研究者詳細 - 大石　充

論文 - 大石　充

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Mizuno J, Otsuji M, Fukuoka Y, Tanaka Y, Ohishi M, Hata Y, Yokoyama T, Arita H, Hanaoka K . Hybrid logistic function characterization of left ventricular pressure-time curve in left heart catheterization . Gazzetta Medica Italiana Archivio per le Scienze Mediche179 ( 5 ) 326 - 334 2020年5月査読

大石充, 赤崎雄一, 樋口公嗣, 窪薗琢郎 . 【夜間頻尿治療の最先端】循環器疾患と夜間頻尿・多尿 . 日本排尿機能学会誌30 ( 2 ) 370 - 373 2020年5月

記述言語：日本語出版者・発行元：(一社)日本排尿機能学会

夜間頻尿・多尿は畜尿障害だけではなく、夜間尿産生が亢進することによって発症することもある。尿産生にはNa利尿と水利尿があり、代表的な疾患として各々高血圧と心不全が考えられる。食塩感受性高血圧が塩分摂取過多となると昼間だけではNaを排泄することができずに夜間にNa排泄をせざるを得なくなる。そのため夜間高血圧によるNa排泄のための尿産生に導かれた夜間多尿を呈する。一方で心不全では夜間臥位により静脈還流が上昇するために水利尿をして心臓への負担軽減を促すような適応現象のために夜間尿産生亢進による夜間多尿を呈する。前者はサイアザイド系降圧利尿薬でNa排泄を促し、後者はループ利尿薬で水分排泄を促すことが夜間頻尿・多尿の治療となりうると考えられる。(著者抄録)

Makizako H., Nakai Y., Tomioka K., Taniguchi Y., Sato N., Wada A., Kiyama R., Tsutsumimoto K., Ohishi M., Kiuchi Y., Kubozono T., Takenaka T. . Effects of a multicomponent exercise program in physical function and muscle mass in sarcopenic/pre-sarcopenic adults . Journal of Clinical Medicine9 ( 5 ) 1386 - 1386 2020年5月査読

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Clinical Medicine

This study aimed to assess the effects of a multicomponent exercise program on physical function and muscle mass in older adults with sarcopenia or pre-sarcopenia. Moreover, we aim to standardize the exercise program for easy incorporation in the daily life of community-dwelling older adults as a secondary outcome. A single-blind randomized controlled trial was conducted with individuals (≥60 years) who had sarcopenia or pre-sarcopenia (n = 72). Participants were randomly assigned to the exercise and control groups. The exercise program consisted of 12 weekly 60-minute sessions that included resistance, balance, flexibility, and aerobic training. Outcome measures were physical function and muscle mass. Assessments were conducted before and immediately after the intervention. Among the 72 participants (mean age: 75.0 ± 6.9 years; 70.8% women), 67 (93.1%) completed the trial. Group-by-time interactions on the chair stand (p = 0.02) and timed “up and go” (p = 0.01) tests increased significantly in the exercise group. Although the exercise group showed a tendency to prevent loss of muscle mass, no significant interaction effects were observed for cross-sectional muscle area and muscle volume. The 12-week exercise program improved physical function in the intervention group. Although it is unclear whether the program is effective in increasing muscle mass, a multicomponent exercise program would be an effective treatment for physical function among older adults with sarcopenia.

DOI： 10.3390/jcm9051386

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PubMed

Ojima Satoko, Kubozono Takuro, Kawasoe Shin, Kawabata Takeko, Miyata Masaaki, Miyahara Hironori, Maenohara Shigeho, Ohishi Mitsuru . 男性における高感度C反応性蛋白質を含むアテローム性動脈硬化症の危険因子と頸動脈内膜中膜複合体厚、頸動脈プラークスコア、脈波伝播速度との関連(Association of risk factors for atherosclerosis, including high-sensitivity C-reactive protein, with carotid intima-media thickness, plaque score, and pulse wave velocity in a male population) . Hypertension Research43 ( 5 ) 422 - 430 2020年5月

