研究者業績

苅尾 七臣

カリオ カズオミ  (Kazuomi Kario)

基本情報

所属
自治医科大学 医学部 内科学講座循環器内科学部門 教授
学位
(BLANK)

J-GLOBAL ID
200901026266273395
researchmap会員ID
1000220767

学歴

 2

論文

 293
  • Naoki Watanabe, Kenji Harada, Hisaya Kobayashi, Yasushi Imai, Saeko Yoshizawa, Koji Kawahito, Kazuomi Kario
    Circulation journal : official journal of the Japanese Circulation Society 87(5) 673-673 2023年4月25日  
  • Takafumi Okuyama, Tomoyuki Kabutoya, Yuki Gonda, Kana Kubota Kashihara, Yasushi Imai, Yuji Morisawa, Kazuomi Kario
    Internal medicine (Tokyo, Japan) 62(8) 1191-1194 2023年4月15日  
    A 23-year-old man with no significant medical history was rushed to a hospital due to transient loss of consciousness with incontinence. The patient had developed a fever after his second dose of coronavirus disease 2019 (COVID-19) vaccine, and the patient was found groaning in bed approximately 40 hours after the vaccination in the early morning. The patient was diagnosed with Brugada syndrome (BrS) based on a drug-provocation test. His father had been diagnosed with BrS and died suddenly at 51 years of age. Young adults with a family history of BrS should be cautioned about fever following COVID-19 vaccination.
  • Masaki Mogi, Satoshi Hoshide, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 2023年4月11日  
  • 芳野 真子, 今井 靖, 根岸 経太, 大木 伸一, 川人 宏次, 苅尾 七臣
    心臓 55(4) 454-462 2023年4月  
    症例は49歳女性.44歳,48歳時に急性大動脈解離を発症し,保存的加療を受けていた.X年末より肺炎,心不全を呈し,当院での管理を希望され紹介受診となった.高身長,漏斗胸,側彎といった身体的特徴,大動脈解離,大動脈基部拡大があり,典型的なマルファン症候群と診断した.重度大動脈弁閉鎖不全症(AR)とそれによる心不全を呈していた.心不全の急性期管理を行ったのち,Bentall手術,上行大動脈弓部置換を施行,心機能は正常レベルまで回復し現在まで問題なく経過している.遺伝子診断ではFBN1変異を認め,マルファン症候群に典型的なCys残基のアミノ酸置換を伴うミスセンス変異であった.マルファン症候群でARに伴う高度収縮不全・心不全を生じても適切な外科治療と薬物療法を実施することで心機能の回復を得て良好な経過をたどった本例は示唆に富むと思われ,文献的考察とともに報告する.(著者抄録)
  • Tomonori Watanabe, Hiroaki Watanabe, Hitoshi Hachiya, Masafumi Sato, Tadayuki Mitama, Takafumi Okuyama, Ayako Yokota, Masashi Kamioka, Takahiro Komori, Tomoyuki Kabutoya, Yasushi Imai, Kazuomi Kario
    Journal of cardiovascular electrophysiology 34(4) 849-859 2023年4月  
    INTRODUCTION: Beyond pulmonary vein isolation (PVI), additional therapeutic strategies for atrial fibrillation (AF) have not been established. Remodeling of the left atrium (LA) could impact AF recurrence post-PVI. We investigated the impact of unipolar voltage (UV) criteria for the LA posterior wall (LA-PW) on AF recurrence post-PVI. METHODS: We reviewed the cases of 106 AF patients (mean age 63.8 years, nonparoxysmal AF: 59%) who underwent extensive encircling PVI by radiofrequency ablation guided by a 3-dimension mapping system, investigating the impact on AF recurrence of the UV criteria of the LA. RESULTS: Out of all patients, 26 patients had AF recurrence during post-PVI follow-up [median 603 days]. They showed a higher percentage of nonparoxysmal AF (80.8 vs. 52.5%, p = .011), longer AF duration (2.9 ± 2.7 vs. 1.0 ± 1.7 years, p = .002), and larger area size of UV < 2.0 mV in LA-PW (2.8 ± 1.8 vs. 1.0 ± 1.5 cm2 , p < .001) than those without recurrence. Cox Hazard analysis for AF recurrence adjusted by age, gender, AF duration, body mass index and left atrial volume index revealed that an area size over 2.0 cm2 of UV < 2.0 mV in LA-PW (HR 6.9 [95% CI:1.3-35.5], p = .021) posed independent risks for AF recurrence post-PVI. The atrial arrhythmia-free survival rate was higher in those with no area of UV < 3.0 mV in LA-PW compared to those with a sizable area (>2.0 cm2 ) of UV < 3.0 mV and <2.0 mV (95.0% vs. 74.2% vs. 57.1%, Log-Rank: p < .001). In the AF etiology of patients with AF recurrence, 9 of 14 patients who underwent the 2nd procedure had no PV reconnection, and 8 patients required the LA-PW isolation for their non-PV AF. CONCLUSION: UV criteria of LA-PW is a useful parameter for AF-recurrence post-PVI. Lower UV in LA-PW as an indication of electrical remodeling could indicate a higher risk of AF recurrence and the need for further therapeutic strategies.
