Faculty Profiles - OHISHI Mitsuru

Papers - OHISHI Mitsuru

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安崎和博, 大石充 . 【高齢者の救急診療トピックス】高齢者の胸痛・呼吸困難 . 日本老年医学会雑誌57 ( 2 ) 119 - 125 2020.4

Language：Japanese Publisher：(一社)日本老年医学会

わが国では,高齢化社会が進行しており,救急搬送を要する高齢者も増加の一途をたどっている.高齢患者では訴えがあいまいであったり,認知機能障害,多数の併存疾患,さまざまな臓器障害など高齢者特有の問題を有しており,救急対応をより困難なものとするケースが多い.胸痛・呼吸困難といった胸部症状を呈する救急患者は致死的な疾患を有することが多く,迅速な診断・治療が望まれる.(著者抄録)

赤崎雄一, 大石充 . 【最新の高血圧診療:「高血圧治療ガイドライン2019」後の展開】高血圧の治療高齢者の高血圧治療 . 診断と治療108 ( 4 ) 501 - 506 2020.4

Language：Japanese Publisher：(株)診断と治療社

＜Headline＞1 高血圧治療の目的は、心血管病の発症・進展・再発の抑制、および死亡を減少させることであるが、高齢者高血圧患者においては、健康寿命の延伸を考慮しなければならない。2 高齢者では、高血圧のみならず、多くの身体的問題を抱えていることが多い。一方で、高齢者においても降圧治療による脳心血管疾患予防の意義も確立されていることから、個々の状況に応じて対応することが求められている。3 自力で外来通院可能な健康状態で忍容性があれば、65～74歳は130/80mmHg未満、75歳以上では140/90mmHg未満を目標とする。併存疾患などによって降圧目標が130/80mmHg未満とされる場合は、75歳以上でも忍容性があれば個別に判断して130/80mmHgを目指す。4 高齢者の特殊性を念頭に、血圧変化に伴う身体所見を注意深く観察することで、高齢者においても降圧治療による心血管イベントの抑制を期待できる。(著者抄録)

安崎和博, 大石充 . 【高齢者の救急診療トピックス】高齢者の胸痛・呼吸困難 . 日本老年医学会雑誌57 ( 2 ) 119 - 125 2020.4

Language：Japanese Publisher：(一社)日本老年医学会

Maruta M, Makizako H, Ikeda Y, Miyata H, Nakamura A, Han G, Shimokihara S, Tokuda K, Kubozono T, Ohishi M, Tomori K, Tabira T. . Associations between depressive symptoms and satisfaction with meaningful activities in community-dwelling Japanese older adults. . J Clin Med 9 ( 3 ) 795 - 795 2020.3Reviewed

赤崎雄一, 大石充 . 【循環器症候群(第3版)-その他の循環器疾患を含めて-】血圧異常　薬剤誘発性高血圧 . 日本臨床別冊 ( 循環器症候群IV ) 86 - 90 2020.3

Michio Maruta, Hyuma Makizako, Yuriko Ikeda, Hironori Miyata, Atsushi Nakamura, Gwanghee Han, Suguru Shimokihara, Keiichiro Tokuda, Takuro Kubozono, Mitsuru Ohishi, Kounosuke Tomori, Takayuki Tabira . Associations between Depressive Symptoms and Satisfaction with Meaningful Activities in Community-Dwelling Japanese Older Adults. . Journal of clinical medicine9 ( 3 ) 795 - 795 2020.3Reviewed International journal

Language：Japanese Publishing type：Research paper (scientific journal)

The aim of this cross-sectional study was to investigate relationships between individuals' ratings of satisfaction and performance of activities that they found meaningful and depressive symptoms. Data was obtained from 806 older adults (mean age 74.9 ± 6.3 years, women = 63.0%) who participated in a community-based health check survey (Tarumizu Study 2018). Participants selected meaningful activities from 95 activities using the Aid for Decision-Making in Occupation Choice and evaluated their satisfaction and performance. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15) and defined by a GDS-15 score of ≥5. Non-linear logistic regression analyses were used separately by gender to examine the association between satisfaction and performance of meaningful activities and depressive symptoms. The prevalence of depressive symptoms was 15.8%. We found no significant difference between meaningful activity choice between older adults with depressive symptoms and those without, in both men and women. After adjusting for potential covariates, satisfaction was associated with depressive symptoms in both men (OR 0.52, 95% CI 0.35-0.77) and women (OR 0.67, 95% CI 0.49-0.91), but performance was limited in women (OR 0.87, 95% CI 0.77-0.99). Our findings suggest that depressive symptoms are associated with satisfaction in meaningful activities regardless of activity categories.

