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Objective: The objective was to determine whether central-venous oxygen saturation (ScvO2<70%) can be detected from the difference between invasively and noninvasively measured systolic blood pressure (BP) (ie, ΔBP defined as arterial BP minus noninvasive BP)., Methods: This is a cross-sectional study at a single medical and surgical intensive care unit in Japan. All hypotensive patients admitted to intensive care unit were eligible. Arterial BP was measured via a radial-artery catheter, and noninvasive BP on the same side was measured via a brachial cuff. ScvO2 was measured by gas analysis of blood sampled from a central-venous chatheter (CVC). We calculate the area under the curve for ΔBP as an indicator of ScvO2<70%., Results: Usable data were obtained from the records of 111 patients. The median and interquartile range of ΔBP and ScvO2 were -4mm Hg (-11, 6) and 67% (60.9, 73.9), respectively. The area under the curve of ΔBP as an indicator of ScvO2<70% was 0.81 (95% confidence interval [CI], 0.73-0.89). With a cutoff ΔBP of 0, sensitivity was 65.7% (95% CI, 53.1-76.8), specificity was 97.7% (95% CI, 88.0-99.8), and positive predictive value was 97.8 (95% CI, 88.2-99.9)., Conclusions: ΔBP can indicate whether ScvO2 is lower than 70%. When that difference is greater than 0, ScvO2 is very likely to be lower than 70%., (Copyright © 2016 Elsevier Inc. All rights reserved.)

We investigated the cardiovascular responses to active standing in Swedish and Japanese pre-pubertal children using non-invasive continuous beat-to-beat finger blood pressure (BP) monitoring. Seventy-eight Swedish (7-12 years) and 53 Japanese children (6-12 years) were examined. There were no significant differences in body weight or height between the two groups (total group). Finger blood pressure and heart rate were continuously recorded in the supine position and during standing. Supine BP was significantly higher in Swedish compared to Japanese children (115/65 vs 98/50 mmHg, P < 0.001), and Swedish children showed a significantly larger initial BP drop upon rising (-28/15 vs - 14/ -10 mmHg, P < 0.05) and a larger increment of heart rate (39 +/- 10 vs 29 +/- 8 beats. min-1, P < 0.05). There were, however, no differences in the blood pressure and heart rate changes in the following steady state period (2-3 min) between the two groups. These results suggest that Swedish pre-pubertal children have a higher basal blood pressure and enhanced cardiovascular autonomic responses, such as pronounced baroreflex receptor sensitivity and vasoconstrictor mechanisms. These differences in the two cohorts were not related to body dimensions or degree of maturation, indicating that autonomic functions in the cardiovascular system largely depend on genetic factors and environmental variables.

Since 1969, community-based hypertension control program has been conducted for non-company-employed residents aged 40 and over (3,039: 70% of the residents) in Noichi town, Kochi prefecture. The program is composed of annual health examinations, health education and referral of hypertensives to local physicians. Incidence and mortality of stroke have declined along with a decrease in systolic blood pressure levels. However, during the period of 1982-84, stroke incidence was higher for nonparticipants in health examinations than in the participants of the same age group. For an understanding of the state of detection and control of hypertension in nonparticipants aged 40-69 of the 1982-84 health examinations, blood pressure was examined for 312 subjects randomly selected from the 2,062 nonparticipants. Blood pressure levels were significantly higher in nonparticipants than in participants. In addition, the proportion of hypertensives who were aware of their blood pressure levels was lower in nonparticipants than in participants. About 87% of residents aged 40-69 reported that they received blood pressure checkups at least once a year. Persons who were involved in manual labor, sales and services received blood pressure checkups less frequently. Among company employees, the proportion of persons who checked their blood pressures annually was progressively lower with decrease in size of companies. The community hypertension control appears to have contributed to a decline of blood pressure levels and stroke incidence. However, detection and control of hypertension was relatively poor in nonparticipants in health examinations, particularly for employees of small companies.

The age- and gender-specific profile of circadian blood pressure variation was examined by monitoring ambulatory blood pressure (ABP) in 477 untreated subjects in a rural community of northern Japan. Autoregressive spectral analysis demonstrated three major peaks at around 24, 12, and 8 h. We fitted a truncated Fourier series with three harmonics to the blood pressure (BP) data using least squares regression. More than half of the BP and pulse rate periodic curves were bimodal, one-third were trimodal, and the remainder were unimodal. The nadir of BP appeared between 00:00 and 01:30, and that of pulse rate occurred between 00:30 and 02:00. The nadir of systolic and diastolic BP, as well as pulse rate, appeared earlier with increasing age, and the difference between subjects in their 20s and those in their 70s was about 1 h. The amplitude of 24 h BP decreased with increasing age in men, but not in women. This type of information on the circadian BP profile of a general population is useful for the diagnosis and treatment of hypertension.