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Special Issue: Current evidence and perspectives for hypertension management in Asia

Blood pressure classification using the Japanese Society of Hypertension Guidelines for the Management of Hypertension and cardiovascular events among young to middle-aged working adults

Hypertension Research (2024)Cite this article

Abstract

The Japanese Society of Hypertension updated guidelines for hypertension management (JSH2019), changing the blood pressure (BP) classification. However, evidence is sparse regarding the association of the classification with cardiovascular disease (CVD) events among young to middle-aged workers in Japan. We examined this issue using longitudinal data from Japan Epidemiology Collaboration on Occupational Health Study with a prospective cohort design. Participants were 81,876 workers (aged 20–64 years) without taking antihypertensive medication at baseline. BP in 2011 or 2010 was used as exposure. CVD events that occurred from 2012 to 2021 were retrieved from a within-study registry. Cox regression was used to calculate multivariable-adjusted hazard ratios of CVD events. During 0.5 million person-years of follow-up, 334 cardiovascular events, 75 cardiovascular deaths, and 322 all-cause deaths were documented. Compared with normal BP (systolic BP [SBP] < 120 mmHg and diastolic BP [DBP] < 80 mmHg), multivariable-adjusted hazard ratios (95% confidence intervals) of cardiovascular events were 1.98 (1.49–2.65), 2.10 (1.58–2.77), 3.48 (2.33–5.19), 4.12 (2.22–7.64), and 7.81 (3.99–15.30) for high normal BP (SBP120–129 mmHg and DBP < 80 mmHg), elevated BP (SBP130–139 mmHg and/or DBP80–89 mmHg), stage 1 hypertension (SBP140–159 mmHg and DBP90–99 mmHg), stage 2 hypertension (SBP160–179 mmHg and/or DBP100–109 mmHg), and stage 3 hypertension (SBP ≥ 180 mmHg and/or DBP ≥ 110 mmHg), respectively. The highest population attributable fraction was observed in elevated BP (17.8%), followed by stage 1 hypertension (14.1%). The present data suggest that JSH2019 may help identify Japanese workers at a higher cardiovascular risk.

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Acknowledgements

The authors are thankful to Dr Toshiteru Ohkubo (National Institute of Occupational Safety and Health, Japan) for his scientific advice on implementing J-ECOH Study, and to Ms Nobumi Katayama, Rika Osawa (National Center for Global Health and Medicine) for their administrative support.

Funding

This study was funded partly by the Industrial Health Foundation, Industrial Disease Clinical Research Grants (140202-01, 150903-01, 170301-01), the JSPS KAKENHI Grant Numbers JP25293146, JP16H05251, JP20H03952 and the NCGM Intramural Research Fund (28-Shi-1206, 30-Shi-2003, 19A1006, 22A1008).

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Authors and Affiliations

  1. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan

    Keisuke Kuwahara, Yosuke Inoue, Maki Konishi & Tetsuya Mizoue

  2. Department of Public Health, Yokohama City University School of Medicine, Kanagawa, Japan

    Keisuke Kuwahara

  3. Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Kanagawa, Japan

    Keisuke Kuwahara

  4. Teikyo University Graduate School of Public Health, Tokyo, Japan

    Keisuke Kuwahara

  5. Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan

    Takayoshi Ohkubo

  6. Hitachi Healthcare Center, Hitachi, Ltd, Ibaraki, Japan

    Toru Honda, Shuichiro Yamamoto & Tohru Nakagawa

  7. Mitsui Chemicals, Inc, Tokyo, Japan

    Hiroko Okazaki & Seitaro Dohi

  8. YAMAHA CORPORATION, Shizuoka, Japan

    Makoto Yamamoto

  9. EAST NIPPON WORKS Kimitsu Area, NIPPON STEEL CORPORATION, Chiba, Japan

    Toshiaki Miyamoto

  10. East Japan Works (Kehin), JFE Steel Corporation, Kanagawa, Japan

    Naoki Gommori

  11. Furukawa Electric Co., Ltd, Tokyo, Japan

    Takeshi Kochi

  12. Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan

    Takayuki Ogasawara

  13. Division of Chemical Information, National Institute of Occupational Safety and Health, Kawasaki, Kanagawa, Japan

    Kenya Yamamoto

  14. KUBOTA Corporation, Tokyo, Japan

    Isamu Kabe

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  1. Keisuke Kuwahara
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Correspondence to Keisuke Kuwahara.

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Kuwahara, K., Ohkubo, T., Inoue, Y. et al. Blood pressure classification using the Japanese Society of Hypertension Guidelines for the Management of Hypertension and cardiovascular events among young to middle-aged working adults. Hypertens Res (2024). https://doi.org/10.1038/s41440-024-01653-3

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