: 729–736.
Mark AL, Correia M, Morgan DA, Shaffer RA, Haynes WG : State-of-the-art-lecture: obesity-induced hypertension: new concepts from the emerging biology of obesity. Hypertension 1999; 33: 537–541.
Goldstein DS : Plasma catecholamines and essential hypertension. An analytical review. Hypertension 1983; 5: 86–99.
Grassi G, Cattaneo BM, Seravalle G, Lanfranchi A, Mancia G : Baroreflex control of sympathetic nerve activity in essential and secondary hypertension. Hypertension 1998; 31: 68–72.
Landsberg L, Saville ME, Young JB : Sympathoadrenal system and regulation of thermogenesis. Am J Physiol 1984; 247: E181–E189.
Fujiura Y, Adachi H, Tsuruta M, Jacobs DR Jr, Hirai Y, Imaizumi T : Heart rate and mortality in a Japanese general population: an 18-year follow-up study. J Clin Epidemiol 2001; 54: 495–500.
Palatini P, Casiglia E, Julius S, Pessina AC : High heart rate: a risk factor for cardiovascular death in elderly men. Arch Intern Med 1999; 159: 585–592.
Verdecchia P, Schillaci G, Reboldi G, Santeusanio F, Porcellati C, Brunetti P : Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. The PIUMA study. Hypertension 2000; 36: 1072–1078.
Coresh J, Wei GL, McQuillan G, et al: Prevalence of high blood pressure and elevated serum creatinine level in the United States: findings from the third National Health and Nutrition Examination Survey (1988–1994). Arch Intern Med 2001; 161: 1207–1216.
Song YM, Sung J, Kim JS : Which cholesterol level is related to the lowest mortality in a population with low mean cholesterol level: a 6.4-year follow-up study of 482,472 Korean men. Am J Epidemiol 2000; 151: 739–747.
Rosengren A, Tibblin G, Wilhelmsen L : Low systolic blood pressure and self perceived wellbeing in middle aged men. BMJ 1993; 306: 243–246.
Kawasaki T, Itoh K, Uezono K, et al: Investigation of high salt intake in a Nepalese population with low blood pressure. J Hum Hypertens 1993; 7: 131–140.
Akahoshi M, Soda M, Nakashima E, Shimaoka K, Seto S, Yano K : Effects of menopause on trends of serum cholesterol, blood pressure, and body mass index. Circulation 1996; 94: 61–66.
SAS/ATAT : User's Guid, Release 6.03 Edition. Cary, SAS Institute Inc, 1988, 1028 pp.
Gavras H, Hatzinikolaou P, North WG, Bresnahan M, Gavras I : Interaction of the sympathetic nervous system with vasopressin and renin in the maintenance of blood pressure. Hypertension 1982; 4: 400–405.
Boushel R, Calbet JA, Radegran G, Sondergaard H, Wagner PD, Saltin B : Parasympathetic neural activity accounts for the lowering of exercise heart rate at high altitude. Circulation 2001; 104: 1785–1791.
Maciel BC, Gallo L Jr, Marin Neto JA, Lima Filho EC, Martins LE : Autonomic nervous control of the heart rate during dynamic exercise in normal man. Clin Sci (Lond) 1986; 71: 457–460.
Julius S, Jamerson K, Mejia A, Krause L, Schork N, Jones K : The association of borderline hypertension with target organ changes and higher coronary risk. Tecumseh Blood Pressure study. JAMA 1990; 264: 354–358.
Julius S, Krause L, Schork NJ, et al: Hyperkinetic borderline hypertension in Tecumseh, Michigan. J Hypertens 1991; 9: 77–84.
Buchholz K, Schachinger H, Wagner M, Sharma AM, Deter HC : Reduced vagal activity in salt-sensitive subjects during mental challenge. Am J Hypertens 2003; 16: 531–536.
Brack KE, Coote JH, Ng GA : Interaction between direct sympathetic and vagus nerve stimulation on heart rate in the isolated rabbit heart. Exp Physiol 2004; 89: 128–139.
Zurlo F, Larson K, Bogardus C, Ravussin E : Skeletal muscle metabolism is a major determinant of resting energy expenditure. J Clin Invest 1990; 86: 1423–1427.
Owens PE, Lyons SP, O'Brien ET : Arterial hypotension: prevalence of low blood pressure in the general population using ambulatory blood pressure monitoring. J Hum Hypertens 2000; 14: 243–247.
Luchner A, Schunkert H : Interactions between the sympathetic nervous system and the cardiac natriuretic peptide system. Cardiovasc Res 2004; 63: 443–449.
Rubattu S, Volpe M : The atrial natriuretic peptide: a changing view. J Hypertens 2001; 19: 1923–1931.
Montorsi P, Tonolo G, Polonia J, Hepburn D, Richards AM : Correlates of plasma atrial natriuretic factor in health and hypertension. Hypertension 1987; 10: 570–576.
Sagnella GA, Markandu ND, Buckley MG, et al: Atrial natriuretic peptides in essential hypertension: basal plasma levels and relationship to sodium balance. Can J Physiol Pharmacol 1991; 69: 1592–1600.
Staessen J, Bulpitt C, Clement D, et al: Relation between mortality and treated blood pressure in elderly patients with hypertension: report of the European Working Party on High Blood Pressure in the Elderly. BMJ 1989; 298: 1552–1556.
Julius S, Valentini M, Palatini P : Overweight and hypertension: a 2-way street? Hypertension 2000; 35: 807–813.
Sinnett PF, Whyte HM : Epidemiological studies in a total highland population, Tukisenta, New Guinea. Cardiovascular disease and relevant clinical, electrocardiographic, radiological and biochemical findings. J Chronic Dis 1973; 26: 265–290.
Marmot MG : Geography of blood pressure and hypertension. Br Med Bull 1984; 40: 380–386.
He J, Klag MJ, Whelton PK, et al: Migration, blood pressure pattern, and hypertension: the Yi Migrant Study. Am J Epidemiol 1991; 134: 1085–1101.
Poulter NR, Khaw K, Hopwood BE, Mugambi M, Peart WS, Sever PS : Determinants of blood pressure changes due to urbanization: a longitudinal study. J Hypertens Suppl 1985; 3: S375–S377.
Sever PS, Gordon D, Peart WS, Beighton P : Blood-pressure and its correlates in urban and tribal Africa. Lancet 1980; 2: 60–64.
Klag MJ, He J, Coresh J, et al: The contribution of urinary cations to the blood pressure differences associated with migration. Am J Epidemiol 1995; 142: 295–303.
Poulter NR, Khaw KT, Hopwood BE, et al: The Kenyan Luo migration study: observations on the initiation of a rise in blood pressure. BMJ 1990; 300: 967–972.
Eto M, Toba K, Akishita M, et al: Impact of blood pressure variability on cardiovascular events in elderly patients with hypertension. Hypertens Res 2005; 28: 1–7.
Boutitie F, Gueyffier F, Pocock S, Fagard R, Boissel JP : J-shaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta-analysis of individual-patient data. Ann Intern Med 2002; 136: 438–448.
Voko Z, Bots ML, Hofman A, Koudstaal PJ, Witteman JC, Breteler MM : J-shaped relation between blood pressure and stroke in treated hypertensives. Hypertension 1999; 34: 1181–1185.
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Akahoshi, M., Hida, A., Imaizumi, M. et al. Basic Characteristics of Chronic Hypotension Cases: A Longitudinal Follow-Up Study from 1958 through 1999. Hypertens Res 29, 1–7 (2006). https://doi.org/10.1291/hypres.29.1
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DOI: https://doi.org/10.1291/hypres.29.1
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