記述言語：英語出版者・発行元：Nature Publishing Group

心血管疾患に対する非侵襲的で簡便なパラメーターと一般的な危険因子との関連を比較検討し、アテローム性動脈硬化症のパラメーターと高感度C反応性蛋白質(hs-CRP)との臨床的関係性を明らかにした。2001年4月～2015年3月に健康診断を実施した男性被験者3128名(平均56±11歳)を対象とした。血液検査を実施し、心血管危険因子を評価した。頸部超音波検査によって頸動脈内膜中膜複合体厚(IMT)とプラークスコア(PS)を判定し、上腕-足首間脈波伝播速度(baPWV)を測定した。年齢と年次推移を補正した頸動脈アテローム性動脈硬化症の多変量ロジスティック回帰分析では、IMT高値が肥満と高血圧に独立して関連していた。アテローム性動脈硬化症の存在は高血圧、空腹時血糖異常(IFG)、脂質異常症と独立して関連した。log hs-CRPと喫煙は進行性アテローム性動脈硬化症と独立して関連した。baPWV高値は高血圧、IFG、log hs-CRPと有意に関連した。

Tanaka A, Taguchi I, Teragawa H, Ishizaka N, Kanzaki Y, Tomiyama H, Sata M, Sezai A, Eguchi K, Kato T, Toyoda S, Ishibashi R, Kario K, Ishizu T, Ueda S, Maemura K, Higashi Y, Yamada H, Ohishi M, Yokote K, Murohara T, Oyama J, Node K, on behalf of the PRIZE study investigators. . Febuxostat does not delay progression of carotid atherosclerosis in patients with asymptomatic hyperuricemia: A randomized, controlled trial. . PLoS Med17 ( 4 ) e1003095 - e1003095 2020年4月

Tanaka A., Taguchi I., Teragawa H., Ishizaka N., Kanzaki Y., Tomiyama H., Sata M., Sezai A., Eguchi K., Kato T., Toyoda S., Ishibashi R., Kario K., Ishizu T., Ueda S., Maemura K., Higashi Y., Yamada H., Ohishi M., Yokote K., Murohara T., Oyama J.I., Node K. . Febuxostat does not delay progression of carotid atherosclerosis in patients with asymptomatic hyperuricemia: A randomized, controlled trial . Plos Medicine17 ( 4 ) e1003095 2020年4月査読国際誌

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Plos Medicine

Background An elevated level of serum uric acid (SUA) is associated with an increased risk of cardiovascular disease. Pharmacological intervention with urate-lowering agents, such as the conventional purine analogue xanthine oxidase (XO) inhibitor, allopurinol, has been used widely for a long period of time in clinical practice to reduce SUA levels. Febuxostat, a novel non-purine selective inhibitor of XO, has higher potency for inhibition of XO activity and greater urate-lowering efficacy than conventional allopurinol. However, clinical evidence regarding the effects of febuxostat on atherosclerosis is lacking. The purpose of the study was to test whether treatment with febuxostat delays carotid intima-media thickness (IMT) progression in patients with asymptomatic hyperuricemia. Methods and findings The study was a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial undertaken at 48 sites throughout Japan between May 2014 and August 2018. Adults with both asymptomatic hyperuricemia (SUA >7.0 mg/dL) and maximum IMT of the common carotid artery (CCA) ≥1.1 mm at screening were allocated equally using a central web system to receive either dose-titrated febuxostat (10–60 mg daily) or as a control-arm, non-pharmacological lifestyle modification for hyperuricemia, such as a healthy diet and exercise therapy. Of the 514 enrolled participants, 31 were excluded from the analysis, with the remaining 483 people (mean age 69.1 years [standard deviation 10.4 years], female 19.7%) included in the primary analysis (febuxostat group, 239; control group, 244), based on a modified intention-to-treat principal. The carotid IMT images were recorded by a single sonographer at each site and read in a treatment-blinded manner by a single analyzer at a central core laboratory. The primary endpoint was the percentage change from baseline to 24 months in mean IMT of the CCA, determined by analysis of covariance using the allocation adjustment factors (age, gender, history of type 2 diabetes, baseline SUA, and baseline maximum IMT of the CCA) as the covariates. Key secondary endpoints included changes in other carotid ultrasonographic parameters and SUA and the incidence of clinical events. The mean values (± standard deviation) of CCA-IMT were 0.825 mm ± 0.173 mm in the febuxostat group and 0.832 mm ± 0.175 mm in the control group (mean between-group difference [febuxostat − control], −0.007 mm [95% confidence interval (CI) −0.039 mm to 0.024 mm; P = 0.65]) at baseline; 0.832 mm ± 0.182 mm in the febuxostat group and 0.848 mm ± 0.176 mm in the control group (mean between-group difference, −0.016 mm [95% CI −0.051 mm to 0.019 mm; P = 0.37]) at 24 months. Compared with the control group, febuxostat had no significant effect on the primary endpoint (mean percentage change 1.2% [95% CI −0.6% to 3.0%] in the febuxostat group (n = 207) versus 1.4% [95% CI −0.5% to 3.3%] in the control group (n = 193); mean between-group difference, −0.2% [95% CI −2.3% to 1.9%; P = 0.83]). Febuxostat also had no effect on the other carotid ultrasonographic parameters. The mean baseline values of SUA were comparable between the two groups (febuxostat, 7.76 mg/dL ± 0.98 mg/dL versus control, 7.73 mg/dL ± 1.04 mg/dL; mean between-group difference, 0.03 mg/dL [95% CI −0.15 mg/dL to 0.21 mg/dL; P = 0.75]). The mean value of SUA at 24 months was significantly lower in the febuxostat group than in the control group (febuxostat, 4.66 mg/dL ± 1.27 mg/dL versus control, 7.28 mg/dL ± 1.27 mg/dL; mean between-group difference, −2.62 mg/dL [95% CI −2.86 mg/dL to −2.38 mg/dL; P < 0.001]). Episodes of gout arthritis occurred only in the control group (4 patients [1.6%]). There were three deaths in the febuxostat group and seven in the control group during follow-up. A limitation of the study was the study design, as it was not a placebo-controlled trial, had a relatively small sample size and a short intervention period, and only enrolled Japanese patients with asymptomatic hyperuricemia. Conclusions In Japanese patients with asymptomatic hyperuricemia, 24 months of febuxostat treatment did not delay carotid atherosclerosis progression, compared with non-pharmacological care. These findings do not support the use of febuxostat for delaying carotid atherosclerosis in this population. Trial registration University Hospital Medical Information Network Clinical Trial Registry UMIN000012911.