DOI： 10.3390/jcm9030795

Scopus

PubMed

赤崎雄一, 大石充 . 【循環器症候群(第3版)-その他の循環器疾患を含めて-】血圧異常薬剤誘発性高血圧 . 日本臨床別冊 ( 循環器症候群IV ) 86 - 90 2020.3

Ohishi M., Yoshida T., Nishigaki N., Oh A., Shimasaki Y. . Antihypertensive treatment for hypertensive patients with heart failure using real-world Japanese data: subanalysis of the Retrospective study of antihypertensives for lowering blood pressure (REAL) study . Clinical and Experimental Hypertension42 ( 2 ) 139 - 145 2020.2Reviewed

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Clinical and Experimental Hypertension

The number of patients with heart failure (HF) is rapidly increasing. Although hypertension is related to onset of HF, antihypertensive treatment status for these patients has not been fully examined. We conducted a claims-based study to discern the treatment status of Japanese hypertensive patients with HF. Two Japanese databases (2008–2016) from acute care hospitals and health insurance societies were used to analyze prescription rates for antihypertensive drug class or category of diuretics in all hypertensive patients and the subset of patients with HF. Totals of hypertensive patients and those with HF in each database in 2015 were 4,191,666 and 1,404,008 patient-months, and 1,382,732 and 148,194 patient-months, respectively. In the acute care hospitals database, calcium channel blockers (CCBs) (55.0–56.5%) and angiotensin II receptor blockers (49.4–54.7%) were prescribed most. β-blockers (38.7–48.0%) and diuretics (42.3–45.6%) were prescribed more for hypertensive patients with HF than for all hypertensive patients (21.5–24.8% and 25.5–26.7%, respectively). Loop diuretics were also prescribed more often for hypertensive patients with HF (68.3–76.0% from acute care hospitals and 47.8–55.8% from health insurance societies) than for all hypertensive patients (56.7–61.7% and 16.4–18.3%). The size of medical institution had a greater effect on drug selection than patient age in both patient groups. Given recommendations in guidelines for hypertensive patients with HF, the differences in drug choice in comparison with all hypertensive patients appear reasonable. However, some deviations, such as the high rate of CCBs in frontline and preference for angiotensin II receptor blockers over angiotensin-converting enzyme inhibitors, did not appear to follow guidelines.

DOI： 10.1080/10641963.2019.1590384

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PubMed

Kanda Daisuke, Ikeda Yoshiyuki, Sonoda Takeshi, Tokushige Akihiro, Kosedo Ippei, Yoshino Satoshi, Takumi Takuro, Ohishi Mitsuru . Malnutrition and Clopidogrel Non-Use Worsen Prognosis of Critical Limb Ischemia Patients After Revascularization . Circulation Reports2 ( 2 ) 121 - 127 2020.2

Language：English Publisher：The Japanese Circulation Society

Background:Critical limb ischemia (CLI) patients have high risk for major adverse cerebrovascular and cardiovascular events. This study investigated the risk factors of cerebrovascular or cardiovascular death in CLI patients with concomitant coronary artery disease (CAD).Methods and Results:The association between baseline characteristics and cerebrovascular or cardiovascular death ≤2 years after revascularization for CLI was investigated in 137 CLI patients who previously underwent successful revascularization for CAD before treatment for CLI. Twenty-three patients (17%) died. Geriatric nutritional risk index (GNRI) in the deceased group (DG) was significantly lower than in the surviving group (SG). On Cox proportional hazard multivariate analysis, hemodialysis (HD) and malnutrition (defined as GNRI <92) were significantly associated with cerebrovascular or cardiovascular death. Also, on Kaplan-Meier analysis, survival rate was significantly lower in CLI patients with either malnutrition or HD compared with patients without either malnutrition or HD, respectively. Furthermore, clopidogrel was less used in the DG than in the SG. The use of clopidogrel was associated with cerebrovascular or cardiovascular death. Especially, non-use of clopidogrel in the malnutrition group further increased the correlation with cerebrovascular or cardiovascular death.Conclusions:Malnutrition is a crucial risk factor for cerebrovascular and cardiovascular death in CLI patients with CAD. Nutritional status intervention and use of clopidogrel may be an important strategy for CLI.

