Original Article

Hypertension Research (2008) 31, 1323–1330; doi:10.1291/hypres.31.1323

Prevalence and Determinants of Prehypertension in a Japanese General Population: The Jichi Medical School Cohort Study

Yukiko Ishikawa1, Joji Ishikawa2, Shizukiyo Ishikawa1, Kazunori Kayaba3, Yosikazu Nakamura4, Kazuyuki Shimada2, Eiji Kajii1, Thomas G Pickering5 and Kazuomi Kario2 the JMS Cohort Investigators Group

  1. 1Division of Community and Family Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
  2. 2Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
  3. 3Saitama Prefectural University, Koshigaya, Japan
  4. 4Division of Public Health, Jichi Medical University School of Medicine, Shimotsuke, Japan
  5. 5Center for Behavioral Cardiovascular Health, Division of General Medicine, Department of Medicine Columbia University Medical Center, New York, USA

Correspondence: Kazuomi Kario, M.D., Ph.D., Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Yakushiji 3311–1, Shimotsuke 329–0498 Japan. E-mail: kkario@jichi.ac.jp

Received 27 November 2007; Accepted 3 March 2008.

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Abstract

It has been reported that subjects with prehypertension (pre-HT) (systolic blood pressure [SBP] 120–139 mmHg and/or diastolic blood pressure [DBP] 80–89 mmHg) have an increased risk of cardiovascular disease (CVD). We evaluated the prevalence and determinants of pre-HT in a Japanese general population. We enrolled 4,706 males and 7,342 females aged 18 to 90 years whose BPs were measured at baseline. The subjects' BPs were classified as follows: normotension (NT: SPB/DBP<120/80 mmHg), pre-HT (120/80–139/89 mmHg), and hypertension (HT: ≥140/90 mmHg or treated hypertension). The prevalence of pre-HT was 34.8% (males), and 31.8% (females). Body mass index (BMI) of more than 23.0 kg/m2 was the strongest determinant of pre-HT (Males—BMI: 23.0–24.9 kg/m2, odds ratio [OR]=1.47, 95% confidence interval [CI]=1.21–1.79; BMI: 25.0–26.9 kg/m2, OR=2.20, 95% CI=1.68–2.87; BMI: 27.0–29.9 kg/m2, OR=2.75, 95% CI=1.80–4.19; BMI:≥30.0 kg/m2, OR=3.39, 95% CI=1.21–9.46. Females—BMI: 23.0–24.9 kg/m2, OR=1.67, 95% CI=1.42– 1.95; BMI: 25.0–26.9 kg/m2, OR=1.79, 95% CI=1.46–2.19; BMI: 27.0–29.9 kg/m2, OR=3.65, 95% CI=2.73–4.89; BMI: ≥30.0 kg/m2, OR=4.23, 95% CI=2.33–7.70). The other determinants of pre-HT were hyperlipidemia (Males: OR=1.25; Females: OR=1.43), and aging (by 10 years; Males: OR=1.12; Females: OR=1.48). Determinants of pre-HT in females were impaired glucose tolerance (OR=1.41, 95% CI=1.03–1.94), diabetes (OR=2.01, 95% CI=1.16–3.47) and a family history of HT in both parents (OR=1.90, 95% CI=1.38–2.62), whereas in males the only other predictor was alcohol drinking (OR=1.45, 95% CI=1.23–1.70). In conclusion, even subjects with a mild increase of BMI (23.0–24.9 kg/m2) had an increased risk of pre-HT in a Japanese population, and the level of BMI associated with pre-HT was lower than that in Western countries. Additionally, there were gender differences in the determinants of pre-HT.

Keywords:

prehypertension, Japanese, obesity, diabetes, cross-sectional study

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