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


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.


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Correspondence to Kazuomi Kario.

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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).

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

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