著者
Kazuomi Kario
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.76, no.3, pp.553-562, 2012 (Released:2012-02-24)
参考文献数
74
被引用文献数
29 38

The devastating Great East Japan Earthquake, which was 9.0 on the Richter scale, occurred on March 11, 2011. Japan experienced the Great Hanshin-Awaji Earthquake 16 years ago, and I was working at the epicenter, and reported the characteristics of the earthquake-associated cardiovascular risk and high blood pressure (BP) found during the continuous practice and clinical studies of Tsuna Medical Association before and after the quake. A major disaster increases thrombophilic tendency and BP, both of which trigger disaster-induced cardiovascular events such as stroke, cardiac events, etc. The high salt intake and the increased salt sensitivity caused by disrupted circadian rhythms are the 2 major leading causes of disaster hypertension (HT) through neurohumoral activation under stressful conditions. To better assess and reduce the risks for disaster-associated cardiovascular events, we introduced the web-based Disaster Cardiovascular Prevention (DCAP) network (which consists of DCAP risk and prevention score assessment, and self-measured BP monitoring at both the shelter and the home) to the survivors of the 2011 disaster, and frequently found newly developed HT. Here I review the recent evidence, possible mechanism and the management of "disaster HT" for effective prevention of disaster-induced cardiovascular events. (Circ J 2012; 76: 553-562)
著者
Toshiaki Ohkuma Hirofumi Tomiyama Toshiharu Ninomiya Kazuomi Kario Satoshi Hoshide Yoshikuni Kita Toyoshi Inoguchi Yasutaka Maeda Katsuhiko Kohara Yasuharu Tabara Motoyuki Nakamura Takayoshi Ohkubo Hirotaka Watada Masanori Munakata Mitsuru Ohishi Norihisa Ito Michinari Nakamura Tetsuo Shoji Charalambos Vlachopoulos Akira Yamashina on behalf of the Collaborative Group for Japan Brachial-Ankle pulse wave VELocity individual participant data meta-analysis of prospective studies (J-BAVEL)
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-0636, (Released:2017-08-24)
参考文献数
14
被引用文献数
1

Background:The optimal cutoff values of the brachial-ankle pulse wave velocity (baPWV) for predicting cardiovascular disease (CVD) were examined in patients with hypertension.Methods and Results:A total of 7,656 participants were followed prospectively. The hazard ratio for the development of CVD increased significantly as the baPWV increased, independent of conventional risk factors. The receiver-operating characteristic curve analysis showed that the optimal cutoff values for predicting CVD was 18.3 m/s. This cutoff value significantly predicted THE incidence of CVD.Conclusions:The present analysis suggests that the optimal cutoff value for CVD in patients with hypertension is 18.3 m/s.
著者
Takahiro Komori Kazuo Eguchi Toshinobu Saito Satoshi Hoshide Kazuomi Kario
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-16-0740, (Released:2016-12-23)
参考文献数
26
被引用文献数
1 11

Background:The cardiovascular prognosis of heart failure with preserved ejection fraction (HFpEF) has been shown to be similar to that of heart failure with reduced ejection fraction (HFrEF). It is unknown which factors predict cardiovascular outcome in HFpEF. We tested the hypothesis that the abnormal pattern of circadian blood pressure (BP) rhythm known as the riser BP pattern is associated with adverse outcomes in HFpEF.Methods and Results:We performed a prospective, observational cohort study of hospitalized HF patients who underwent ambulatory BP monitoring (ABPM). Five hundred and sixteen hospitalized HF patients (age, 69±13 years; male, n=321 [62%]; female, n=195 [38%]) were followed up for a median 20.9 months. The composite outcome consisting of all-cause mortality and cardiovascular events was observed in 220 patients. On Kaplan-Meier analysis, the riser BP pattern subgroup had a significantly higher incidence of the composite outcome than the other subgroups of HFpEF patients (HR, 3.01; 95% CI: 1.54–6.08, P<0.01), but not the HFrEF patients.Conclusions:The riser BP pattern was found to be a novel predictor of cardiovascular outcome in HFpEF patients.
著者
Kazuomi Kario Deepak L. Bhatt David E. Kandzari Sandeep Brar John M. Flack Colleen Gilbert Suzanne Oparil Mark Robbins Raymond R. Townsend George Bakris
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-16-0035, (Released:2016-04-26)
参考文献数
42
被引用文献数
7 19

