A CROSS-SECTIONAL STUDY TO ELUCIDATE FACTORS ASSOCIATED WITH UNTREATED HYPERTENSION AMONG HYPERTENSIVES

Abstract

Objectives: Hypertension is a risk factor for various diseases such as cardiovascular and cerebrovascular diseases, but many people in Japan have untreated hypertension. In this cross-sectional study, we examined factors associated with untreated hypertension using health examination data from a health examination organization.

Methods: In 2023, 50,619 subjects aged 40 years or older who used the Ehime General Healthcare Association were included in the study. The prevalence of hypertension was assessed in the entire study population. Those without hypertension were then excluded from the analysis, and factors associated with untreated hypertension were examined in those with hypertension. Adjusted odds ratios for untreated hypertension were calculated using multiple logistic regression analysis, adjusting for sex, age, habitual smoking, habitual exercise, diabetes, dyslipidemia, history of cerebrovascular disease, history of cardiovascular disease, history of chronic nephritis, BMI, and medical examination category.

Results: Of the 50,619 individuals, the prevalence of hypertension was 38.6%(19,548). Of the 19,548 people with hypertension, 41.0%(8,009) had untreated hypertension. Factors that were significantly inversely associated with the prevalence of untreated hypertension were male sex, age > 50 years, diabetes, dyslipidemia, history of cerebrovascular disease, history of cardiovascular disease, history of chronic nephritis and BMI > 25 kg/m² . On the other hand, habitual smoking, habitual exercise and a BMI less than 23 kg/m² were significantly positively associated with the prevalence of untreated hypertension.

Conclusions: The positive association between BMI < 23 kg/m² and untreated hypertension is noteworthy and may require a paradigm shift in health screening policies, as BMI < 25 kg/m² is a blind spot in specific health screening in Japan.