Hypertension: Teramoto S

Tanaka H, Teramoto S, Oashi K, Saikai T, Tanaka S, Suzuki K, Hashimoto M, Abe S. · Third Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan. · Circulation. · Pubmed #11457745 links to  free full text

Abstract: BACKGROUND: Candesartan, an AT(1) receptor antagonist, has been reported to have no association with persistent cough in subjects with hypertension, but there has been no study on the safety of its administration to hypertensive patients with symptomatic asthma. The aim of this study was to compare the adverse effects of candesartan and calcium antagonists on cough, pulmonary function, and bronchial hyperresponsiveness in these patients. METHODS AND RESULTS: Sixty mildly to moderately hypertensive patients with bronchial asthma received either candesartan (n=30) or the calcium antagonists nifedipine or manidipine (n=30) for 6 months. The candesartan group included 5 subjects with a history of ACE inhibitor-induced cough. There were no differences between the 2 groups in patient characteristics, ACE gene polymorphism, pulmonary function, or bronchial hyperresponsiveness to methacholine. Control of hypertension was the primary end point; new cough detected by self-administrated questionnaire and an increase in cough frequency by visual analog scale were the second end point. No patient complained of persistent cough. Neither mean visual analog scale score nor pulmonary functions changed during this study. Bronchial hyperresponsiveness had a tendency to improve in the candesartan group, but there was no difference between the 2 groups. CONCLUSIONS: Incidence, frequency, and severity of persistent cough, pulmonary functions, and bronchial hyperresponsiveness did not change in either the candesartan or calcium antagonist group. It is suggested that candesartan is as effective and safe as calcium antagonists in the treatment of hypertension associated with symptomatic asthma.

Yamamoto H, Teramoto S, Yamaguchi Y, Hanaoka Y, Ishii M, Hibi S, Ouchi Y. · Department of Geriatric Medicine, Faculty of Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. · Sleep Med. · Pubmed #17512795 No free full text.

Abstract: BACKGROUND AND PURPOSE: Obstructive sleep apnea syndrome (OSAS) is recognized as one of the risk factors of hypertension and cardiovascular disorders. In the current study, we hypothesized that the hypoxic stress caused by obstructive sleep apnea would increase circulating adrenomedullin (ADM) levels in untreated OSAS patients compared to an age-matched control group. We further hypothesized that oxygen administration treatment may decrease OSAS-induced hypoxic stress and ADM levels. METHODS: We examined short-term and long-term oxygen administration effects on circulating ADM in 48 OSAS patients. RESULTS: The circulating levels of ADM in untreated OSAS patients were significantly greater than those in the controls. We did not observe a significant effect in 2 weeks of oxygen administration on the circulating ADM in the patients, but we observed a significant effect in long-term oxygen administration for more than 3 months on plasma ADM levels. Long-term oxygen therapy decreased both the magnitude of arterial oxygen desaturation and plasma ADM levels in patients but did not decrease blood pressure. CONCLUSIONS: These observations suggest that long-term oxygen therapy could reduce OSAS-induced nocturnal hypoxemia and plasma ADM levels in patients with OSAS.

Teramoto S, Kume H, Matsuse T, Ishii T, Miyashita A, Akishita M, Toba K, Ouchi Y. · Department of Geriatric Medicine, Tokyo University Hospital, 7-3-1, Hongo Bunkyo-Ku, Tokyo 113-8655, Japan. · Sleep Med. · Pubmed #14592281 No free full text.

Abstract: OBJECTIVES AND BACKGROUND: Nocturnal apnea and hypoxia are implicated in the pathogenesis of pulmonary and systemic hypertension in obstructive sleep apnea syndrome (OSAS). We have hypothesized that vasodilating factors including nitric oxide (NO) are affected by nocturnal apnea and hypoxia in patients with OSAS. METHOD: We examined the serum level of NO production in 24 patients with OSAS (mean age 54.2+/-7.9 years) and 24 age-matched control subjects (53.4+/-8.1 years) and tested the effects of oxygen administration on the production of NO in the patients. RESULTS: The serum level of nitrite/nitrates (NO(x)), which are stable metabolites of NO, was lower in patients with OSAS than in control subjects. Administration of 1-2 l/min of oxygen during night increased the patients' NO(x) level from 35.6+/-7.3 to 57.8+/-11.6 microM. Compressed air administration did not affect the NO(x) level in the patients. CONCLUSION: These results indicate that systemic NO production is impaired in OSAS patients, possibly due to nocturnal hypoxia.