Background:Obstructive sleep apnea (OSA) is associated with activation of the sympathetic nervous system, and patients with this condition often experience elevated blood pressure (BP), increased BP variability, and nocturnal BP surges.Methods and Results:The SYMPLICITY HTN-3 trial was a large prospective, randomized, blinded, sham-controlled trial of renal denervation for treatment of uncontrolled, apparently treatment-resistant hypertension. In a post hoc analysis, we examined the effect of renal denervation vs. sham control on office and ambulatory (including nocturnal) systolic BP in patients with and without OSA. 26% (94/364) of renal denervation subjects and 32% (54/171) of sham control subjects had OSA. Baseline office and nighttime systolic BP values were similar in both arms, including in subjects with and without OSA. Compared with sham control, renal denervation reduced the 6-month office systolic BP in subjects with (−17.0±22.4 vs. −6.3±26.1 mmHg, P=0.01) but not in subjects without OSA (−14.7±24.5 vs. −13.4±26.4 mmHg, P=0.64), P=0.07 for the interaction between treatment arm and OSA status. In those with sleep apnea, renal denervation was also associated with a reduction in maximum (−4.8±21.8 vs. 4.5±24.6 mmHg, P=0.03) and average peak (−5.6±20.4 vs. 3.2±22.4 mmHg, P=0.02) nighttime systolic BP.Conclusions:OSA subjects appeared to be responsive to renal denervation therapy. However, this hypothesis requires prospective testing.
著者
Kazuomi Kario Deepak L. Bhatt David E. Kandzari Sandeep Brar John M. Flack Colleen Gilbert Suzanne Oparil Mark Robbins Raymond R. Townsend George Bakris
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.80, no.6, pp.1404-1412, 2016-05-25 (Released:2016-05-25)
参考文献数
42
被引用文献数
7 19

Background:Obstructive sleep apnea (OSA) is associated with activation of the sympathetic nervous system, and patients with this condition often experience elevated blood pressure (BP), increased BP variability, and nocturnal BP surges.Methods and Results:The SYMPLICITY HTN-3 trial was a large prospective, randomized, blinded, sham-controlled trial of renal denervation for treatment of uncontrolled, apparently treatment-resistant hypertension. In a post hoc analysis, we examined the effect of renal denervation vs. sham control on office and ambulatory (including nocturnal) systolic BP in patients with and without OSA. 26% (94/364) of renal denervation subjects and 32% (54/171) of sham control subjects had OSA. Baseline office and nighttime systolic BP values were similar in both arms, including in subjects with and without OSA. Compared with sham control, renal denervation reduced the 6-month office systolic BP in subjects with (−17.0±22.4 vs. −6.3±26.1 mmHg, P=0.01) but not in subjects without OSA (−14.7±24.5 vs. −13.4±26.4 mmHg, P=0.64), P=0.07 for the interaction between treatment arm and OSA status. In those with sleep apnea, renal denervation was also associated with a reduction in maximum (−4.8±21.8 vs. 4.5±24.6 mmHg, P=0.03) and average peak (−5.6±20.4 vs. 3.2±22.4 mmHg, P=0.02) nighttime systolic BP.Conclusions:OSA subjects appeared to be responsive to renal denervation therapy. However, this hypothesis requires prospective testing. (Circ J 2016; 80: 1404–1412)
著者
Sohei Yoshimura Masatoshi Koga Shoichiro Sato Kenichi Todo Hiroshi Yamagami Masaya Kumamoto Ryo Itabashi Tadashi Terasaki Kazumi Kimura Yoshiki Yagita Yoshiaki Shiokawa Kenji Kamiyama Satoshi Okuda Yasushi Okada Shunya Takizawa Yasuhiro Hasegawa Tomoaki Kameda Satoshi Shibuya Yoshinari Nagakane Yasuhiro Ito Hideki Matsuoka Kazuhiro Takamatsu Kazutoshi Nishiyama Kyohei Fujita Teppei Kamimura Daisuke Ando Toshihiro Ide Takeshi Yoshimoto Masayuki Shiozawa Soichiro Matsubara Yoshitaka Yamaguchi Naoto Kinoshita Takayuki Matsuki Junji Takasugi Keisuke Tokunaga Kyoko Higashida Kazunari Homma Kazuomi Kario Shoji Arihiro Kazunori Toyoda for the SAMURAI Study Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-0067, (Released:2018-06-01)
参考文献数
27