DOI： 10.1253/circrep.cr-19-0105

PubMed

CiNii Research

Kosedo I, Tokushige A, Takumi T, Yoshikawa A, Teraguchi K, Takenouchi K, Shiraishi K, Ikeda D, Imamura M, Sonoda T, Kanda D, Ikeda Y, Ido A, Ohishi M. . Use of proton pump inhibitors is associated with an increase in adverse cardiovascular events in patients with hemodialysis: insight from the KIDS Registry. . Eur J Intern Med72 79 - 87 2020.2Reviewed

Kanda D, Ikeda Y, Sonoda T, Tokushige A, Kosedo I, Yoshino S, Takumi T, Ohishi M. . Malnutrition and non-use clopidogrel additively aggravate prognosis of critical limb ischemia patients who underwent revascularization. . Circ Rep2 121 - 127 2020.2Reviewed

徳重明央, 大石充 . 【高血圧診療update-診断・治療の最新動向-】高血圧診療における多職種連携 . 日本臨床78 ( 2 ) 355 - 359 2020.2

Ippei Kosedo, Akihiro Tokushige, Takuro Takumi, Akiko Yoshikawa, Kiyo Teraguchi, Kenichi Takenouchi, Kouzou Shiraishi, Daisuke Ikeda, Masakazu Imamura, Takeshi Sonoda, Daisuke Kanda, Yoshiyuki Ikeda, Akio Ido, Mitsuru Ohishi . Use of proton pump inhibitors is associated with an increase in adverse cardiovascular events in patients with hemodialysis: Insight from the kids registry. . European journal of internal medicine72 79 - 87 2020.2International journal

Language：Japanese

BACKGROUND: Proton pump inhibitors (PPIs) are known to increase the risk of mortality and cardiovascular events in the general population. However, in patients with maintenance hemodialysis, PPI effects are under investigated. METHODS: We analyzed the risk of PPIs for cardiovascular events using the Kagoshima Dialysis (KIDS) registry, a prospective, multicenter, observational study in patients with maintenance hemodialysis in Japan. RESULTS: In all, 531 patients were enrolled from June 2015 to December 2018. One-year follow-up data were available for 376 patients (Use of PPIs at baseline (PPI group): 217 patients and without PPIs (No PPI group): 159 patients). The incidence of a composite outcome (all-cause mortality, non-fatal myocardial infarction, or non-fatal stroke) was higher in patients in the PPI group than the No PPI group (15.2% vs. 4.4%; hazard ratio (HR): 3.65, 95% confidence interval (CI): 1.61-8.23, P = 0.002). In the multivariate analysis, even after adjustment for covariates, the use of PPIs was an independent risk factor for a composite outcome (HR: 2.38, 95% CI: 1.02-5.54, P = 0.045). We performed propensity score matching analysis as a sensitivity analysis, showing a consistent result. The incidence of bleeding showed no difference between the two groups (15.7% vs. 11.3%; HR: 1.46, 95% CI: 0.83-2.59, P = 0.19). CONCLUSIONS: These results indicate that the use of PPIs in patients with maintenance hemodialysis might increase mortality and cardiovascular events without decreasing the risk of bleeding. Therefore, it should always be analyzed if a patient truly needs PPIs.

DOI： 10.1016/j.ejim.2019.11.002

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PubMed

Kanda Daisuke, Ikeda Yoshiyuki, Sonoda Takeshi, Tokushige Akihiro, Kosedo Ippei, Yoshino Satoshi, Takumi Takuro, Ohishi Mitsuru . 重症虚血肢患者では低栄養状態とクロピドグレル未投与が血行再建術後の予後を悪化させている(Malnutrition and Clopidogrel Non-Use Worsen Prognosis of Critical Limb Ischemia Patients After Revascularization) . Circulation Reports2 ( 2 ) 121 - 127 2020.2

Language：English Publisher：(一社)日本循環器学会

冠動脈疾患(CAD)を併発する重症虚血肢(CLI)患者の脳血管死亡と心血管死亡の危険因子を調査するため、後方視的コホート研究を施行した。2014年1月～2016年8月に入院したCLI患者連続137名を組み入れた。全患者が以前にCADへの血行再建術を施行されていた。CLIに対しては血管内治療を行い61名ではバイパス手術も併用した。CLIに対する血行再建術から2年以内の脳血管死亡と心血管死亡の複合アウトカムを主要評価項目とした。そのアウトカムに合致した死亡群23名(17%)(平均76±9歳、男性14名)と生存群114名(平均69±11歳、男性66名)を比較したところ、死亡群でのGeriatric Nutritional Risk Index(GNRI)は生存群よりも有意に低かった。主要評価項目に有意に関連する因子として血液透析と低栄養状態(GNRI 92未満)の2つが多変量Cox比例ハザード分析によって同定され、その2因子のいずれかを有する患者の生存率はいずれも認めない患者に比べ有意に低いことがKaplan-Meier法にて示された。さらにクロピドグレル使用に関しても死亡群の方がその使用率が有意に低く、低栄養状態の患者ではクロピドグレル非使用が主要評価項目との相関を強めることが判明した。低栄養状態への介入およびクロピドグレル使用はCLIへの重要な治療戦略になると考えられた。