  • Satoshi Hoshide, Masaki Mogi, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 46(4) 815-816 2023年4月  
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 46(4) 950-958 2023年4月  
    Increased blood pressure (BP) variability and the BP surge have been reported to be associated with increased cardiovascular risk independently of BP levels and can also be a trigger of cardiovascular events. There are multiple types of BP variation: beat-to-beat variations related to breathing and the autonomic nervous system, diurnal BP variation and nocturnal dipping related to sleep and physical activity over a 24-hr period, day-to-day BP variability with anomalous readings within a several-day period, visit-to-visit BP variability between outpatient visits, and seasonal variations. BP variability is also associated with the progression to hypertension from prehypertension and the progression of chronic kidney disease and cognitive impairments. Our research group proposed the "resonance hypothesis of blood pressure surge" as a new etiological hypothesis of BP variability and surges; i.e., the concept that when the time phases of surges and hypertension-inducing environmental influences coincide, resonance occurs and is amplified into a larger "dynamic surge" that triggers the onset of cardiovascular disease. New devices to assess BP variability as well as new therapeutic interventions to reduce BP variability are being developed. Although there are still issues to be addressed (including measurement accuracy), cuffless devices and information and communication technology (ICT)-based BP monitoring devices have been developed and validated. These new devices will be useful for the individualized optimal management of BP. However, evidence regarding the usefulness of therapeutic interventions to control BP variability is still lacking.
  • 横田 彩子, 甲谷 友幸, 三玉 唯由季, 奥山 貴文, 渡邉 裕昭, 上岡 正志, 渡部 智紀, 小森 孝洋, 今井 靖, 苅尾 七臣
    日本循環器学会学術集会抄録集 87回 PJ073-5 2023年3月  
  • 三玉 唯由季, 甲谷 友幸, 奥山 貴文, 渡邉 裕昭, 横田 彩子, 上岡 正志, 渡部 智紀, 小森 孝洋, 今井 靖, 苅尾 七臣
    日本循環器学会学術集会抄録集 87回 PJ113-2 2023年3月  
  • 小林 久也, 船山 大, 篠原 肇, 大場 祐輔, 小古山 由佳子, 清水 勇人, 苅尾 七臣
    日本循環器学会学術集会抄録集 87回 CROJ16-9 2023年3月  
  • Kazuomi Kario, Satoshi Hoshide, Masaki Mogi
    Hypertension research : official journal of the Japanese Society of Hypertension 46(3) 553-555 2023年3月  
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Hypertension (Dallas, Tex. : 1979) 80(2) 451-459 2023年2月  
    BACKGROUND: Although international guidelines for hypertension management recommend home and ambulatory blood pressure (BP) monitoring, few studies have assessed which is more useful in predicting cardiovascular incidence in hypertensive outpatients. METHODS: We analyzed the association of home and ambulatory BP with cardiovascular prognosis in 1336 practice outpatients with hypertension who underwent both home and ambulatory BP measurements in the J-HOP study (Japan Morning Surge-Home Blood Pressure). RESULTS: During the median 6.9 years of follow-up, 111 cardiovascular events occurred. Both home and ambulatory systolic BP (SBP) were associated with cardiovascular risk independent of office SBP (hazard ratio [95% CI] per 20 mm Hg of average morning and evening home SBP, 1.46 [1.11-1.93]; 24-hour ambulatory SBP, 1.41 [1.02-1.94]). Moreover, average morning and evening home SBP was also associated with cardiovascular risk even adjusted by 24-hour ambulatory SBP (hazard ratio [95%CI] per 20 mm Hg, 1.38 [1.01-1.87]), but 24-hour ambulatory SBP was not associated with cardiovascular risk adjusted by average morning and evening home SBP. Regarding this relationship, the model-fit was significantly improved by using the analysis of likelihood ratio, but that was not significant in the analysis using C statistics. Additionally, even in patients with well-controlled 24-hour ambulatory BP, uncontrolled morning home BP was associated with cardiovascular risks (hazard ratio [95% CI], 2.15 [1.02-4.50]). In patients with well-controlled average morning and evening home BP, uncontrolled ambulatory BP was not associated with cardiovascular risks. CONCLUSIONS: This study demonstrated the prognostic values of home and ambulatory BP in practice hypertensive outpatients. Our findings indicated the modest superiority of home BP compared to ambulatory BP to predict cardiovascular prognosis.
  • Naoyuki Akashi, Tetsuya Matoba, Takahide Kohro, Yusuke Oba, Tomoyuki Kabutoya, Yasushi Imai, Kazuomi Kario, Arihiro Kiyosue, Yoshiko Mizuno, Kotaro Nochioka, Masaharu Nakayama, Takamasa Iwai, Yoshihiro Miyamoto, Masanobu Ishii, Taishi Nakamura, Kenichi Tsujita, Hisahiko Sato, Hideo Fujita, Ryozo Nagai
    Circulation Journal 87(6) 775-782 2023年1月28日  
  • 今井 靖, 根岸 経太, 甲谷 友幸, 久保田 香菜, 苅尾 七臣, 岡 徳彦, 関 満, 永井 良三
    日本成人先天性心疾患学会雑誌 12(1) 139-139 2023年1月  
  • 甲谷 友幸, 今井 靖, 久保田 香菜, 古井 貞浩, 鈴木 峻, 岡 健介, 関 満, 井上 崇道, 金子 政弘, 友保 貴博, 岡 徳彦, 苅尾 七臣
    日本成人先天性心疾患学会雑誌 12(1) 166-166 2023年1月  
  • 今井 靖, 高倉 祐希, 野田 達也, 荒川 昌史, 稲見 薫, 大塚 由紀子, 吉岡 崇幸, 釜井 聡子, 片野 昌宏, 中澤 寛仁, 桂田 健一, 苅尾 七臣
    日本臨床薬理学会学術総会抄録集 43回 4-1 2022年12月  
  • Kazuomi Kario, Satoshi Hoshide, Masaki Mogi
    Hypertension research : official journal of the Japanese Society of Hypertension 45(12) 1906-1907 2022年12月  
  • Kazuomi Kario, Naoyuki Hasebe, Ken Okumura, Takeshi Yamashita, Masaharu Akao, Hirotsugu Atarashi, Takanori Ikeda, Yukihiro Koretsune, Wataru Shimizu, Shinya Suzuki, Hiroyuki Tsutsui, Kazunori Toyoda, Atsushi Hirayama, Masahiro Yasaka, Takenori Yamaguchi, Satoshi Teramukai, Tetsuya Kimura, Yoshiyuki Morishima, Atsushi Takita, Hiroshi Inoue
    Hypertension (Dallas, Tex. : 1979) 79(12) 2696-2705 2022年12月  
