Epidemiological study using large-scale DPC data - Relationship between air pollution, incidence of cardiovascular heart disease and medical costs

• Project/Area Number: 18K08119
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: Yoneyama Kihei 聖マリアンナ医科大学, 医学部, 講師 (70386944)
• Co-Investigator(Kenkyū-buntansha): 明石 嘉浩 聖マリアンナ医科大学, 医学部, 教授 (40350615) ; 樋熊 拓未 聖マリアンナ医科大学, 医学部, 准教授 (40361018)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000); Fiscal Year 2020: ¥260,000 (Direct Cost: ¥200,000、Indirect Cost: ¥60,000); Fiscal Year 2019: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000); Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 心血管病 / 心不全 / 心筋梗塞 / 不整脈 / 医療費 / 大気汚染 / 気温 / 疫学 / PM2.5 / 温度 / 心疾患病 / 心臓病 / 動脈解離 / 公害 / 心臓 / 湿度 / 死亡 / 循環器 / 心疾患

Outline of Final Research Achievements

We used an epidemiological approach to investigate the risk of cardiovascular disease and its associated medical costs associated with unbridled temperature and air pollutants in a nationwide sample of 1,067,171 cases of cardiovascular disease requiring emergency hospitalization.
The elderly (65 years and older) were more sensitive to the effects of temperature and air pollutants. The highest per capita medical costs for cardiovascular disease were found in the 65-74 age group. The health care costs were clearly lower for those aged 90 and over than for younger people. The hospital stay for those aged 90 and over was significantly longer than for younger people.

Academic Significance and Societal Importance of the Research Achievements

温度変化を少なくすること、大気汚染物質を少なくすることが、循環器疾患のリスクをさらに軽減できることを明らかにした。こればかりでなく、特に高齢者では環境の変化に鋭敏でありより注意が必要であることを明らかにした。また、大気汚染物質(PM2.5)が基準値 以下でもPM2.5と循環器疾患と関係があり、PM2.5はさらに低くする努力が必要である。高齢者は病院収入が低くなるにも関わらず長期滞在してしまう傾向を示した。これは、病院経営にとって、長期滞在する高齢者より若年の循環器疾患を中心に医療を行う方が利潤を出せる可能性があり、超高齢化社会に向けた本邦の医療のゆく方向とは異なる可能性があることがわかった。

Research Products

• [Presentation] Lower Weather Temperature and Humidity Incidence of Hospitalization for Acute Myocardial Infarction in Japan (2021)
  • Author(s): Kihei Yoneyama, Takumi Higuma, Kanako Teramoto, Mika Watanabe, Toshiki Kaihara, Yuki Ishibashi, Masaki Izumo, Yasuhiro Tanabe, Tomoo Harada, Yohishiro J. Akashi
  • Organizer: 第85回日本循環器学会学術集会
  • Int'l Joint Research
• [Presentation] Effect of Change in Weather Temperature and Incidence of Hospitalization for Cardiovascular Disease in a Super-aging Society (2021)
  • Author(s): Kihei Yoneyama, Takumi Higuma, Kanako Teramoto, Mika Watanabe, Toshiki Kaihara, Yuki Ishibashi, Masaki Izumo, Yasuhiro Tanabe, Tomoo Harada, Yohishiro J. Akashi
  • Organizer: 第85回日本循環器学会学術集会
  • Int'l Joint Research
• [Presentation] Effect Of Change In Temperature And Hospital Admissions For Cardiovascular Disease: A Nationwide Study From Thejapanese Registry Of All Cardiac And Vascular Diseases (2020)
  • Author(s): Kihei Yoneyama, MD, PhD, Takumi, Higuma, MD, PhD, Kanako Teramoto, MD, PhD, MPH, Mika Watanabe, MD, Yuki, Ishibashi, MD, PhD, Masaki Izumo, MD, PhD, Yasuhiro Tanabe, MD, PhD, Tomoo Harada, MD, PhD, Yohishiro J. Akashi. MD, PhD
  • Organizer: AHA scientific sessions 2019
  • Int'l Joint Research
• [Presentation] Effect of Change in Temperature and Hospital Admissions for Cardiovascular Disease: A Nationwide Study From the Japanese Registry of All Cardiac and Vascular Diseases (2019)
  • Author(s): Kihei Yoneyama , Takumi Higuma , Kanaka Teramoto , Mika Watanabe , Yuki Ishibashi , Masaki Izumo , Yasuhiro Tanabe , Tomoo Harada , Yoshihiro J Akashi
  • Organizer: AHA Scientific Sessions 2019
  • Int'l Joint Research