胎生期から成人にわたる医療薬学的視点からの生活習慣病予防に対するアプローチ

• Project/Area Number: 13J07756
• Research Category: Grant-in-Aid for JSPS Fellows
• Allocation Type: Single-year Grants
• Section: 国内
• Research Field: Medical pharmacy
• Research Institution: Tohoku University
• Principal Investigator: 保坂 実樹 東北大学, 薬学研究科, 特別研究員(DC1)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Project Status: Completed (Fiscal Year 2015)
• Budget Amount: ¥3,600,000 (Direct Cost: ¥3,600,000); Fiscal Year 2015: ¥1,200,000 (Direct Cost: ¥1,200,000); Fiscal Year 2014: ¥1,200,000 (Direct Cost: ¥1,200,000); Fiscal Year 2013: ¥1,200,000 (Direct Cost: ¥1,200,000)
• Keywords: 家庭血圧 / 尿中アルブミンクレアチニン比 / 降圧薬 / 高血圧 / 上腕-足首間脈波伝播速度 / 薬効評価

Outline of Annual Research Achievements

本研究は家庭血圧をツールとして、成人において、降圧薬がもたらす代謝系への影響および妊婦・授乳婦の薬剤使用が小児の家庭血圧および成長に及ぼす影響を検討することを目的としている。
今年度は、J-HOME研究の対象者を用いて、尿中アルブミンクレアチニン比(UACR)が10mg/g Cr以上300mg/g Cr未満である本態性高血圧患者に対するイルベサルタン単独治療およびアムロジピン、エホニジピン、トリクロルメチアジドとの併用療法が腎機能、家庭血圧に及ぼす影響を検討した。対象者175名中、11名はイルベサルタン100/200 mgで家庭収縮期血圧が125 mmHg未満に降圧した。イルベサルタン単剤で家庭血圧が降圧目標に達しなかった対象者のうち、115名が、イルベサルタンと、アムロジピン、エホニジピン、もしくはトリクロルメチアジドいずれかとの併用療法3群に割り付けられた。割付から8週間の降圧治療の結果、家庭血圧は有意な降圧を認め、UACRも有意に低下を認めた。しかしながら、家庭血圧の降圧度、およびUACRの低下率に3群間で有意差は認められなかった。本検討からは、腎機能改善効果における3剤の降圧薬いずれかの優位性は明らかとはならなかったが、いずれの降圧薬も家庭血圧降圧および腎機能改善に有用であることが改めて示された。
本研究結果は、微量アルブミン尿を呈する本態性高血圧患者における適正な降圧治療および降圧薬選択において重要な結果である。

