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Visit-to-visit variability of blood pressure and cardiovascular events among the working-age population in Japan: findings from the Japan Epidemiology Collaboration on Occupational Health Study

Hypertension Research volume 44, pages 1017–1025 (2021)Cite this article

Abstract

Increased visit-to-visit variability (VVV) of blood pressure, which is calculated based on several readings, has been suggested to be a significant predictor of cardiovascular events and mortality, independent of mean blood pressure. This study examined associations between the VVV of systolic blood pressure (SBP) measured annually and cardiovascular disease (CVD) events among 72,617 Japanese subjects. Data were obtained from the Japan Epidemiology Collaboration on Occupational Health Study, which is an ongoing epidemiological survey of workers in Japan. VVV was calculated as the coefficient of variation of SBP readings from 2008 to 2011; information on fatal and nonfatal CVD events was collected from registries of specific outcomes between April 2012 and March 2019. A Cox proportional hazards model was applied to investigate associations after adjusting for mean SBP between 2008 and 2011 and covariates. During the 7-year follow-up period, there were 63 CVD fatalities and 314 CVD events (combining fatal and nonfatal events). The results showed that a one-standard deviation increase in VVV was associated with a significant increase in the risk of CVD mortality (hazard ratio [HR] = 1.42; 95% confidence interval [CI] = 1.32–1.54); those in the highest tertile had a 3.20 times (95% CI = 1.26–8.17) higher risk of CVD mortality than those in the lowest tertile. We found less pronounced associations regarding CVD events (HR = 1.08, 95% CI = 1.02–1.15). In conclusion, VVV was significantly associated with CVD mortality in our Japanese working population.

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References

  1. Lackland DT, Weber MA. Global burden of cardiovascular disease and stroke: hypertension at the core. Can J Cardiol. 2015;31:569–71. https://doi.org/10.1016/j.cjca.2015.01.009

    Article  PubMed  Google Scholar 

  2. Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990–2015. JAMA. 2017;317:165–82. https://doi.org/10.1001/jama.2016.19043

    Article  PubMed  Google Scholar 

  3. Hussein WF, Chang TI. Visit-to-visit variability of systolic blood pressure and cardiovascular disease. Curr Hypertens Rep. 2015;17:14 https://doi.org/10.1007/s11906-014-0527-8

    Article  CAS  PubMed  Google Scholar 

  4. Dolan E, O’Brien E. Is it daily, monthly, or yearly blood pressure variability that enhances cardiovascular risk? Curr Cardiol Rep. 2015;17:93 https://doi.org/10.1007/s11886-015-0649-x

    Article  PubMed  Google Scholar 

  5. Diaz KM, Tanner RM, Falzon L, Levitan EB, Reynolds KS, Daichi MP. Visit-to-visit variability of blood pressure and cardiovascular disease and all-cause mortality. Hypertension. 2014;64:965–82. https://doi.org/10.1161/HYPERTENSIONAHA.114.03903

    Article  CAS  PubMed  Google Scholar 

  6. Wang J, Shi X, Ma C, Zheng H, Xiao J, Bian H, et al. Visit-to-visit blood pressure variability is a risk factor for all-cause mortality and cardiovascular disease: a systematic review and meta-analysis. J Hypertension. 2017;35:10–17. https://doi.org/10.1097/HJH.0000000000001159

    Article  CAS  Google Scholar 

  7. Tai C, Sun Y, Dai N, Xu D, Chen W, Wang J, et al. Prognostic significance of visit-to-visit systolic blood pressure variability: a meta-analysis of 77,299 patients. J Clin Hypertension. 2015;17:107–15. https://doi.org/10.1111/jch.12484

    Article  Google Scholar 

  8. Parati G, Ochoa JE, Lombardi C, Bilo G. Assessment and management of blood-pressure variability. Nat Rev Cardiol. 2013;10:143–55. https://doi.org/10.1038/nrcardio.2013.1

    Article  PubMed  Google Scholar 

  9. Laurent S, Boutouyrie P. Visit-to-visit blood pressure variability: added ‘VALUE’ as a risk marker in low- and high-risk patients. Eur Heart J. 2018;39:2252–4. https://doi.org/10.1093/eurheartj/ehy011

    Article  PubMed  Google Scholar 

  10. Mancia G, Parati G. The role of blood pressure variability in end-organ damage. J Hypertension. 2003;21:S17.

    Article  CAS  Google Scholar 

  11. Di Iorio B, Pota A, Sirico ML, Torraca S, Di Micco L, Rubino R, et al. Blood pressure variability and outcomes in chronic kidney disease. Nephrol Dial Transpl. 2012;27:4404–10. https://doi.org/10.1093/ndt/gfs328

    Article  Google Scholar 

  12. Hsieh Y-T, Tu S-T, Cho T-J, Chang S-J, Chen J-F, Hsieh M-C. Visit-to-visit variability in blood pressure strongly predicts all-cause mortality in patients with type 2 diabetes: a 5·5-year prospective analysis. Eur J Clin Investig. 2012;42:245–53. https://doi.org/10.1111/j.1365-2362.2011.02574.x

    Article  Google Scholar 

  13. Mallamaci F, Minutolo R, Leonardis D, D’Arrigo G, Tripepi G, Rapisarda F, et al. Long-term visit-to-visit office blood pressure variability increases the risk of adverse cardiovascular outcomes in patients with chronic kidney disease. Kidney Int. 2013;84:381–9. https://doi.org/10.1038/ki.2013.132

    Article  CAS  PubMed  Google Scholar 

  14. McMullan CJ, Bakris GL, Phillips RA, Forman JP. Association of BP variability with mortality among African Americans with CKD. CJASN. 2013;8:731–8. https://doi.org/10.2215/CJN.10131012

