Oka Mayumi, Yamamoto Mio, Mure Kanae, Takeshita Tatsuya, Arita Mikio
School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan.
School of Public Health, Wakayama Medical University, Wakayama, Japan.
PLoS One. 2016 Oct 27;11(10):e0165313. doi: 10.1371/journal.pone.0165313. eCollection 2016.
This study aims to investigate factors that contribute to the differences in incidence of hypertension between different regions in Japan, by accounting for not only individual lifestyles, but also their living environments. The target participants of this survey were individuals who received medical treatment for hypertension, as well as hypertension patients who have not received any treatment. The objective variable for analysis was the incidence of hypertension as data aggregated per prefecture. We used data (in men) including obesity, salt intake, vegetable intake, habitual alcohol consumption, habitual smoking, and number of steps walked per day. The variables within living environment included number of rail stations, standard/light vehicle usage, and slope of habitable land. In addition, we analyzed data for the variables related to medical environment including, participation rate in medical check-ups and number of hospitals. We performed multiple stepwise regression analyses to elucidate the correlation of these variables by using hypertension incidence as the objective variable. Hypertension incidence showed a significant negative correlation with walking and medical check-ups, and a significant positive correlation with light-vehicle usage and slope. Between the number of steps and variables related to the living environment, number of rail stations showed a significant positive correlation, while, standard- and light-vehicle usage showed significant negative correlation. Moreover, with stepwise multiple regression analysis, walking showed the strongest effect. The differences in daily walking based on living environment were associated with the disparities in the hypertension incidence in Japan.
本研究旨在通过不仅考虑个体生活方式,还考虑其生活环境,来调查导致日本不同地区高血压发病率差异的因素。本次调查的目标参与者是接受高血压治疗的个体以及未接受任何治疗的高血压患者。分析的目标变量是按县汇总的数据中的高血压发病率。我们使用了(男性)包括肥胖、盐摄入量、蔬菜摄入量、习惯性饮酒、习惯性吸烟以及每天步行步数的数据。生活环境中的变量包括火车站数量、标准/轻型车辆使用情况以及可居住土地的坡度。此外,我们分析了与医疗环境相关的变量数据,包括体检参与率和医院数量。我们以高血压发病率为目标变量,进行了多元逐步回归分析以阐明这些变量之间的相关性。高血压发病率与步行和体检呈显著负相关,与轻型车辆使用情况和坡度呈显著正相关。在步行步数与生活环境相关变量之间,火车站数量呈显著正相关,而标准和轻型车辆使用情况呈显著负相关。此外,通过逐步多元回归分析,步行显示出最强的影响。基于生活环境的每日步行差异与日本高血压发病率的差异相关。