    BACKGROUND: Blood pressure (BP) fluctuates significantly in patients with atrial fibrillation (AF); office BP measurements seem insufficient to assess AF patient risk accurately. We hypothesized that home BP could better predict the risk of stroke/systemic embolic events (SEE) and major bleeding in patients with AF than office BP. METHODS: In this prespecified subcohort study of the ANAFIE (All Nippon AF in the Elderly) Registry, we evaluated the impact of home BP on the risk of stroke/SEE, major bleeding, intracranial hemorrhage, all-cause death, and net cardiovascular outcome (a composite of stroke/SEE and major bleeding). At enrollment, home BP was measured twice in the morning and evening for 7 days. RESULTS: In total, 4933 elderly patients (aged ≥75 years) with nonvalvular AF participated. Incidences of net cardiovascular outcome, stroke/SEE, major bleeding, and intracranial hemorrhage increased significantly with increasing home systolic BP (H-SBP). Compared with H-SBP <125 mm Hg, ≥145 mm Hg was associated with increased risk of these events. The association between H-SBP and the events was observed only in patients with ≥20 H-SBP measurements. CONCLUSIONS: In elderly patients with nonvalvular AF, high H-SBP (≥145 mm Hg) was a significant predictor of stroke/SEE, major bleeding, and intracranial hemorrhage risk. Strict BP control guided by the increasing number of home BP measurements may provide an accurate clinical outcome risk assessment. REGISTRATION: URL: https://www.umin.ac.jp/ctr; Unique identifier: UMIN000024006.
  • Yusuke Oba, Tomoyuki Kabutoya, Takahide Kohro, Yasushi Imai, Kazuomi Kario, Hisahiko Sato, Kotaro Nochioka, Masaharu Nakayama, Hideo Fujita, Yoshiko Mizuno, Arihiro Kiyosue, Takamasa Iwai, Yoshihiro Miyamoto, Yasuhiro Nakano, Taishi Nakamura, Kenichi Tsujita, Tetsuya Matoba, Ryozo Nagai
    Circulation Journal 87(2) 336-344 2022年10月7日  
  • Satoshi Hoshide, Masaki Mogi, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 45(10) 1552-1552 2022年10月  
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Expert review of cardiovascular therapy 20(10) 829-838 2022年10月  
    INTRODUCTION: Stroke is the second-leading cause of death worldwide and the second-leading cause of disability-adjusted life-years. It is well known that hypertension is a significant risk factor for cardiovascular events, including stroke. AREAS COVERED: Recent interventional trials have demonstrated the superiority of intensive blood pressure (BP) control for prevention of cardiovascular events compared to standard BP control. Notably, in the Strategy of Blood Pressure Intervention in Elderly Hypertensive Patients (STEP) trial, intensive BP control showed superiority in the prevention of stroke events in elderly hypertensive patients. Novel medications such as angiotensin receptor-neprilysin inhibitors and sodium glucose cotransporter 2 inhibitors have the potential to suppress various CVD events including stroke. Non-pharmacological antihypertensive therapies such as renal denervation have demonstrated BP-lowering effects and may be useful for stroke prevention. Additionally, new methods and systems of BP monitoring including various kinds of nighttime BP measurement devices, wearable devices, and methods using information and communication technology can be used to assess the pathophysiology of BP variability as a risk factor and an event trigger of stroke incidence. EXPERT OPINION: Novel therapies and new technologies for BP evaluation strongly support the development of individualized anticipatory medicine, which should be useful for the prevention of stroke.
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Journal of the American Heart Association 11(17) e025901 2022年9月6日  
  • Kazuomi Kario, Satoshi Hoshide, Naoko Tomitani, Masafumi Nishizawa, Tetsuro Yoshida, Tomoyuki Kabutoya, Takeshi Fujiwara, Hiroyuki Mizuno, Keisuke Narita, Takahiro Komori, Yukiyo Ogata, Daisuke Suzuki, Yukako Ogoyama, Akifumi Ono, Kayo Yamagiwa, Yasuhisa Abe, Jun Nakazato, Naoki Nakagawa, Tomohiro Katsuya, Noriko Harada, Hiroshi Kanegae
    American journal of hypertension 36(2) 90-101 2022年9月2日  
    BACKGROUND: Inconsistencies between office and out-of-office blood pressure (BP) values (described as white-coat hypertension or masked hypertension) may be attributable in part to differences in the BP monitoring devices used. METHODS: We studied consistency in the classification of BP control (well-controlled BP vs. uncontrolled BP) among office, home, and ambulatory BPs by using a validated "all-in-one" BP monitoring device. In the nationwide, general practitioner-based multicenter HI-JAMP study, 2,322 hypertensive patients treated with antihypertensive drugs underwent office BP measurements and 24-h ambulatory BP monitoring (ABPM), consecutively followed by 5-day home BP monitoring (HBPM), for a total of seven BP measurement days. RESULTS: Using the thresholds of the JSH2019 and ESC2018 guidelines, the patients with consistent classification of well-controlled status in office (<140 mmHg) and home systolic BP (SBP) (<135 mmHg) (n=970) also tended to have well-controlled 24-h SBP (<130 mmHg) (n=808, 83.3%). The patients with consistent classification of uncontrolled status in office and home SBP (n=579) also tended to have uncontrolled 24-h SBP (n=444, 80.9%). Among the patients with inconsistent classifications of office and home BP control (n=803), 46.1% had inconsistent ABPM-vs.-HBPM out-of-office BP control status. When the 2017 ACC/AHA thresholds were applied as an alternative, the results were essentially the same. CONCLUSIONS: The combined assessment of office and home BP is useful in clinical practice. Especially for patients whose office BP classification and home BP classification conflict, the complementary clinical use of both HBPM and ABPM might be recommended.
