ここでは,2014年3~4月に発表された注目文献のタイトルを紹介します。
家庭血圧でみた孤立性収縮期高血圧,孤立性拡張期高血圧,脈圧はいずれも心血管疾患発症リスクと関連 [Finn-home study]
Niiranen TJ, et al. Overall cardiovascular prognosis of isolated systolic hypertension, isolated diastolic hypertension and pulse pressure defined with home measurements: the Finn-home study. J Hypertens. 2014; 32: 518-24.
心血管疾患リスクと関連するのは,未治療の白衣高血圧,未治療の仮面高血圧,ならびに治療中の仮面高血圧 [IDHOCO]
Stergiou GS, et al.; International Database on HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO) Investigators. Prognosis of white-coat and masked hypertension: international database of home blood pressure in relation to cardiovascular outcome. Hypertension. 2014; 63: 675-82.
JNC8血圧ガイドラインを用いることで,JNCよりも治療対象の高血圧者は減少し,目標血圧達成者は増加(とくに高齢者) [NHANES]
Navar-Boggan AM, et al. Proportion of US adults potentially affected by the 2014 hypertension guideline. JAMA. 2014; 311: 1424-9.
スタチン治療基準はガイドライン間で大きく異なり,AHA/ACCガイドラインを用いると治療対象者がもっとも多くなる [Rotterdam Study]
Kavousi M, et al. Comparison of application of the ACC/AHA guidelines, Adult Treatment Panel III guidelines, and European Society of Cardiology guidelines for cardiovascular disease prevention in a European cohort. JAMA. 2014; 311: 1416-23.
BMIが代謝系危険因子(血圧,血糖,脂質)を介して発症リスクに関与する割合は,冠動脈疾患では46%,脳卒中では76% [Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration]
Lu Y, et al.; Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects). Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet. 2014; 383: 970-83.
「代謝的に健康だが肥満」の人では,心筋梗塞発症リスクは増加しないが,心不全発症リスクは増加 [HUNT Study]
Mørkedal B, et al. Risk of myocardial infarction and heart failure among metabolically healthy but obese individuals: HUNT (Nord-Trøndelag Health Study), Norway. J Am Coll Cardiol. 2014; 63: 1071-8.
血中のフルクトサミンおよびグリコアルブミンレベルの糖尿病・糖尿病合併症発症リスク予測能はHbA1cと同等 [ARIC]
Selvin E, et al. Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol. 2014; 2: 279-88.
ガイドラインとは異なり,多価不飽和脂肪酸と飽和脂肪酸の摂取量および血中濃度と冠動脈疾患発症リスクとの関連はみられず [メタ解析]
Chowdhury R, et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med. 2014; 160: 398-406.
ApoB/A1比とnon-HDL-C/HDL-C比と冠動脈疾患発症リスクとの関連の度合いを比較した結果,慢性腎臓病(CKD)の有無を問わず両者は同等 [ARIC]
Lamprea-Montealegre JA, et al. Chronic kidney disease, lipids and apolipoproteins, and coronary heart disease: the ARIC study. Atherosclerosis. 2014; 234: 42-6.
炎症性サイトカイン(IL-6,IL-18,MMP-9,sCD40L,TNF-α)はいずれも冠動脈疾患発症リスクと関連 [デンマークのコホート研究+メタ解析]
Kaptoge S, et al. Inflammatory cytokines and risk of coronary heart disease: new prospective study and updated meta-analysis. Eur Heart J. 2014; 35: 578-89.
従来の心血管リスクモデルにHbA1c値を加えても,予測能の改善はわずか [Emerging Risk Factors Collaboration]
Di Angelantonio E, et al.; Emerging Risk Factors Collaboration. Glycated hemoglobin measurement and prediction of cardiovascular disease. JAMA. 2014; 311: 1225-33.
1990~2010年の国際的な脂肪・油の摂取状況の変化:国や地域によって大きく異なるが,全体では飽和脂肪酸は不変,ω3・6系脂肪酸は増加 [Global Burden of Diseases 2010 (Nutrition and Chronic Diseases Expert Group)]
Micha R, et al.; Global Burden of Diseases Nutrition and Chronic Diseases Expert Group NutriCoDE. Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys. BMJ. 2014; 348: g2272.
ALT高値は脳内出血発症リスク増加と関連 [東アジア脳卒中予防研究]
Kim HC, et al.; East Asian Network for Stroke Prevention Study group. Association between alanine aminotransferase and intracerebral hemorrhage in East Asian populations. Neuroepidemiology. 2013; 41: 131-8.
血清アルブミン低値は虚血性脳卒中発症リスク(とくに心原性脳塞栓および病型不明)と関連 [Northern Manhattan Study]
Xu WH, et al. Serum albumin levels are associated with cardioembolic and cryptogenic ischemic strokes: Northern Manhattan Study. Stroke. 2014; 45: 973-8.
食事からのマグネシウム摂取量が多い人の脳卒中発症リスクは低い [オランダの3万6000人]
Sluijs I, et al. Intakes of potassium, magnesium, and calcium and risk of stroke. Stroke. 2014; 45: 1148-50.
性ホルモンと心房細動: テストステロン低値とエストラジオール高値は高齢男性の心房細動リスクと関連 [Framingham Heart Study]
Magnani JW, et al. Association of sex hormones, aging, and atrial fibrillation in men: the Framingham Heart Study. Circ Arrhythm Electrophysiol. 2014; 7: 307-12.
L型Caチャネルのリモデリングに関与するマイクロRNA-328の血中レベルは心房細動有病率と有意に関連 [Framingham Offspring Study]
McManus DD, et al. Relations between circulating microRNAs and atrial fibrillation: data from the Framingham Offspring Study. Heart Rhythm. 2014; 11: 663-9.
外見上の加齢サイン(男性型脱毛症,耳たぶのしわ,眼瞼黄色腫[xanthelasmata])は,実年齢とは独立した虚血性心疾患の危険因子 [デンマークの1万人]
Christoffersen M, et al. Visible age-related signs and risk of ischemic heart disease in the general population: a prospective cohort study. Circulation. 2014; 129: 990-8.
身体活動量が「仕事と余暇の両方で低い人」だけでなく,「仕事で高いが余暇で低い人」でも死亡リスクが増加 [Belgian Physical Fitness Study]
Clays E, et al. The combined relationship of occupational and leisure-time physical activity with all-cause mortality among men, accounting for physical fitness. Am J Epidemiol. 2014; 179: 559-66.
1980~2010年の世界的な虚血性心疾患死亡率の変化: 高所得国を含む多くの地域で低下も,一部の地域では依然として高い [Global Burden of Diseases 2010]
Moran AE, et al. Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the global burden of disease 2010 study. Circulation. 2014; 129: 1483-92.