Research Progress Status

27年度が最終年度であるため、記入しない。

Strategy for Future Research Activity

27年度が最終年度であるため、記入しない。

Research Products

• [Journal Article] Home blood pressure level and decline in renal function among treated hypertensive patients: the J-HOME-Morning Study. (2016)
  • Author(s): Ishikura K, Obara T, Kikuya M, Satoh M, Hosaka M, Metoki H, Nishigori H, Mano N, Nakayama M, Imai Y, Ohkubo T.
  • Journal Title: Hypertens Res Volume: 39(2) Issue: 2 Pages: 107-112
  • DOI: 10.1038/hr.2015.110
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Long-Term Stroke Risk Due to Partial White-Coat or Masked Hypertension Based on Home and Ambulatory Blood Pressure Measurements: The Ohasama Study. (2016)
  • Author(s): Satoh M, Asayama K, Kikuya M, Inoue R, Metoki H, Hosaka M, Tsubota-Utsugi M, Obara T, Ishiguro A, Murakami K, Matsuda A, Yasui D, Murakami T, Mano N, Imai Y, Ohkubo T.
  • Journal Title: Hypertension Volume: 67(1) Issue: 1 Pages: 48-55
  • DOI: 10.1161/hypertensionaha.115.06461
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Randomized trial comparing the velocities of the antihypertensive effects on home blood pressure of candesartan and candesartan with hydrochlorothiazide. (2015)
  • Author(s): Hosaka M, Metoki H, Satoh M, Ohkubo T, Asayama K, Kikuya M, Inoue R, Obara T, Hirose T, Imai Y on behalf of The J-HOME-CARD Study group.
  • Journal Title: HYPERTENSION RESEARCH Volume: 38 Issue: 10 Pages: 701-707
  • DOI: 10.1038/hr.2015.64
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Relationship between maternal gestational hypertension and home blood pressure in 7-year-old children and their mothers: Tohoku Study of Child Development. (2015)
  • Author(s): Hosaka M, Asayama K, Staessen JA, Tatsuta N, Satoh M, Kikuya M, Ohkubo T, Satoh H, Imai Y, Nakai K.
  • Journal Title: Hypertension Research Volume: 38 Issue: 11 Pages: 776-782
  • DOI: 10.1038/hr.2015.63
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Association between N-terminal pro BNP and day-to-day blood pressure and heart rate variability in a general population: The Ohasama Study. (2015)
  • Author(s): Satoh M, Hosaka M, Asayama K, Kikuya M, Inoue R, Metoki H, Tsubota-Utsugi M, Hara A, Hirose T, Obara T, Totsune K, Hoshi H, Mano N, Node K, Imai Y, Ohkubo T.
  • Journal Title: Journal of Hypertension Volume: - Issue: 8 Pages: 1536-1541
  • DOI: 10.1097/hjh.0000000000000570
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Salt intake and the validity of a salt intake assessment system based on a 24-h dietary recall method in pregnant Japanese women. (2015)
  • Author(s): Satoh M, Tanno Y, Hosaka M, Metoki H, Obara T, Asayama K, Hoshi K, Suzuki M, Mano N, Imai Y.
  • Journal Title: Clin Exp Hypertens Volume: 37(6) Issue: 6 Pages: 459-462
  • DOI: 10.3109/10641963.2015.1057832
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Differential effects of angiotensin II receptor blocker and losartan/hydrochlorothiazide combination on central blood pressure and augmentation index. (2015)
  • Author(s): Metoki H, Obara T, Asayama K, Satoh M, Hosaka M, Elnagar N, Miyawaki Y, Kojima I, Ohkubo T, Imai Y for the Japan-Home versus Office Blood Pressure Measurement Evaluation-Augmentation Index Study Investigators.
  • Journal Title: CLINICAL AND EXPERIMENTAL HYPERTENSION Volume: 37 Issue: 4 Pages: 294-302