  • Kazuomi Kario, Masaki Mogi, Satoshi Hoshide
    Hypertension research : official journal of the Japanese Society of Hypertension 45(9) 1405-1407 2022年9月  
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Hypertension (Dallas, Tex. : 1979) 79(9) 2062-2070 2022年9月  
    BACKGROUND: Although day-by-day home blood pressure (BP) variability (BPV) has been associated with cardiovascular disease (CVD) risk, it remains unclear whether this association differs from season to season. The present study aimed to assess seasonal variation in day-by-day home BP variability and its association with CVD risk. METHODS: We analyzed the data from a nationwide, prospective observational study, the J-HOP study (Japan Morning Surge-Home Blood Pressure), in which 14 consecutive days of home BP monitoring were conducted. The values of SD (SDsystolic BP [SBP]), coefficient of variationSBP, and average real variabilitySBP of home SBP were used as indices of day-by-day home BPV. RESULTS: Among 4231 participants (mean age, 64.9±10.9 years, 46.7% male, 91.5% hypertensives), all 3 day-by-day home BPV indices were lower in summer than winter after adjusting for confounding factors. In winter, SDSBP, coefficient of variationSBP, and average real variabilitySBP were significantly associated with increased risk of CVD events (coronary artery disease, stroke, heart failure, and aortic dissection; adjusted hazard ratio [95%CI] per 1-SD of SDSBP, 1.26 [1.02-1.54]; coefficient of variationSBP, 1.24 [1.02-1.52]; average real variabilitySBP, 1.44 [1.17-1.77]). These relationships were also observed in the analysis of quartiles of BPV parameters (adjusted hazard ratio [95%CI] compared to the first quartile, fourth quartile of SDSBP 2.26 [1.06-4.85]; coefficient of variationSBP 2.96 [1.43-6.15]; average real variabilitySBP 2.73 [1.25-5.93]). In other seasons, however, there were no significant associations between day-by-day home BPV and CVD event risk. CONCLUSIONS: Our findings indicate that day-by-day home BPV measured in winter is more strongly associated with future CVD incidence than that measured in other seasons.
  • Masaki Mogi, Satoshi Hoshide, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 45(8) 1223-1224 2022年8月  
  • Keisuke Narita, Satoshi Hoshide, Ryusuke Ae, Kazuomi Kario
    Journal of hypertension 40(8) 1513-1521 2022年8月1日  
    OBJECTIVE: The decision whether to measure night-time blood pressure (BP) is challenging as these values cannot be easily evaluated because of problems with measurement devices and related stress. Using the nationwide, practice-based Japan Morning Surge-Home BP Nocturnal BP study data, we developed a simple predictive score that physicians can use to diagnose nocturnal hypertension. METHODS: We divided 2765 outpatients (mean age 63 years; hypertensive patients 92%) with cardiovascular risks who underwent morning, evening, and night-time home BP (HBP) measurements (0200, 0300, and 0400 h) into a calibration group ( n  = 2212) and validation group ( n  = 553). We used logistic-regression models in the calibration group to identify the predictive score for nocturnal hypertension (night-time HBP ≥120/70 mmHg) and then evaluated the score's predictive ability in the validation group. RESULTS: In the logistic-regression model, male sex, increased BMI) (≥25 kg/m 2 ), diabetes, elevated urine-albumin creatinine ratio (UACR) (≥30 mg/g Cr), elevated office BP (≥140/90 mmHg) and home (average of morning and evening) BP (≥135/85 mmHg) had positive relationships with nocturnal hypertension. The predictive scores for nocturnal hypertension were 1 point (male, BMI, and UACR); 2 points (diabetes); 3 points (office BP ≥140/90 mmHg); 6 points (home BP ≥135/85 mmHg); total 14 points. Over 75% of the nocturnal hypertension cases in the validation group showed at least 10 points [AUC 0.691, 95% CI (0.647-0.735)]. We also developed a score for masked nocturnal hypertension, that is, nocturnal hypertension despite controlled daytime HBP. CONCLUSION: We developed a simple predictive score for nocturnal hypertension that can be used in clinical settings and for diagnoses.
