Achievement of Target Blood Pressure Levels among Japanese Workers with Hypertension and Healthy Lifestyle Characteristics Associated with Therapeutic Failure

• Published in: PloS one Vol. 10; no. 7; p. e0133641
• Main Authors: Kudo, Nagako, Yokokawa, Hirohide, Fukuda, Hiroshi, Sanada, Hironobu, Miwa, Yuichi, Hisaoka, Teruhiko, Isonuma, Hiroshi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 30.07.2015; Public Library of Science (PLoS)
• Subjects: Achievement; Adults; Aged; Alcohol; Alcohol Drinking - physiopathology; Alcohol use; Alcoholic beverages; Analysis; Asian Continental Ancestry Group; Blood; Blood pressure; Blood Pressure - physiology; Blood Pressure Determination - methods; Body mass; Body Mass Index; Body size; Body weight; Cardiovascular disease; Cerebrovascular system; Cholesterol; Chronic kidney failure; Coronary artery; Coronary heart disease; Coronary vessels; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Diabetes Mellitus - physiopathology; Failure analysis; Family medical history; Female; Geriatrics; Health; Health behavior; Health services; Humans; Hypertension; Hypertension - physiopathology; Life Style; Lifestyles; Male; Medical screening; Medical treatment; Medicine; Middle Aged; Multivariate analysis; Occupational health; Older people; Patients; Primary care; Questionnaires; Renal Insufficiency, Chronic - physiopathology; Sleep; Studies; Treatment Failure; Workers
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0133641

Few studies have examined Japanese with regard to the achievement rates for target blood pressure levels, or the relationship between these rates and healthy lifestyle characteristics in patients with hypertension as defined by the newly established hypertension management guidelines (JSH2014). The aim of this study was to elucidate achievement rates and examine healthy lifestyle characteristics associated with achievement status among Japanese. This cross-sectional study, conducted in January-December 2012, examined blood pressure control and healthy lifestyle characteristics in 8,001 Japanese workers with hypertension (mean age, 57.0 years; 78.8% were men) who participated in a workplace health checkup. Data were collected from workplace medical checkup records and participants' self-administered questionnaires. We divided into 5 groups [G1; young, middle-aged, and early-phase elderly patients (65-74 years old) without diabetes mellitus or chronic kidney disease (CKD) (<140/90 mmHg), G2; late-phase elderly patients (≥75 years old) without diabetes mellitus or CKD (<150/90 mmHg), G3; diabetic patients (<130/80 mmHg), G4; patients with CKD (<130/80 mmHg), and G5; patients with cerebrovascular and/or coronary artery diseases (<140/90 mmHg)] according to JSH2014. And then, achievement rates were calculated in each group. Multivariate analysis identified healthy lifestyle characteristics associated with "therapeutic failure" of target blood pressure. Target blood pressures were achieved by 60.2% of young, middle-aged, and early-phase elderly patients (G1), 71.4% of late-phase elderly patients (G2), 30.5% of diabetic patients (G3), 33.4% of those with chronic kidney disease (G4), and 66.0% of those with cerebrovascular and/or coronary artery diseases (G5). A body mass index of 18.5-24.9 and non-daily alcohol consumption were protective factors, and adequate sleep was found to contribute to therapeutic success. We found low achievement rates for treatment goals among patients with chronic kidney disease and diabetes mellitus. Maintaining an ideal body weight and adequate alcohol consumption may help with blood pressure control. Lifestyle modification may be necessary for better management of hypertension.