The roles of urinary albumin, eGFRcystatin (eGFRcys), and eGFRcreatinine (eGFRcre) in the progression of coronary artery calcification (CAC) remain unclear. Therefore, the present study investigated the relationship between kidney function and CAC progression.Methods: A total of 760 Japanese men aged 40-79 years were enrolled in this population-based study. Kidney function was measured using eGFRcre, eGFRcys, and the urine albumin-to-creatinine ratio. CAC scores were calculated using the Agatston method. CAC progression was defined as an annual increase of ＞10 Agatston units (AU) among men with 0＜CAC＜100 AU at baseline, that of ＞10% among those with CAC ≥ 100 AU, and any progression for those with CAC = 0 at baseline. The relative risk (RR) of CAC progression based on kidney function was assessed using a robust Poisson regression model. Results:The mean follow-up period was 4.9 years. CAC progression was detected in 45.8% of participants. Positive associations between CAC progression and albuminuria (＞30mg/g) (RR: 1.29; 1.09 to 1.53; p = 0.004) and low eGFRcys (＜60ml/min/1.73m 2 ) (RR: 1.27; 1.05 to 1.53; p=0.012) remained significant after adjustments for age, the follow-up time, and computerized tomography type. Following further adjustments for hypertension, diabetes mellitus, dyslipidemia, C-reactive protein, and lifestyle factors, CAC progression was associated with albuminuria (RR: 1.20; 1.01 to 1.43; p=0.04) and low eGFRcys (RR: 1.19; 0.99 to 1.43; p=0.066), but not with eGFRcre. Conclusion:CAC progression was associated with albuminuria; however, its relationship with eGFRcys was weakened by adjustments for risk factors. associated with cardiovascular disease (CVD) events and mortality 3) . CKD is diagnosed by increases in urinary albumin or decreases in the estimated glomerular filtration rate (eGFR). Therefore, urinary albumin and eGFR may predict the progression of Copyright©2021 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

Growing epidemiological evidence has shown an association of the urinary sodium (Na) to potassium (K) ratio (Na/K ratio) with blood pressure and cardiovascular diseases. However, no clear cutoff level has been defined. We investigated the cutoff level of the urinary Na/K ratio under different dietary guidelines for Japanese individuals, especially that endorsed by the 2020 revised Japanese Dietary Reference Intakes (DRIs). A population of 1145 Japanese men and women aged 40 to 59 years from the INTERMAP study was examined. Using high-quality standardized data, the averages of two 24 h urinary collections and four 24 h dietary recalls were used to calculate the 24 h urinary and dietary Na/K ratios, respectively. Associations between the urinary and dietary Na/K ratios were tested by sex- and age-adjusted partial correlation. The optimal urinary Na/K ratio cutoff level was determined by receiver operating characteristic (ROC) curves and sex-specific cross tables for recommended dietary K and salt. Overall, the average molar ratio of 24 h urinary Na/K was 4.3. We found moderate correlations (P < 0.001) of the 24 h urinary Na/K ratio with 24 h urinary Na and K excretion (r = 0.52, r = −0.49, respectively) and the dietary Na/K ratio (r = 0.53). ROC curves showed that a 24 h urinary Na/K ratio of approximately 2 predicted Na and K intake that meets the dietary goals of the Japanese DRIs. The range of urinary Na/K ratios meeting the dietary goals of the Japanese DRIs for both Na and K was 1.6‒2.2 for men and 1.7‒1.9 for women. Accomplishing a urinary Na/K ratio of 2 would be desirable to achieve the DRIs dietary goals for both Na and K simultaneously in middle-aged Japanese men and women accustomed to Japanese dietary habits. This observational study is registered at www.clinicaltrials.gov as NCT00005271.

The relationship of blood pressure (BP) indexes (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], mean arterial pressure [MAP]) to subclinical cerebrovascular diseases (SCVDs) remains unclear. This study aimed to elucidate the relationship of four BP indexes measured at two visits on SCVDs assessed by magnetic resonance imaging (MRI) in general Japanese men. Methods: In general Japanese men aged 40-79 years (N 616), office BP indexes were measured at two visits (Visits 1 [2006-2008] and 2 [2010-2014]). MRI images obtained on the third visit (2012-2015) were examined for prevalent SCVDs: lacunar infarction, periventricular hyperintensity (PVH), deep subcortical white matter hyperintensity (DSWMH), microbleeds, and intracranial artery stenosis (ICAS). Using a multivariable logistic regression analysis, we computed and estimated the odds ratio of each prevalent SCVD for one standard deviation higher BP indexes. The same analyses were performed using home BP. Results: All four office BP indexes at both visits associated with lacunar infarction. Visit 1 and 2 DBP and Visit 1 MAP associated with PVH and DSWMH, and Visit 1 SBP associated with DSWMH. All Visit 2 BP indexes appear to show stronger association with microbleeds than Visit 1 indexes, and Visit 1 and 2 SBP, PP, and MAP showed similar associations with ICAS. Additional analyses using home BP indexes revealed similar relationships; however, the significance of some relationships decreased. Conclusion: In general Japanese men, BP indexes were associated with most of SCVDs, and BP indexes measured at different periods associated with different SCVDs assessed by MRI. brain may be easily detected by neuroimaging scans using magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). These incidental findings have been identified as silent MRI markers of stroke in the elderly 1, 2). Increased blood pressure (BP) is an important and modifiable risk factor for cerebral small vessel

Background:In Asia Pacific region, 66% of deaths are caused from cardiovascular diseases (CVD) which are attributed to hypertension, and in India alone, ischemic heart disease and stroke are the top causes of death. Awareness of hypertension and blood pressure (BP) control rate are still low in India; therefore, physicians and patients hypertension education are important for increasing awareness and improving hypertension management. Home blood pressure monitoring (HBPM) is recognized as a valuable tool to diagnose and support hypertension treatment including prevention of CVD and target organ damage. We explored the prevailing knowledge and current recommendation of HBPM in daily practice by physicians in India.Methods:As part of Asia HBPM Survey-2020, a cross-sectional survey was conducted among health care professionals from India between December 2020 to June 2021. The questionnaire consisted of 37 questions, including sub-questions, related to HBPM awareness and recommendations to patients. All analyses were performed using the proper statistical software and results were presented as descriptive data.Results:A total of 832 physicians participated in the survey. Almost 83% were male, whereas age, specialty and workplace were well distributed. Among physicians who recommend HBPM in the morning, more than 60% of respondents are giving instruction to their patients in alignment with local Indian hypertension guidelines regarding the body position and time of rest before measurement. Nevertheless, only 31% of physicians instruct their patients to measure their BP before taking anti-hypertensive drugs, while around 30% of physicians gave no instructions. A noticeable percentage of the physicians gave no instructions related to home BP measurement to their patients. Reference value of hypertension diagnosis amongst the physicians was substantially low based on clinic BP (34%) and home BP (15%).Among physicians who manage hypertensive patients, nearly 88% recommend HBPM to their patients, however, only 29% of their patients own HBPM device and 35% of the patients measure their own BP at home.Conclusions:The survey reveals that awareness of HBPM amongst physicians in India is low and instruction to their patients are either lacking or not well aligned with the local hypertension guidelines which may have led to the low HBPM rate among patients. Considering the challenges and limitations physicians face in daily practice, clear and practical educational material and sessions are needed to improve the understanding of HBPM amongst physicians.