DOI： 10.1371/JOURNAL.PMED.1003095

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PubMed

赤崎雄一, 大石充 . 特集最新の高血圧診療:｢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年4月

中井雄貴, 富岡一俊, 谷口善昭, 木山良二, 佐藤菜々, 和田あゆみ, 窪園琢郎, 大石充, 牧迫飛雄馬 . 地域在住高齢者における腰痛および膝痛と身体機能との関連　急性および慢性疼痛が歩行速度や握力に及ぼす影響 . 理学療法学47 ( 2 ) 146 - 152 2020年4月

記述言語：日本語出版者・発行元：(公社)日本理学療法士協会

【目的】地域在住高齢者の有する腰痛と膝痛が、急性もしくは慢性疼痛であるかの違いによって身体機能に及ぼす影響を明らかにする。【方法】地域コホート研究(垂水研究2018)に参加した65歳以上の高齢者735名を対象とした。質問紙により急性・慢性疼痛の有無を聴取し、歩行速度および握力との関連を分析した。【結果】ロジスティック回帰分析の結果、慢性疼痛の有無は歩行速度低下と有意に関連していたが(調整後オッズ比2.55、p=0.001)、急性疼痛との関連はなかった(調整後オッズ比1.19、p=0.632)(年齢、性別、GDS-15、内服薬数、ASMI、握力を共変量)。急性・慢性疼痛の有無と握力低下との関連はなかった(急性疼痛有無:調整後オッズ比1.22、p=0.477。慢性疼痛有無:調整後オッズ比0.85、p=0.530)。【結論】地域在住高齢者において、慢性疼痛を有することと歩行速度低下との関連が示唆された。(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年4月

記述言語：日本語出版者・発行元：(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年4月

記述言語：日本語出版者・発行元：(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年4月

記述言語：日本語出版者・発行元：(株)診断と治療社

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年4月

記述言語：日本語出版者・発行元：(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年3月査読

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年3月

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 . Journal of Clinical Medicine9 ( 3 ) 795 - 795 2020年3月査読国際誌

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Clinical Medicine

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年3月

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年2月査読

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：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 D, Ikeda Y, Sonoda T, Tokushige A, Kosedo I, Yoshino S, Takumi T, Ohishi M . Malnutrition and Clopidogrel Non-Use Worsen Prognosis of Critical Limb Ischemia Patients After Revascularization. . Circulation Reports2 ( 2 ) 121 - 127 2020年2月

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年2月査読

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年2月査読

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