  • George S Stergiou, Ramakrishna Mukkamala, Alberto Avolio, Konstantinos G Kyriakoulis, Stephan Mieke, Alan Murray, Gianfranco Parati, Aletta E Schutte, James E Sharman, Roland Asmar, Richard J McManus, Kei Asayama, Alejandro De La Sierra, Geoffrey Head, Kazuomi Kario, Anastasios Kollias, Martin Myers, Teemu Niiranen, Takayoshi Ohkubo, Jiguang Wang, Grégoire Wuerzner, Eoin O'Brien, Reinhold Kreutz, Paolo Palatini
    Journal of hypertension 40(8) 1449-1460 2022年8月1日  
    BACKGROUND: Many cuffless blood pressure (BP) measuring devices are currently on the market claiming that they provide accurate BP measurements. These technologies have considerable potential to improve the awareness, treatment, and management of hypertension. However, recent guidelines by the European Society of Hypertension do not recommend cuffless devices for the diagnosis and management of hypertension. OBJECTIVE: This statement by the European Society of Hypertension Working Group on BP Monitoring and Cardiovascular Variability presents the types of cuffless BP technologies, issues in their validation, and recommendations for clinical practice. STATEMENTS: Cuffless BP monitors constitute a wide and heterogeneous group of novel technologies and devices with different intended uses. Cuffless BP devices have specific accuracy issues, which render the established validation protocols for cuff BP devices inadequate for their validation. In 2014, the Institute of Electrical and Electronics Engineers published a standard for the validation of cuffless BP devices, and the International Organization for Standardization is currently developing another standard. The validation of cuffless devices should address issues related to the need of individual cuff calibration, the stability of measurements post calibration, the ability to track BP changes, and the implementation of machine learning technology. Clinical field investigations may also be considered and issues regarding the clinical implementation of cuffless BP readings should be investigated. CONCLUSION: Cuffless BP devices have considerable potential for changing the diagnosis and management of hypertension. However, fundamental questions regarding their accuracy, performance, and implementation need to be carefully addressed before they can be recommended for clinical use.
  • 篠原 肇, 金子 大介, 佐藤 雅史, 小林 久也, 大場 祐輔, 清水 勇人, 船山 大, 苅尾 七臣
    日本心血管インターベンション治療学会抄録集 30回 [MO519]-[MO519] 2022年7月  
  • 久保田 香菜, 今井 靖, 松薗 構佑, 苅尾 七臣
    日本肺高血圧・肺循環学会学術集会・日本小児肺循環研究会プログラム・抄録集 7回・28回 158-158 2022年7月  
  • Satoshi Hoshide, Masaki Mogi, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 45(7) 1095-1096 2022年7月  
  • Kazuomi Kario, Satoshi Hoshide, Hiroyuki Mizuno, Tomoyuki Kabutoya, Masafumi Nishizawa, Tetsuro Yoshida, Hideyasu Abe, Tomohiro Katsuya, Yukie Okawara, Hiroshi Kanegae
    Clinical research in cardiology : official journal of the German Cardiac Society 2022年6月27日  
    BACKGROUND: Non-dipper and riser patterns of nocturnal blood pressure (BP) are risk factors for cardiovascular disease (CVD), including heart failure (HF). However, the risk associated with a disrupted nocturnal pattern of heart rate is not well known. OBJECTIVES: To investigate whether the nighttime heart rate is a risk factor for HF, alongside nighttime BP phenotype. METHODS: The practitioner-based, nationwide, prospective Japan Ambulatory Blood Pressure Monitoring Prospective (JAMP) study included patients with ≥ 1 CVD risk factor but without symptomatic CVD at baseline. All patients underwent 24-h ambulatory BP monitoring at baseline and were followed annually. Nocturnal heart rate dipping (%) was calculated as 100•[1 - nighttime/daytime heart rate]. RESULTS: During a mean 4.5 years' follow-up in 6,359 patients (mean age 68.6 years), there were 306 CVD events (119 stroke, 99 coronary artery disease, and 88 HF). A 10-beats/min increase in nighttime heart rate was significantly associated with a 36-47% increase in the risk of total CVD, stroke and HF events independently of office SBP and nighttime SBP (all p < 0.005). The CVD and HF risk associated with nocturnal heart rate dipping status was independent of office and 24-h systolic BP and nocturnal BP dipping status (p < 0.001). Performance of the final model for predicting HF including BP parameters was significantly improved by the addition of nocturnal heart rate dipping patterns (p = 0.038; C-statistic 0.852). CONCLUSION: Nighttime non-dipper and riser patterns of heart rate were associated with CVD especially HF, independently and additively of nocturnal BP dipping status, indicating the importance of antihypertensive strategies targeting nighttime hemodynamics. CLINICAL TRIAL REGISTRATION: URL: https://www.umin.ac.jp/ctr/ ; Unique identifier: UMIN000020377.
  • 桂田 健一, 小古山 由佳子, 清水 勇人, 星出 聡, 苅尾 七臣
    日本高血圧学会臨床高血圧フォーラムプログラム・抄録集 10回 82-82 2022年6月  
  • Kazuomi Kario, Satoshi Hoshide, Masaki Mogi
    Hypertension research : official journal of the Japanese Society of Hypertension 45(6) 933-935 2022年6月  
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    JACC. Asia 2(3) 387-389 2022年6月  
  • Satoshi Hoshide, Akiomi Yoshihisa, Fumihiro Tsuchida, Hiroyuki Mizuno, Hiroki Teragawa, Takatoshi Kasai, Hitoshi Koito, Shin-Ichi Ando, Yoshihiko Watanabe, Yasuchika Takeishi, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 45(6) 1001-1007 2022年6月  
    Pulse transit time (PTT), which refers to the travel time between two arterial sites within the same cardiac cycle, has been developed as a novel cuffless form of continuous blood pressure (BP) monitoring. The aim of this study was to investigate differences in BP parameters, including BP variability, between those assessed by beat-to-beat PTT-estimated BP (eBPBTB) and those assessed by intermittent PTT-estimated BP at fixed time intervals (eBPINT) in patients suspected of having sleep disordered breathing (SDB). In 330 patients with SDB (average age, 66.8 ± 11.9 years; 3% oxygen desaturation index [ODI], 21.0 ± 15.0/h) from 8 institutes, PTT-estimated BP was continuously recorded during the nighttime. The average systolic eBPBTB, maximum systolic and diastolic eBPBTB, standard deviation (SD) of systolic and diastolic eBPBTB, and coefficient variation (CV) of systolic and diastolic eBPBTB were higher than the respective values of eBPINT (all P < 0.05). Bland-Altman analysis showed a close agreement between eBPBTB and eBPINT in average systolic BP and SD and CV of systolic BP, while there were disagreements in both minimum and maximum values of eBPBTB and eBPINT in patients with high systolic BP (P < 0.05). Although systolic BP variability incrementally increased according to the tertiles of 3%ODI in both eBPBTB and eBPINT (all P < 0.05), there was no difference in this tendency between eBPBTB and eBPINT. In patients with suspected SDB, the difference between eBPBTB and eBPINT was minimal, and there were disagreements regarding both the minimum and maximum BP. However, there were agreements in regard to the index of BP variability between eBPBTB and eBPINT.