Morio Y, Muramatsu M, Takahashi K, Teramoto S, Oka T, Fukuchi Y. · Department of Respiratory Medicine, Juntendo University School of Medicine, Tokyo, Japan. · Respiration. · Pubmed #11223735 links to  free full text

Abstract: BACKGROUND: A recent study has revealed that the peripheral airspace in the lungs of the fawn-hooded rat (FHR) is enlarged. However, morphological and functional factors of the FHR lung have not been fully investigated. OBJECTIVE: The purpose of our study was to examine the structural and functional changes in the FHR lung and to investigate the influence of aging on this process. Furthermore, morphological and functional measurements of the lungs of FHRs (4-48 weeks of age) were performed and the results compared with those of age-matched Wistar control rats (WCRs). METHODS: All animals were studied under controlled conditions, and morphological and functional changes of the lungs were examined. Measurements of body and lung weights were recorded, and the lungs were subjected to morphological evaluation. Morphological measurements: mean linear intercept (MLI) and destructive index were determined. Functional evaluation of the lungs: total lung capacity, pressure-volume curve, and exponential constant (K) which describes the shape of the curve were analyzed. In addition, right ventricular hypertrophy measurements were performed to assess the severity of pulmonary hypertension. Statistical analysis was performed using the unpaired t test, analysis of variance, and the Fisher post hoc test (p < 0.05). RESULTS: Morphological analysis revealed a significant increase in airspace size (MLI) in all FHRs as compared with the WCRs which was evident from an early age (4 weeks). The increase in MLI did not progress age dependently in the FHR, whereas a tendency for an age-dependent increase in MLI was observed in the WCR. The destructive index measurements revealed that the increase in MLI of FHR was not accompanied by alveolar wall destruction. Concerning the functional examination, a leftward and upward shift of the pressure-volume curve was observed in the FHRs as compared with the WCRs at all ages. As compared with the WCRs, a higher K value was observed in all FHRs which was evident from an early age (4 weeks). Age-dependent changes similar to those in MLI were observed in the K in both rat strains. CONCLUSIONS: The results of our study suggest that FHRs manifest characteristics of distal airspace enlargement accompanied by increased lung distensibility without alveolar wall destruction at an early age and that the changes do not progress age dependently. Neither an accelerated aging process nor destruction of the alveolar walls appears to be the mechanism responsible for the enlarged airspace in this rat strain.

Teramoto S, Kume H, Matsuse T. · No affiliation provided · J Gen Intern Med. · Pubmed #11405197 links to  free full text

This publication has no abstract.

Teramoto S, Kume H, Fukuchi Y. · No affiliation provided · Lancet. · Pubmed #11247586 No free full text.

This publication has no abstract.

Yamamoto H, Teramoto S, Yamaguchi Y, Ouchi Y. · Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. · Hypertens Res. · Pubmed #18250556 No free full text.

Abstract: Obstructive sleep apnea syndrome (OSAS) is recognized as one of the risk factors of hypertension and cardiovascular disorders. In the current study, we hypothesized that the hypoxic stress and oxidative stress caused by obstructive sleep apnea would increase circulating adrenomedullin (ADM) levels in untreated OSAS patients as compared to an age and body mass index (BMI)-matched control group and an age-matched, but normal-BMI control group. We further hypothesized that nasal continuous positive airway pressure (nCPAP) treatment may decrease OSAS-induced hypoxic stress, oxidative stress and ADM levels. To examine these hypotheses, we measured circulating ADM and reactive oxygen species (ROS) from leukocytes before and after nCPAP therapy in OSAS patients. The circulating levels of ADM and amount of ROS in untreated OSAS patients were significantly greater than those in the controls. No differences in ADM levels were found between the increased-BMI controls and normal-BMI controls. We observed that nCPAP treatment decreased sleep apneas, nocturnal oxyhemoglobin desaturation, the circulating ADM, and ROS production by leukocytes in OSAS patients. The ADM levels were associated with the magnitude of oxyhemoglobin desaturation rather than the number of sleep apneas. These observations suggest that nCPAP therapy could reduce OSAS-induced nocturnal hypoxemia, generation of ROS, and ADM in patients with OSAS.