[Risk factors for circulatory disease in patients on antihypertensive drug treatment]

Proportion of severe cases and mortality in stroke patients has decreased steadily in the Minami-Uwa District. The reason for this, has been assumes to be that severe hypertensive patients were being detected and treated in early stage by the increase in response rate of medical check-up and from improvements in health education in cooperation with the Mishou Public Health Center in the towns and Villages in the District. However, as there are multiple risk factors for hypertensive circulatory disease other then it is necessary to determine what factors exist in hypertensive patients. Risk factors for circulatory disease were studied in patients using antihypertensive medication at the time of the health examination. Of 5,284 residents studied from 1993 to 1994 the prevalence of risk factors of atherosclerosis such as obesity, disorders of lipid metabolism and glucose intolerance were higher in hypertensive who were normotensive due to antihypertensive drugs than in the non-hypertensive residents. Patients with resistant hypertension accounted for a third of all the patients using antihypersive drugs. Results also showed a relationship between excessive reduction in diastolic blood pressure and increased risk of coronary heart disease (the J-curve phenomenon) in patients on antihypertensive drug treatment. For preventing circulatory disease, it is important to improve the life style of hypertensive patients, in areas such as physical activity or dietary habits, and develop close cooperation among doctors, public health nurses and nutritionists in the regional community, in addition to increasing compliance in maintaining antihypertensive treatment. Construction of a network among public health, medical care and welfare services is important for prevention and for an improved prognosis in circulatory disease.