Scholarlink

<p>This study assessed regional variations in blood pressure (BP) control after antihypertensive treatment and explored the associations with healthcare resource indicators across Japan. Using nationwide health check-up data from the Japan Health Insurance Association between 2015 and 2022, we analyzed 1,318,437 individuals aged 40–74 who initiated antihypertensive treatment based on consecutive health check-ups. We evaluated prefecture-level differences in post-treatment BP control rates (systolic BP [SBP]/diastolic BP [DBP] &lt;130/&lt;80 mmHg). Prefecture-level ecological analyses examined the associations between adjusted BP control rates and cerebrovascular disease mortality rates and six healthcare resource indicators, including the Physician Uneven Distribution Index (PUDI). Mean SBP/DBP decreased from 148.3/92.4 mmHg to 134.1/83.1 mmHg following treatment initiation. Only 26.7% of patients achieved the target BP (&lt;130/&lt;80 mmHg). This level is the universal target in the Japanese Society of Hypertension Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025, highlighting a significant public health challenge. Unadjusted BP control rates varied by 10.2% across prefectures, narrowing to 7.4% after adjusting for individual-level patient characteristics. Pre-treatment SBP was the strongest predictor of post-treatment BP control. Ecological analysis revealed that each 1% increase in patients achieving the target BP of &lt;130/&lt;80 mmHg was associated with 3.5 fewer cerebrovascular disease deaths per 100,000 population in both sexes. PUDI showed a significant positive association with BP control rate (weighted Pearson’s <i>r</i> = 0.47; <i>p</i> &lt; 0.001). In conclusion, substantial regional disparities in BP control persist across Japan, which are significantly influenced by physician availability and associated with differences in stroke mortality.</p><p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Regional disparities in blood pressure control after hypertension treatment initiation in Japan: a real-world data analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月18日

查看全文
  • Yutaro Iwabe,
  • Michihiro Satoh,
  • Hiroki Nobayashi,
  • Seiya Izumi,
  • Takahisa Murakami,
  • Maya Toyama,
  • Takahito Yagihashi,
  • Yuya Suzuki,
  • Tomoko Muroya,
  • Shingo Nakayama,
  • Takayoshi Ohkubo,
  • Hirohito Metoki

摘要

This study assessed regional variations in blood pressure (BP) control after antihypertensive treatment and explored the associations with healthcare resource indicators across Japan. Using nationwide health check-up data from the Japan Health Insurance Association between 2015 and 2022, we analyzed 1,318,437 individuals aged 40–74 who initiated antihypertensive treatment based on consecutive health check-ups. We evaluated prefecture-level differences in post-treatment BP control rates (systolic BP [SBP]/diastolic BP [DBP] <130/<80 mmHg). Prefecture-level ecological analyses examined the associations between adjusted BP control rates and cerebrovascular disease mortality rates and six healthcare resource indicators, including the Physician Uneven Distribution Index (PUDI). Mean SBP/DBP decreased from 148.3/92.4 mmHg to 134.1/83.1 mmHg following treatment initiation. Only 26.7% of patients achieved the target BP (<130/<80 mmHg). This level is the universal target in the Japanese Society of Hypertension Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025, highlighting a significant public health challenge. Unadjusted BP control rates varied by 10.2% across prefectures, narrowing to 7.4% after adjusting for individual-level patient characteristics. Pre-treatment SBP was the strongest predictor of post-treatment BP control. Ecological analysis revealed that each 1% increase in patients achieving the target BP of <130/<80 mmHg was associated with 3.5 fewer cerebrovascular disease deaths per 100,000 population in both sexes. PUDI showed a significant positive association with BP control rate (weighted Pearson’s r = 0.47; p < 0.001). In conclusion, substantial regional disparities in BP control persist across Japan, which are significantly influenced by physician availability and associated with differences in stroke mortality.