  • DOI: 10.3109/10641963.2014.960972
  • Peer Reviewed
• [Journal Article] Living situations associated with poor dietary intake among healthy Japanese elderly: the Ohasama study. (2015)
  • Author(s): Tsubota-Utsugi M, Kikuya M, Satoh M, Inoue R, Hosaka M, Metoki H, Hirose T, Asayama K, Imai Y, Ohkubo T.
  • Journal Title: THE JOURNAL OF NUTRITION, HEALTH & AGING Volume: 19 Issue: 4 Pages: 375-382
  • DOI: 10.1007/s12603-015-0456-5
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Relationship between maternal gestational hypertension and home blood pressure in 7-year-old children and their mothers: the Tohoku Study of child Development. (2015)
  • Author(s): Miki Hosaka, Kei Asayama, et al.
  • Journal Title: Hypertens Res. Volume: in press
  • Peer Reviewed
• [Journal Article] Differential effects of angiotensin II receptor blocker and losartan/hydrochlorothiazide combination on central blood pressure and augmentation index. (2015)
  • Author(s): Metoki H, Obara T, Asayama K, Satoh M, Hosaka M, et al.
  • Journal Title: Clin Exp Hypertens. Volume: in press
  • Peer Reviewed
• [Journal Article] Association of aldosterone-to-renin ratio with hypertension differs by sodium intake: the Ohasama study. (2015)
  • Author(s): Satoh M, Kikuya M, Hosaka M, et al.
  • Journal Title: Am J Hypertens. Volume: 28 Issue: 2 Pages: 208-215
  • DOI: 10.1093/ajh/hpu115
  • Peer Reviewed / Open Access
• [Journal Article] Validity of salt intake assessment system based on a 24-h dietary recall method using a touch panel computer. (2014)
  • Author(s): Satoh M, Kato N, Hosaka M, et al.
  • Journal Title: Clin Exp Hypertens. Volume: 36 Issue: 7 Pages: 471-477
  • DOI: 10.3109/10641963.2013.863319
  • Peer Reviewed
• [Journal Article] Animal Protein Intake Is Associated with Higher-Level Functional Capacity in Elderly Adults : The Ohasama Study (2014)
  • Author(s): Imai E, Tsubota-Utsugi M, Kikuya M, Satoh M, Inoue R, Hosaka M, et al.
  • Journal Title: J Am Geriatr Soc. Volume: 62 Issue: 3 Pages: 426-434
  • DOI: 10.1111/jgs.12690
  • Peer Reviewed
• [Journal Article] Clinical significance of home blood pressure measurements for the prevention and management of high blood pressure (2014)
  • Author(s): Imai Y, Hosaka M, et al.
  • Journal Title: Clin Exp Pharmacol Physiol. Volume: 41 Issue: 1 Pages: 37-45
  • DOI: 10.1111/1440-1681.12142
  • Peer Reviewed
• [Journal Article] Aldosterone-to-renin ratio and nocturnal blood pressure decline assessed by self-measurement of blood pressure at home : the Ohasama Study (2014)
  • Author(s): Satoh M, Hosaka M, et al.
  • Journal Title: Clin Exp Hypertens. Volume: 36 Issue: 2 Pages: 108-114
  • DOI: 10.3109/10641963.2014.892121
  • Peer Reviewed
• [Journal Article] The velocity of home blood pressure reduction in response to low-dose eplerenone combined with other antihypertensive drugs determined by exponential decay function analysis (2014)
  • Author(s): Elnagar N, Satoh M, Hosaka M, et al.
  • Journal Title: Clin Exp Hypertens. Volume: 36 Issue: 2 Pages: 83-91
  • DOI: 10.3109/10641963.2014.892117
  • Peer Reviewed
• [Journal Article] Predictive power of home blood pressure and clinic blood pressure in hypertensive patients with impaired glucose metabolism and diabetes. (2013)
