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Epidemiology and control of hypertension in Japan: a comparison with Western countries

Abstract

Based on data from national surveys, the prevalence of hypertension rests at 40–60% in Japan, the USA, and in European countries. This suggests there has been little progress in the prevention of hypertension in even high-income countries despite their well-functioning health systems. In particular, compared with the USA and European countries, the improvement in awareness, treatment, and control of hypertension has been relatively low in Japan. For example, the rates of hypertension awareness, treatment, and control were observed, respectively, in 60–70%, 50–60%, and 20–30% of Japanese compared with 80–90%, 70–80%, and 50–60% of US citizens in the years around 2015. The lower proportions in Japan might be explained by the slower progress in lowering the accepted thresholds for diagnosis of hypertension and initiation of treatment compared with Western countries; however, the underlying reasons for the differences warrant further study. The high prevalence (>40%) of uncontrolled hypertension in even high-income countries has major implications for the prevention of cardiovascular disease. Health policy and research on early control of high blood pressure at the individual and public health levels will contribute to decreases in the prevalence of hypertension. Furthermore, proactive treatment and strict adherence to intensified antihypertensive treatment guidelines will more effectively achieve targeted blood pressure levels. In this context, it is important to continue to carefully monitor and compare trends in hypertension across countries.

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Fig. 1: Trends in mean systolic blood pressure across age groups by sex from 1961 to 2016 in Japan.
Fig. 2: Trends in mean diastolic blood pressure across age groups by sex from 1961 to 2016 in Japan.
Fig. 3: Trends in the prevalence of hypertension across age groups by sex from 1980 to 2016 in Japan. Hypertension was defined as blood pressure ≥140/90 mmHg or the use of antihypertensive medication.
Fig. 4: Trends in the treatment rate of hypertension across age groups by sex from 1980 to 2016 in Japan. The treatment rate was calculated as the proportion of use of antihypertensive medication among patients with hypertension.
Fig. 5: Trends in the control rate of hypertension across age groups by sex from 1980 to 2016 in Japan. The control rate of hypertension was defined as the proportion of those with BP < 140/90 mmHg among hypertensive patients taking antihypertensive medication.
Fig. 6: Prevalence of hypertension and rates of awareness, treatment, and control in women aged 40–79 years in 12 high-income countries.
Fig. 7: Prevalence of hypertension and rates of awareness, treatment, and control in men aged 40–79 years in 12 high-income countries.

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Acknowledgements

We thank Eleanor Scharf, MSc(A), from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

Funding

The NIPPON DATA80/90/2010 were supported by Grants-in-Aid from the Ministry of Health, Labour and Welfare under the auspices of the Japanese Association for Cerebro-cardiovascular Disease Control; a Research Grant for Cardiovascular Diseases (7A-2) from the Ministry of Health, Labour and Welfare; and a Health and Labour Sciences Research Grant, Japan (Comprehensive Research on Aging and Health [H11-Chouju-046, H14-Chouju-003, H17-Chouju-012, H19-Chouju-Ippan-014] and Comprehensive Research on Life-Style Related Diseases including Cardiovascular Diseases and Diabetes Mellitus [H22-Junkankitou-Seishuu-Sitei-017, H25- Junkankitou-Seishuu-Sitei-022, H30-Junkankitou-Seishuu-Sitei-002]).

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Correspondence to Takashi Hisamatsu.

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Hisamatsu, T., Miura, K. Epidemiology and control of hypertension in Japan: a comparison with Western countries. J Hum Hypertens (2021). https://doi.org/10.1038/s41371-021-00534-3

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