Background:We determined the 2-year long-term risk-benefit profile in patients with stroke or transient ischemic attack (TIA) receiving warfarin or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry in Japan.Methods and Results:NVAF patients within 7 days after onset of ischemic stroke/TIA were enrolled in 18 stroke centers. Outcome measures included ischemic and bleeding events and death in the 2-year follow-up period. We enrolled 1,116 patients taking either warfarin (650 patients) or DOACs (466 patients) at acute hospital discharge. DOAC users were younger and had lower National Institutes of Health Stroke Scale, CHADS2and discharge modified Rankin Scale scores than warfarin users (P<0.0001 each). Incidences of stroke/systemic embolism (adjusted hazard ratio, 1.07; 95% CI, 0.66–1.72), all ischemic events (1.13; 0.72–1.75), and ischemic stroke/TIA (1.58; 0.95–2.62) were similar between groups. Risks of intracranial hemorrhage (0.32; 0.09–0.97) and death (0.41; 0.26–0.63) were significantly lower for DOAC users. Infection was the leading cause of death, accounting for 40% of deaths among warfarin users.Conclusions:Stroke/TIA patients receiving DOACs for secondary prevention were younger and had lower stroke severity and risk indices than those receiving warfarin. Estimated cumulative incidences of stroke and systemic embolism within 2 years were similar between warfarin and DOACs users, but those of death and intracranial hemorrhage were significantly lower among DOAC users.
著者
Kazuomi Kario Hisao Ogawa Ken Okumura Takafumi Okura Shigeru Saito Takafumi Ueno Russel Haskin Manuela Negoita Kazuyuki Shimada on behalf of the SYMPLICITY HTN-Japan Investigators
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-15-0150, (Released:2015-04-24)
参考文献数
28
被引用文献数
20 40

Background:SYMPLICITY HTN-Japan is a prospective, randomized, controlled trial comparing renal artery denervation (RDN) with standard pharmacotherapy for treatment of resistant hypertension (systolic blood pressure [SBP] ≥160 mmHg on ≥3 anti-hypertensive drugs including a diuretic for ≥6 weeks). When SYMPLICITY HTN-3 failed to meet the primary efficacy endpoint, the HTN-Japan enrollment was discontinued before completion.Methods and Results:The 6-month change in office and 24-h ambulatory SBP were compared between RDN (n=22) and control (n=19) subjects. Mean baseline office SBP was 181.0±18.0 mmHg and 178.7±17.8 mmHg for the RDN and control groups, respectively. The 6-month office SBP change was –16.6±18.5 mmHg for RDN subjects (P<0.001) and –7.9±21.0 mmHg for control subjects (P=0.117); the difference between the 6-month change in RDN and control subjects was –8.64 (95% CI: –21.12 to 3.84, P=0.169). Mean 24-h SBP was 164.7±18.3 (RDN group) and 163.3±17.2 mmHg (control group). The 24-h 6-month SBP change for the RDN group was –7.52±11.98 mmHg (P=0.008) and –1.38±10.2 mmHg (P=0.563) for control subjects; the between-group difference in SBP change was –6.15 (95% CI: –13.23 to 0.94, P=0.087). No major adverse events were reported.Conclusions:SYMPLICITY HTN-Japan, the first randomized controlled trial of RDN in an Asian population, was underpowered for the primary endpoint analysis and did not demonstrate a significant difference in 6-month BP change between RDN and control subjects.