  • Hiroyuki Mizuno, Satoshi Hoshide, Ryoko Nozue, Daichi Shimbo, Kazuomi Kario
    Blood pressure monitoring 27(3) 173-179 2022年6月1日  
    Accurate blood pressure (BP) measurement is necessary for the evaluation and treatment of hypertension to prevent the progression of subclinical vascular disease, including arterial stiffness. We investigated the associations between brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, and each of office brachial systolic BP (SBP) with and without an observer present (attended or unattended office brachial SBP), attended or unattended office central SBP, and home brachial SBPs (specifically, the means of morning, evening, or morning-evening home brachial SBP) in patients being treated for hypertension. Measurements were performed among 70 adults (mean age, 67.0 ± 9.4 years; women, 51.4%) with a mean attended office brachial SBP of 127.6 ± 14.5 mmHg and mean baPWV of 16.3 ± 2.8 m/s. Univariate analysis showed that higher attended office brachial SBP, morning home brachial SBP, and morning-evening home brachial SBP were each statistically significantly associated with higher baPWV (r = 0.25, P = 0.04; r = 0.37, P = 0.002; and r = 0.32, P = 0.006, respectively). Multiple linear regression analysis with adjustments for traditional cardiovascular risk factors showed that only morning home brachial SBP was statistically significantly associated with baPWV [β = 0.06, 95% confidence interval (0.01-0.11), P = 0.02). In conclusion, higher morning home brachial SBP - but none of the office-measured SBP values - was associated with arterial stiffness.
  • Satoshi Hoshide, Tetsuro Yoshida, Hiroyuki Mizuno, Hiroyoshi Aoki, Naoko Tomitani, Kazuomi Kario
    Journal of the American Heart Association 11(7) e024865 2022年4月5日  
    Background The aim of this study was to investigate the association between night-to-night adherence to continuous positive airway pressure (CPAP) therapy and both home blood pressure (BP) level on the following day and seasonal variation in home BP in patients with obstructive sleep apnea. Methods and Results We analyzed 105 participants who had been diagnosed with obstructive sleep apnea (average apnea-hypopnea index, 49.7±18.4 per hour) and who were already receiving CPAP therapy. Home BP (twice every morning and evening) and CPAP adherence data were automatically transmitted to a server for 1 year. A mixed-effects model for repeated measures analysis was used to examine associations of night-to-night good CPAP adherence with day-to-day home BP within the same patient after adjusting for covariates. The average number of days in which patients achieved both CPAP adherence and morning or evening home BP measurement was 206.6±122.7 days (21 487 readings) and 191.2±126.3 days (20 170 readings), respectively. Good CPAP adherence (>4 hours per night of use) was achieved on the evening or morning before home BP measurements (86.8% and 86.9%, respectively). After adjustment for confounders, good CPAP adherence was negatively associated with morning home systolic BP (β, -0.663; P=0.004) and diastolic BP (β, -0.829; P<0.001). Morning home systolic BP in winter in the individuals with good CPAP adherence was significantly lower than that in individuals without such adherence (P<0.05). These associations were not found in evening home BP. Conclusions Good adherence to CPAP therapy was negatively associated with morning home BP on the following day in patients with obstructive sleep apnea. The association was remarkable in the winter season.
  • 成田 圭佑, 苅尾 七臣
    救急・集中治療 34(1) 437-443 2022年4月  
    <ここがポイント!>▼高血圧緊急症の定義と病態。▼高血圧緊急症における緊急降圧の適応。▼高血圧緊急症の初期対応。(著者抄録)
  • 的場 哲哉, 仲野 泰啓, 興梠 貴英, 今井 靖, 苅尾 七臣, 藤田 英雄, 明石 直之, 清末 有宏, 水野 由子, 中山 雅晴, 後岡 広太郎, 宮本 恵宏, 辻田 賢一, 永井 良三, 筒井 裕之
    循環器内科 91(4) 488-492 2022年4月  
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Hypertension (Dallas, Tex. : 1979) 79(2) e18-e20 2022年2月  
  • 今井 靖, 甲谷 友幸, 久保田 香菜, 関 満, 岡 徳彦, 苅尾 七臣
    日本成人先天性心疾患学会雑誌 11(1) 158-158 2022年1月  
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 45(1) 75-86 2022年1月  
    In diagnosis of treatment-resistant hypertension (TRH), guidelines recommend out-of-office blood pressure (BP) measurements, ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). Although evidence of an association between ABPM-evaluated TRH and cardiovascular disease (CVD) prognosis has accumulated, data are sparse regarding HBPM-evaluated TRH. We investigated this issue using data from the nationwide practice-based J-HOP (Japan Morning-Surge Home BP) study, which recruited 4,261 outpatients (mean age 64.9 years; 46.8% men; 91.5% hypertensives) who underwent morning and evening HBPM for 14 days. During 6.2 ± 3.8 years (26,418 person-years) follow-up, 270 total CVDs (stroke, coronary artery disease, aortic dissection, and heart failure) occurred. The adjusted hazard ratio (HR) (95% CIs) of uncontrolled TRH, i.e., uncontrolled BP using 3 classes of medications including diuretics or ≥4 classes of medications, for total CVD risk compared to controlled BP using <3 classes were 2.02 (1.38-2.94) and 1.81 (1.23-2.65) in home BP of 135/85 mmHg and 130/80 mmHg, respectively. Additionally, patients with TRH defined by guidelines, i.e., uncontrolled BP using 3 classes of medications including diuretics or controlled/uncontrolled BP using ≥4 classes of medications, also had higher total CVD risk compared to non-TRH under all home BP criteria. Moreover, in patients with uncontrolled apparent-TRH, i.e., TRH defined by office BP, uncontrolled home BP (≥135/85 mmHg) was still associated with atherosclerotic CVD (CVDs except heart failure) risk (adjusted HR [95% CI], 2.38 [1.09-5.19]). This is the first study to demonstrate an independent association between TRH evaluated by HBPM and CVD outcomes.
