Kitaoka Kaori, Kaneko Hidehiro, Suzuki Yuta, Okada Akira, Mizuno Atsushi, Fujiu Katsuhito, Takeda Norifumi, Morita Hiroyuki, Azegami Tatsuhiko, Hayashi Kaori, Node Koichi, Furui Yuji, Miura Katsuyuki, Yasunaga Hideo, Takeda Norihiko
NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan.
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Hypertens Res. 2025 Jul 25. doi: 10.1038/s41440-025-02284-y.
Hypertension is a major risk factor for cardiovascular diseases. This study aimed to clarify blood pressure (BP) management after the health check-up among individuals with grade II or severer hypertension, defined as systolic BP (SBP) ≥ 160 mmHg or diastolic BP (DBP) ≥ 100 mmHg in Japan. This retrospective study used the JMDC Claims Database (2005-2022) in Japan, including 63,785 individuals (median age 50 years; men 75.3%) with BP above grade II hypertension thresholds during the health check-up. We evaluated the BP control and treatment status at 1 year after the first check-up. Poisson regression with robust error variance analyses were performed to assess the association with grade II or severer hypertension at 1 year after the first check-up. Notably, 45.4% continued to have grade II or severer hypertension at 1 year after the first check-up. Among the individuals, 54.5% visited a medical institution within 3 months after undergoing a health check-up, only 23.6% were prescribed antihypertensive medications at 1 year after the first check-up. Factors associated with sustained grade II or severer hypertension included per 5 years lower in age (relative risk [RR]: 1.01, 95% confidence interval [CI]: 1.01-1.02), obesity (RR: 1.04, 95% CI: 1.02-1.06), and skipping breakfast ≥3 times per week (RR: 1.06, 95% CI: 1.04-1.08). Despite strong recommendations for medical consultation, BP control remains inadequate among individuals with grade II or severer hypertension, nearly half of individuals had SBP ≥ 160 mmHg or DBP ≥ 100 mmHg at 1 year after the first check-up in our study. The findings highlight the need for prompt follow-up, particularly among younger adults and those with unhealthy lifestyles.
高血压是心血管疾病的主要危险因素。本研究旨在明确日本二级及以上高血压患者（定义为收缩压（SBP）≥160mmHg或舒张压（DBP）≥100mmHg）健康体检后的血压管理情况。这项回顾性研究使用了日本的JMDC理赔数据库（2005 - 2022年），其中包括63785名在健康体检期间血压高于二级高血压阈值的个体（中位年龄50岁；男性占75.3%）。我们评估了首次体检后1年时的血压控制和治疗状况。采用稳健误差方差分析的泊松回归来评估首次体检后1年时与二级及以上高血压的关联。值得注意的是，在首次体检后1年时，45.4%的人仍患有二级及以上高血压。在这些个体中，54.5%在接受健康体检后的3个月内就诊于医疗机构，在首次体检后1年时，只有23.6%的人被开具了降压药物。与持续性二级及以上高血压相关的因素包括每小5岁（相对风险[RR]：1.01，95%置信区间[CI]：1.01 - 1.02）、肥胖（RR：1.04，95%CI：1.02 - 1.06）以及每周不吃早餐≥3次（RR：1.06，95%CI：1.04 - 1.08）。尽管强烈建议进行医疗咨询，但二级及以上高血压患者的血压控制仍然不足，在我们的研究中，近一半的个体在首次体检后1年时收缩压≥160mmHg或舒张压≥100mmHg。这些发现凸显了及时随访的必要性，特别是在年轻人和生活方式不健康者中。