徳重明央, 大石充 . 【高血圧診療update-診断・治療の最新動向-】高血圧診療における多職種連携 . 日本臨床78 ( 2 ) 355 - 359 2020.2

Language：English Publisher：(一社)日本循環器学会

Sasaki Y, Ikeda Y, Miyauchi T, Uchikado Y, Akasaki Y, Ohishi M. . Estrogen-SIRT1 axis plays a pivotal role in protecting arteries against menopause-induced senescence and atherosclerosis. . J Atheroscler Thromb27 ( 1 ) 47 - 59 2020.1Reviewed

Sasaki Yuichi, Ikeda Yoshiyuki, Miyauchi Takahiro, Uchikado Yoshihiro, Akasaki Yuichi, Ohishi Mitsuru . Estrogen-SIRT1 Axis Plays a Pivotal Role in Protecting Arteries Against Menopause-Induced Senescence and Atherosclerosis . Journal of Atherosclerosis and Thrombosis27 ( 1 ) 47 - 59 2020.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Atherosclerosis Society

Aim: Menopause causes arterial senescence and atherosclerotic development through decrease of estrogen. Recently, histone deacetylase SIRT1 has been reported to have protective effects against arterial senescence and atherosclerosis. However, the relationship between estrogen and SIRT1 in the context of menopause-induced arterial senescence is not well understood. The present study aims to investigate whether SIRT1 is involved in the etiology of menopause-induced arterial senescence and atherosclerotic development.Methods: Twelve-week old female apolipoprotein E-knockout (ApoE-KO) mice underwent ovariectomy (OVX) or sham surgery.Results: SIRT1 expression and endothelial nitric oxide synthase (eNOS) activation in the aorta were significantly lower in OVX mice than they were in sham mice (OVX vs. sham, n=5 per group). Senescence-associated β-galactosidase activity, protein expression of Ac-p53 and PAI-1, and aortic atherosclerosis lesions were significantly greater in OVX mice than they were in sham mice. Administration of 17β-estradiol (E2) for eight weeks to OVX mice restored aortic SIRT1 expression, activated eNOS, and retarded OVX-induced arterial senescence and atherosclerotic development (E2 vs. control, n=5 per group). The effects of E2 on SIRT1 upregulation, anti-senescence and anti-atherosclerosis were attenuated by administration of a SIRT1 inhibitor, sirtinol. In vitro experiment using human endothelial cells demonstrated that E2 also increased SIRT1 expression and retarded oxidized low density lipoprotein-induced premature senescence, which were also abolished by sirtinol. These results suggested that estrogen modulated arterial senescence and atherosclerosis through SIRT1. Additionally a selective estrogen receptor modulator (SERM), bazedoxifene, also augmented SIRT1 and inhibited arterial senescence and atherosclerotic development (SERM vs. control, n=3 per group).Conclusions: Downregulation of SIRT1 causes OVX-induced arterial senescence and atherosclerosis in ApoE-KO mice. Administration of estrogen or SERM enables OVX mice to restore these alterations by SIRT1 induction.

DOI： 10.5551/jat.47993

Scopus

PubMed

CiNii Research

Kario K, Chirinos JA, Townsend RR, Weber MA, Scuteri A, Avolio A, Hoshide S, Kabutoya T, Tomiyama H, Node K, Ohishi M, Ito S, Kishi T, Rakugi H, Li Y, Chen CH, Park JB, Wang JG . Systemic hemodynamic atherothrombotic syndrome (SHATS) – Coupling vascular disease and blood pressure variability: Proposed concept from pulse of Asia . Prog Cardiovasc Dis63 ( 1 ) 22 - 32 2020.1Reviewed

佐々木雄一, 大石充 . 【新しい時代の高血圧診療】高血圧の薬物治療　レニン・アンジオテンシン系阻害薬 . 臨牀と研究97 ( 1 ) 33 - 39 2020.1

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Papers - OHISHI Mitsuru