  • Naoyuki Akashi, Masanari Kuwabara, Tetsuya Matoba, Takahide Kohro, Yusuke Oba, Tomoyuki Kabutoya, Yasushi Imai, Kazuomi Kario, Arihiro Kiyosue, Yoshiko Mizuno, Kotaro Nochioka, Masaharu Nakayama, Takamasa Iwai, Yoko Nakao, Yoshitaka Iwanaga, Yoshihiro Miyamoto, Masanobu Ishii, Taishi Nakamura, Kenichi Tsujita, Hisahiko Sato, Hideo Fujita, Ryozo Nagai
    Frontiers in cardiovascular medicine 9 1062894-1062894 2022年  
    BACKGROUND: The causal relationship between hyperuricemia and cardiovascular diseases is still unknown. We hypothesized that hyperuricemic patients after percutaneous coronary intervention (PCI) had a higher risk of major adverse cardiovascular events (MACE). METHODS: This was a large-scale multicenter cohort study. We enrolled patients with chronic coronary syndrome (CCS) after PCI between April 2013 and March 2019 using the database from the Clinical Deep Data Accumulation System (CLIDAS), and compared the incidence of MACE, defined as a composite of cardiovascular death, myocardial infarction, and hospitalization for heart failure, between hyperuricemia and non-hyperuricemia groups. RESULTS: In total, 9,936 patients underwent PCI during the study period. Of these, 5,138 patients with CCS after PCI were divided into two group (1,724 and 3,414 in the hyperuricemia and non-hyperuricemia groups, respectively). The hyperuricemia group had a higher prevalence of hypertension, atrial fibrillation, history of previous hospitalization for heart failure, and baseline creatinine, and a lower prevalence of diabetes than the non-hyperuricemia group, but the proportion of men and age were similar between the two groups. The incidence of MACE in the hyperuricemia group was significantly higher than that in the non-hyperuricemia group (13.1 vs. 6.4%, log-rank P < 0.001). Multivariable Cox regression analyses revealed that hyperuricemia was significantly associated with increased MACE [hazard ratio (HR), 1.52; 95% confidential interval (CI), 1.23-1.86] after multiple adjustments for age, sex, body mass index, estimated glomerular filtration rate, left main disease or three-vessel disease, hypertension, diabetes mellitus, dyslipidemia, history of myocardial infarction, and history of hospitalization for heart failure. Moreover, hyperuricemia was independently associated with increased hospitalization for heart failure (HR, 2.19; 95% CI, 1.69-2.83), but not cardiovascular death or myocardial infarction after multiple adjustments. Sensitive analyses by sex and diuretic use, B-type natriuretic peptide level, and left ventricular ejection fraction showed similar results. CONCLUSION: CLIDAS revealed that hyperuricemia was associated with increased MACE in patients with CCS after PCI. Further clinical trials are needed whether treating hyperuricemia could reduce cardiovascular events or not.
  • Taro Fukuda, Hiroyuki Mizuno, Kenji Harada, Kazuomi Kario
    European heart journal. Cardiovascular Imaging 23(1) e5 2021年12月18日  
  • 今井 靖, 久保田 香菜, 上野 修市, 苅尾 七臣, 荒川 昌史, 西島 秀和, 片野 昌宏, 吉岡 崇幸, 釜井 聡子, 中澤 寛仁
    日本臨床薬理学会学術総会抄録集 42回 1-2 2021年12月  
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 44(12) 1597-1605 2021年12月  
    Little is known about the relationship of the difference between morning and evening systolic blood pressure (BP) (MEdif) in home BP with cardiovascular disease (CVD) incidence. To assess this relationship, we used data from the nationwide practice-based J-HOP (Japan Morning Surge-Home BP) study, which recruited 4258 cardiovascular risk participants (mean age 64.9 years; 46.8% men; 79.2% using antihypertensive medications) who underwent morning and evening home BP monitoring using a validated, automated device for 14 consecutive days. During a mean ± SD follow-up of 6.2 ± 3.8 years (26,295 person-years), 269 CVD events occurred. Adjusted Cox models suggested that higher MEdif (≥20 mmHg) was associated with higher CVD risks than was medium MEdif (0-20 mmHg) independent of the average morning and evening (MEave) home systolic BP (SBP) (adjusted hazard ratio [HR]: 1.40; 95% confidence interval [CI] 1.02-1.91). We also divided participants into four BP phenotype groups as follows: "both non-elevated" (MEdif < 20 mmHg and MEave SBP < 135 mmHg), "elevated-MEdif" (MEdif ≥ 20 mmHg and MEave SBP < 135 mmHg), "elevated-MEave" (MEdif < 20 mmHg and MEave SBP ≥ 135 mmHg), and "both elevated" (MEdif ≥ 20 mmHg and MEave SBP ≥ 135 mmHg). The cumulative incidence of CVD events was higher in patients with the "elevated-MEdif," "elevated-MEave," and "both elevated" phenotypes than in those with the "both non-elevated" phenotype. After adjusting for covariates, the "both elevated" phenotype was associated with higher CVD risk than the "both non-elevated" phenotype (adjusted HR: 1.64; 95% CI: 1.09-2.46). This is the first study demonstrating a direct correlation between CVD outcomes and the difference between morning and evening home SBP.
