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.
Chobanian AV, Bakris GL, Black HR, et al: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206–1252.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R : Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–1913.
Greenlund KJ, Croft JB, Mensah GA : Prevalence of heart disease and stroke risk factors in persons with prehypertension in the United States, 1999-2000. Arch Intern Med 2004; 164: 2113–2118.
Choi KM, Park HS, Han JH, et al: Prevalence of prehypertension and hypertension in a Korean population: Korean National Health and Nutrition Survey 2001. J Hypertens 2006; 24: 1515–1521.
Grotto I, Grossman E, Huerta M, Sharabi Y : Prevalence of prehypertension and associated cardiovascular risk profiles among young Israeli adults. Hypertension 2006; 48: 254–259.
Tsai PS, Ke TL, Huang CJ, et al: Prevalence and determinants of prehypertension status in the Taiwanese general population. J Hypertens 2005; 23: 1355–1360.
Choo V : WHO reassesses appropriate body-mass index for Asian populations. Lancet 2002; 360: 235.
Ishikawa S, Gotoh T, Nago N, Kayaba K : The Jichi Medical School (JMS) Cohort Study: design, baseline data and standardized mortality ratios. J Epidemiol 2002; 12: 408–417.
WHO/IASO/IOTF ( ed): The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. Melbourne, Health Communications Australia Pty Ltd, 2000.
Kanauchi M, Kanauchi K, Hashimoto T, Saito Y : Metabolic syndrome and new category ‘pre-hypertension’ in a Japanese population. Curr Med Res Opin 2004; 20: 1365–1370.
Wang W, Lee ET, Fabsitz RR, et al: A longitudinal study of hypertension risk factors and their relation to cardiovascular disease: the Strong Heart Study. Hypertension 2006; 47: 403–409.
Mainous AG 3rd, Everett CJ, Liszka H, King DE, Egan BM : Prehypertension and mortality in a nationally representative cohort. Am J Cardiol 2004; 94: 1496–1500.
Washio M, Tokunaga S, Yoshimasu K, et al: Role of prehypertension in the development of coronary atherosclerosis in Japan. J Epidemiol 2004; 14: 57–62.
Reckelhoff JF, Fortepiani LA : Novel mechanisms responsible for postmenopausal hypertension. Hypertension 2004; 43: 918–923.
Pelzer T, de Jager T, Muck J, Stimpel M, Neyses L : Oestrogen action on the myocardium in vivo: specific and permissive for angiotensin-converting enzyme inhibition. J Hypertens 2002; 20: 1001–1006.
Rappelli A : Hypertension and obesity after the menopause. J Hypertens Suppl 2002; 20: S26–S28.
Esler M, Rumantir M, Wiesner G, Kaye D, Hastings J, Lambert G : Sympathetic nervous system and insulin resistance: from obesity to diabetes. Am J Hypertens 2001; 14: 304S–309S.
Ohmori S, Kiyohara Y, Kato I, et al: Alcohol intake and future incidence of hypertension in a general Japanese population: the Hisayama study. Alcohol Clin Exp Res 2002; 26: 1010–1016.
Nanchahal K, Ashton WD, Wood DA : Alcohol consumption, metabolic cardiovascular risk factors and hypertension in women. Int J Epidemiol 2000; 29: 57–64.
Lauer RM, Burns TL, Clarke WR, Mahoney LT : Childhood predictors of future blood pressure. Hypertension 1991; 18: I74–I81.
Hahn WK, Brooks JA, Hite R : Blood pressure norms for healthy young adults: relation to sex, age, and reported parental hypertension. Res Nurs Health 1989; 12: 53–56.
Goldstein IB, Shapiro D, Guthrie D : Ambulatory blood pressure and family history of hypertension in healthy men and women. Am J Hypertens 2006; 19: 486–491.
Lascaux-Lefebvre V, Ruidavets J, Arveiler D, et al: Influence of parental history of hypertension on blood pressure. J Hum Hypertens 1999; 13: 631–636.
Japanese Society of Hypertension: Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2004). Hypertension Res 2006; 29 ( Suppl): S1–S105.
About this article
Cite this article
Ishikawa, Y., Ishikawa, J., Ishikawa, S. et al. Prevalence and Determinants of Prehypertension in a Japanese General Population: The Jichi Medical School Cohort Study. Hypertens Res 31, 1323–1330 (2008). https://doi.org/10.1291/hypres.31.1323
- cross-sectional study
Catheter-based ultrasound renal denervation in patients with resistant hypertension: the randomized, controlled REQUIRE trial
Hypertension Research (2021)
Impact of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines on the Next Blood Pressure Guidelines in Asia
Current Hypertension Reports (2019)
Current Hypertension Reports (2019)
Hypertension Research (2015)
Journal of Human Hypertension (2013)