Abstract
Objective: To investigate the management of hypertension including measures against arteriosclerosis by analyzing data from residents undertaking a Japan Health Insurance Association (JHIA; called Kyoukai Kenpo) health examination for lifestyle-related disease prevention at the Ehime Prefecture Imabari Public Health Center.
Method: This study of 9,709 people was conducted in 2012 at the Ehime Prefecture Imabari Public Health Center as part of JHIA’s health examinations to help prevent lifestyle-related diseases. The subjects were classified into four groups: normotensive, untreated hypertensive, normotensive taking antihypertensive medication, and hypertensive taking antihypertensive medication. (The latter three groups were defined as the “three hypertension groups”.) The normotensive group was compared with the three hypertension groups with the results expressed as mean values of the examination data using two-way analysis of variance. The responses in the health examination questionnaire between the normotensive group and three hypertension groups were compared using an age-adjusted odds ratio. The history of stroke, heart disease, and chronic kidney disease, and risk factors in men aged 50–75 years were inferred.
Results: The proportion of people with inadequately controlled hypertension greater than 139/89 mmHg represented half the hypertensive taking antihypertensive medication group. The mean values for abdomen circumference, triglyceride level, liver function, and blood glucose level were significantly higher in all three of the hypertension groups in both men and women than in the normotensive group. The mean value for HDL cholesterol was significantly lower in the women in all three of the hypertension groups and the men in the normotensive taking antihypertensive medication group than the normotensive group. The age-adjusted odds ratio of the “yes” response for the following three items in the health examination questionnaire was significantly higher in the three hypertension groups than the normotensive group: “weight increased more than 10 kg from age 20”, “eating speed is faster than others”, and “drink alcohol every day or drink a lot”. The results of multiple logistic regression analysis show the men aged 50–75 years in the hypertensive taking antihypertensive medication group have a history of stroke, heart disease, and chronic kidney disease. Further, the J-curve effect was observed in those aged 50–75 years taking antihypertensive medications in which coronary artery disease increases due to excessive lowering of diastolic blood pressure.
Conclusion: This research clarified that the factors constituting metabolic syndrome accumulated more in the three hypertension groups compared with the normotensive group. Consequently, we suggest that preventing the onset or exacerbation of arteriosclerotic diseases is achieved not only by medication for each disease but also by the need for a radical improvement in the treatment of metabolic syndrome such as reducing visceral fat．