  • Kazuomi Kario, Satoshi Hoshide, Keisuke Narita, Yukie Okawara, Hiroshi Kanegae
    Hypertension (Dallas, Tex. : 1979) 78(6) 1781-1790 2021年12月  
    [Figure: see text].
  • Wataru Umishio, Toshiharu Ikaga, Kazuomi Kario, Yoshihisa Fujino, Masaru Suzuki, Shintaro Ando, Tanji Hoshi, Takesumi Yoshimura, Hiroshi Yoshino, Shuzo Murakami
    Environmental Health and Preventive Medicine 26(1) 2021年12月  
    Background: Excess winter mortality caused by cardiovascular disease is particularly profound in cold houses. Consistent with this, accumulating evidence indicates that low indoor temperatures at home increase blood pressure. However, it remains unclear whether low indoor temperatures affect other cardiovascular biomarkers. In its latest list of priority medical devices for management of cardiovascular diseases, the World Health Organization (WHO) included electrocardiography systems as capital medical devices. We therefore examined the association between indoor temperature and electrocardiogram findings. Methods: We collected electrocardiogram data from 1480 participants during health checkups. We also measured the indoor temperature in the living room and bedroom for 2 weeks in winter, and divided participants into those living in warm houses (average exposure temperature ≥ 18 °C), slightly cold houses (12–18 °C), and cold houses (< 12 °C) in accordance with guidelines issued by the WHO and United Kingdom. The association between indoor temperature (warm vs. slightly cold vs. cold houses) and electrocardiogram findings was analyzed using multivariate logistic regression models, with adjustment for confounders such as demographics (e.g., age, sex, body mass index, household income), lifestyle (e.g., eating habit, exercise, smoking, alcohol drinking), and region. Results: The average temperature at home was 14.7 °C, and 238, 924, and 318 participants lived in warm, slightly cold, and cold houses, respectively. Electrocardiogram abnormalities were observed in 17.6%, 25.4%, and 30.2% of participants living in warm, slightly cold, and cold houses, respectively (p = 0.003, chi-squared test). Compared to participants living in warm houses, the odds ratio of having electrocardiogram abnormalities was 1.79 (95% confidence interval: 1.14–2.81, p = 0.011) for those living in slightly cold houses and 2.18 (95% confidence interval: 1.27–3.75, p = 0.005) for those living in cold houses. Conclusions: In addition to blood pressure, living in cold houses may have adverse effects on electrocardiogram. Conversely, keeping the indoor thermal environment within an appropriate range through a combination of living in highly thermal insulated houses and appropriate use of heating devices may contribute to good cardiovascular health. Trial registration: The trial was retrospectively registered on 27 Dec 2017 to the University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, https://www.umin.ac.jp/ctr/, registration identifier number UMIN000030601).
  • Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 44(11) 1534-1539 2021年11月  

MISC

 224
  • 石井 正将, 大塚 康弘, 池邉 壮, 中村 太志, 辻田 賢一, 藤田 英雄, 的場 哲哉, 興梠 貴英, 大場 祐輔, 甲谷 友幸, 苅尾 七臣, 清末 有宏, 水野 由子, 中山 雅晴, 宮本 恵宏, 佐藤 寿彦, 永井 良三
    日本循環器学会学術集会抄録集 88回 PJ122-2 2024年3月  
  • Masaki Mogi, Yasuhito Ikegawa, Shunsuke Haga, Satoshi Hoshide, Kazuomi Kario
    Hypertension Research 2024年  
    Hypertension, a disease whose prevalence increases with age, induces pathological conditions of ischemic vascular disorders such as cerebral infarction and myocardial infarction due to accelerated arteriosclerosis and circulatory insufficiency of small arteries and sometimes causes hemorrhagic conditions such as cerebral hemorrhage and ruptured aortic aneurysm. On the other hand, as it is said that aging starts with the blood vessels, impaired blood flow associated with vascular aging is the basis for the development of many pathological conditions, and ischemic changes in target organs associated with vascular disorders result in tissue dysfunction and degeneration, inducing organ hypofunction and dysfunction. Therefore, we hypothesized that hypertension is associated with all age-related vascular diseases, and attempted to review the relationship between hypertension and diseases for which a relationship has not been previously well reported. Following our review, we hope that a collaborative effort to unravel age-related diseases from the perspective of hypertension will be undertaken together with experts in various specialties regarding the relationship of hypertension to all pathological conditions. (Figure presented.).
  • 人見泰弘, 今井靖, 桑原政成, 牧元久樹, 興梠貴英, 相澤健一, 大場祐輔, 甲谷友幸, 苅尾七臣, 的場哲哉, 藤田英雄, 永井良三
    日本臨床薬理学会学術総会抄録集(Web) 44th 2023年  
  • Michiaki Nagai, Takeshi Fujiwara, Kazuomi Kario
    Journal of Clinical Hypertension 23(9) 1681-1683 2021年9月1日  
  • Michiaki Nagai, Kazuomi Kario
    Journal of Clinical Hypertension 23(8) 1526-1528 2021年8月1日  

共同研究・競争的資金等の研究課題

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