Mitsuko Koresawa

Publications (3)5.3 Total impact

• Article: Long-term effects of angiotensin II receptor blockade with valsartan on carotid arterial stiffness and hemodynamic alterations in patients with essential hypertension.

  Takafumi Okura, Sanae Watanabe, Mie Kurata, Mitsuko Koresawa, Jun Irita, Daijiro Enomoto, Masanori Jotoku, Ken-Ichi Miyoshi, Tomikazu Fukuoka, Jitsuo Higaki
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  ABSTRACT: Increased arterial stiffness and intima media thickness (IMT) in the common carotid artery (CCA) are related to cardiovascular risk in essential hypertension. Angiotensin II plays an important role in structural and functional changes in the vasculature. In this study, we evaluated the long-term effect of the angiotensin II receptor blocker, valsartan, on IMT, arterial stiffness, and hemodynamics in the CCA in patients with essential hypertension. A prospective 24 month study of treatment with valsartan (80-160 mg/day) was performed in 24 hypertensive patients. An ultrasound of the CCA was carried out to determine IMT, the cross-sectional distensibility coefficient (CSDC), the carotid arterial stiffness index beta, and diastolic flow velocity to systolic flow velocity ratio (Vd/Vs). Treatment with valsartan for 24 months reduced systolic and diastolic blood pressure significantly. Compared to baseline, the decrease in pulse pressure was greater after 24 months treatment than after 12 months treatment. Valsartan did not influence IMT; however, after 24 months, it caused a significant increase in CSDC and a decrease in stiffness index beta compared to baseline. These changes were not observed after 12 months of treatment. In addition, Vd/Vs, a sensitive marker of relative diastolic blood flow, increased after 24 months' treatment with valsartan. These results suggest that long-term treatment with valsartan improves vascular wall function and hemodynamics in patients with essential hypertension.
  Clinical and Experimental Hypertension 07/2008; 30(5):415-22. · 1.07 Impact Factor
• Article: Relationship between cardio-ankle vascular index (CAVI) and carotid atherosclerosis in patients with essential hypertension.

  Takafumi Okura, Sanae Watanabe, Mie Kurata, Seiko Manabe, Mitsuko Koresawa, Jun Irita, Daijiro Enomoto, Ken-ichi Miyoshi, Tomikazu Fukuoka, Jitsuo Higaki
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  ABSTRACT: Aortic stiffness measured by aorta-iliac or carotid-femoral pulse wave velocity (PWV) predicts all-cause and cardiovascular mortality. Brachial-ankle PWV (baPWV) has been developed as a more convenient assessment of arterial stiffness. However, the problem with clinical use of baPWV is that the index itself is closely dependent on blood pressure. Recently, a new method, termed the cardio-ankle vascular index (CAVI), has been proposed in Japan to overcome the disadvantages associated with measuring PWV. However, its clinical usefulness has not yet been fully clarified. In the present study, we compared the usefulness of CAVI with that of ultrasound for evaluating atherosclerosis in patients with essential hypertension. CAVI was measured in 70 hypertensive patients. The intima-media thickness (IMT), cross-sectional distensibility coefficient (CSDC), stiffness parameter beta, and mean diastolic (V(d)) and systolic (V(s)) flow velocities were evaluated by carotid ultrasound. The V(d)/V(s) ratio, an index of peripheral arterial resistance, was also calculated. CAVI was positively correlated with IMT (r=0.360, p=0.0022) and stiffness beta (r=0.270, p=0.0239) and negatively correlated with V(d)/V(s) (r=-0.471, p<0.0001) and CSDC (r=-0.315, p=0.0079). Stepwise regression analysis revealed that age (r=0.475, p<0.0001) and pulse pressure (r=0.492, r<0.0001) were independent determinants of CAVI. These results suggest that CAVI is a useful clinical marker for evaluating atherosclerosis and arteriolosclerosis in patients with essential hypertension.
  Hypertension Research 05/2007; 30(4):335-40. · 2.58 Impact Factor
• Source

  Available from: Mie Kurata

  Article: Renal resistance index is a marker of future renal dysfunction in patients with essential hypertension.

  Takafumi Okura, Mie Kurata, Jun Irita, Daijiro Enomoto, Masanori Jotoku, Tomoaki Nagao, Mitsuko Koresawa, Shiho Kojima, Yasuyuki Hamano, Shinichi Mashiba, Ken-Ichi Miyoshi, Jitsuo Higaki
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  ABSTRACT: In patients with essential hypertension (EHT), the intrarenal resistance index (RI) has been shown to be related to the severity of target organ damage (TOD). Cystatin C is has been reported to be related to TOD in EHT. The aim of the present study was to clarify whether the RI predicts future renal function assessed by cystatin C levels in EHT. One-hundred and twelve patients participated. RI and cystatin C were measured at baseline, and 12 months later, cystatin C was measured again. The patients were divided into 2 groups according to RI value: the low RI group (RI<0.7) and the high RI group (RI> or =0.7). After 12 months, cystatin C levels were significantly elevated in the high RI group, whereas the levels remained unchanged in the low RI group. Stepwise regression analysis using the baseline values of RI, age, pulse pressure, HbA1c, cystatin C, log-transformed (ln) C-reactive protein and ln urinary albumin/creatinine as covariates, showed baseline RI was the only independent determinant of the time-related changes in cystatin C levels. This finding suggests that the renal RI may be a marker of future renal dysfunction in EHT.
  Journal of nephrology 23(2):175-80. · 1.65 Impact Factor