  • Author(s): Noguchi Y, Asayama K, Staessen JA, Inaba M, Ohkubo T, Hosaka M, et al.
  • Journal Title: J Hypertens. Volume: 31 Issue: 8 Pages: 1593-1602
  • DOI: 10.1097/hjh.0b013e328361732c
  • Peer Reviewed
• [Journal Article] Night-time blood pressure is associated with the development of chronic kidney disease in a general population : the Ohasama Study. (2013)
  • Author(s): Kanno A, Kikuya M, Asayama K, Satoh M, Inoue R, Hosaka M, et al.
  • Journal Title: J Hypertens. Volume: 31 Issue: 12 Pages: 2410-2417
  • DOI: 10.1097/hjh.0b013e328364dd0f
  • Peer Reviewed
• [Presentation] 出生後18ヶ月の体重増加と7歳児の家庭血圧の関連: Tohoku Study of Child Development (2015)
  • Author(s): 保坂 実樹、浅山 敬、佐藤 倫広、菊谷 昌浩、大久保 孝義、今井 潤
  • Organizer: 第38回日本高血圧学会総会
  • Place of Presentation: 愛媛県県民文化会館(愛媛県松山市)
  • Year and Date: 2015-10-09
• [Presentation] 本態性高血圧患者における家庭血圧と脳心血管疾患発症リスクの男女別解析: HOMED-BP研究 (2014)
  • Author(s): 保坂 実樹、浅山 敬、佐藤 倫広、井上 隆輔、小原 拓、目時 弘仁、菊谷 昌浩、大久保 孝義、今井 潤
  • Organizer: 第37回日本高血圧学会総会
  • Place of Presentation: パシフィコ横浜（神奈川県横浜市）
  • Year and Date: 2014-10-17 – 2014-10-19
• [Presentation] Long-term impact of antihypertensive drug treatment on brachial-ankle pulse wave velocity: the HOMED-BP study (2014)
  • Author(s): Miki HOSAKA, Kei ASAYAMA, Michihiro SATOH, Takayoshi OHKUBO, Akira YAMASHINA, and Yutaka IMAI.
  • Organizer: Pulse of Asia 2014
  • Place of Presentation: ギリシャ（アテネ）
  • Year and Date: 2014-06-12 – 2014-06-13
• [Presentation] Home blood pressure in children and their mothers with pregnancy-induced hypertension : the Tohoku Study of Child Development (2014)
  • Author(s): Hosaka M, et al.
  • Organizer: 10th Asian-Pacific Congress of Hypertension
  • Place of Presentation: セブ、フィリピン
  • Year and Date: 2014-02-13
• [Presentation] 妊娠高血圧症候群と出産7年後の母児の家庭血圧との関連 (2013)
  • Author(s): 保坂実樹, ほか
  • Organizer: 第36回日本高血圧学会総会
  • Place of Presentation: 大阪
  • Year and Date: 2013-10-24
• [Presentation] 妊婦に対する気管支喘息治療薬の処方状況の把握に関する研究 (2013)
  • Author(s): 保坂実樹, ほか
  • Organizer: 第23回医療薬学会年会
  • Place of Presentation: 仙台
  • Year and Date: 2013-09-22
• [Presentation] The velocity of antihypertensive effect of candesartan/ hydrochlorothiazide combination and incremental dose of candesartan evaluated by daily serial morning home blood pressure measurements. (2013)
  • Author(s): Hosaka M, et al.
  • Organizer: ESC Congress 2013
  • Place of Presentation: アムステルダム、オランダ
  • Year and Date: 2013-09-04
• [Book] 血圧11月号 (2015)
  • Author(s): 保坂実樹、浅山敬、今井潤
  • Total Pages: 92
  • Publisher: 先端医学社
• [Book] 血圧 1月号 (2015)
  • Author(s): 保坂実樹、浅山敬、今井潤
  • Total Pages: 63
  • Publisher: 先端医学社
• [Book] 血圧 2月号 (2015)
  • Author(s): 保坂実樹、大久保孝義
  • Total Pages: 86
  • Publisher: 先端医学社
• [Book] 高齢者高血圧の治療と管理 (2014)
  • Author(s): 今井潤、保坂実樹、佐藤倫広
  • Total Pages: 204
  • Publisher: 先端医学社
• [Book] 治療 5月号 (2014)
  • Author(s): 今井潤、保坂実樹、佐藤倫広
  • Total Pages: 916
  • Publisher: 南山堂
• [Book] 動脈硬化予防 4月号 (2014)
  • Author(s): 保坂実樹、大久保孝義
  • Total Pages: 79
  • Publisher: メジカルビュー社
• [Book] 動脈硬化予防 : 危険因子 家庭血圧 (2014)
  • Author(s): 保坂実樹、大久保孝義
  • Publisher: メジカルビュー社
• [Book] 血圧 : 母乳と小児の血圧 (2013)
  • Author(s): 保坂実樹、浅山敬、今井潤
  • Publisher: 先端医学社
• [Book] 血圧 : 家庭血圧の変動性と脳心血管リスク (2013)
  • Author(s): 淺山敬、保坂実樹、今井潤
  • Publisher: 先端医学社
• [Book] 血圧 : 糖尿病と仮面高血圧 (2013)
  • Author(s): 保坂実樹、浅山敬、今井潤
  • Publisher: 先端医学社