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kostis JB, Sedjro JE, Cabrera J, Cosgrove NM, Pantazopoulos JS, Kostis WJ, et al. VisiT-to-visit Blood Pressure Variability and Cardiovascular Death in the Systolic Hypertension in the Elderly Program. J Clin Hypertension. 2014;16:34–40. https://doi.org/10.1111/jch.12230

    Article  Google Scholar 

  16. Lau K-K, Wong Y-K, Teo K-C, Chang RSK, Chan K-H, Hon SFK, et al. Long-term prognostic implications of visit-to-visit blood pressure variability in patients with ischemic stroke. Am J Hypertens. 2014;27:1486–94. https://doi.org/10.1093/ajh/hpu070

    Article  CAS  PubMed  Google Scholar 

  17. Gondo K, Miura S, Suematsu Y, Shiga Y, Kuwano T, Sugihara M, et al. Association between visit-to-visit variability in blood pressure and cardiovascular events in hypertensive patients after successful percutaneous coronary intervention. J Clin Med Res. 2015;7:545–50–550. https://doi.org/10.14740/jocmr.v7i7.2173

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chang TI, Tabada GH, Yang J, Tan TC, Go AS. Visit-to-visit variability of blood pressure and death, end-stage renal disease, and cardiovascular events in patients with chronic kidney disease. J Hypertension. 2016;34:244–52. https://doi.org/10.1097/HJH.0000000000000779

    Article  CAS  Google Scholar 

  19. Men X, Sun W, Fan F, Min Z, Huang X, Wang Y, et al. China stroke primary prevention trial: visit‐to‐visit systolic blood pressure variability is an independent predictor of primary stroke in hypertensive patients. J Am Heart Assoc. 2017;6:e004350. https://doi.org/10.1161/JAHA.116.004350

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wightman SS, Sainsbury CAR, Jones GC. Visit-to-visit HbA1c variability and systolic blood pressure (SBP) variability are significantly and additively associated with mortality in individuals with type 1 diabetes: an observational study. Diabetes Obes Metab. 2018;20:1014–7. https://doi.org/10.1111/dom.13193

    Article  CAS  PubMed  Google Scholar 

  21. Seo SM, Chung W-B, Choi IJ, Koh Y-S, Ihm S-H, Kim P-J, et al. Visit-to-visit variability of systolic blood pressure predicts all-cause mortality in patients received percutaneous coronary intervention with drug-eluting stents. Heart Vessels. 2018;33:489–97. https://doi.org/10.1007/s00380-017-1085-1

    Article  PubMed  Google Scholar 

  22. Suchy-Dicey AM, Wallace ER, Elkind MS, Aguilar M, Gottesman RF, Rice K, et al. Blood pressure variability and the risk of all-cause mortality, incident myocardial infarction, and incident stroke in the cardiovascular health study. Am J Hypertens. 2013;26:1210–7. https://doi.org/10.1093/ajh/hpt092

    Article  PubMed  PubMed Central  Google Scholar 

  23. Muntner P, Whittle J, Lynch AI, Colantonio LD, Simpson LM, Einhorn PT, et al. Visit-to-visit variability of blood pressure and coronary heart disease, stroke, heart failure, and mortality: a cohort study. Ann Intern Med. 2015;163:329 https://doi.org/10.7326/M14-2803

    Article  PubMed  PubMed Central  Google Scholar 

  24. Gosmanova EO, Mikkelsen MK, Molnar MZ, Lu JL, Yessayan LT, Kalantar-Zadeh K, et al. Association of systolic blood pressure variability with mortality, coronary heart disease, stroke, and renal disease. J Am Coll Cardiol. 2016;68:1375–86. https://doi.org/10.1016/j.jacc.2016.06.054

    Article  PubMed  PubMed Central  Google Scholar 

  25. Dolan Eamon O’BrienEoin. Blood pressure variability. Hypertension. 2010;56:179–81. https://doi.org/10.1161/HYPERTENSIONAHA.110.154708

    Article  CAS  PubMed  Google Scholar 

  26. Hu H, Nakagawa T, Honda T, Yamamoto S, Nanri A, Konishi M, et al., Metabolic Syndrome Over 4 Years Before the Onset of Cardiovascular Disease—Nested Case-Control Study—. Circ J. 2017. https://doi.org/10.1253/circj.CJ-17-0513

  27. Endo M, Inoue Y, Kuwahara K, Nishiura C, Hori A, Ogasawara T, et al. and Medically Certified Long-Term Sickness Absence Among Japanese Employees. Obesity. 2020;28:437–44. https://doi.org/10.1002/oby.22703

    Article  PubMed  Google Scholar 

  28. Hori A, Inoue Y, Kuwahara K, Kunugita N, Akter S, Nishiura C, et al. Smoking and long-term sick leave in a Japanese working population: Findings of the Japan Epidemiology Collaboration on Occupational Health Study. Nicotine Tob Res. 2021;23:135-42. https://doi.org/10.1093/ntr/ntz204.

    Article  PubMed  Google Scholar 

  29. Akter S, Nakagawa T, Honda T, Yamamoto S, Kuwahara K, Okazaki H, et al. Smoking, Smoking Cessation, and Risk of Mortality in a Japanese Working Population—Japan Epidemiology Collaboration on Occupational Health Study—. Circulation J. 2018;82:3005–12. https://doi.org/10.1253/circj.CJ-18-0404

    Article  Google Scholar 

  30. Hu H, Hori A, Nishiura C, Sasaki N, Okazaki H, Nakagawa T, et al. HbA1c, Blood Pressure, and Lipid Control in People with Diabetes: Japan Epidemiology Collaboration on Occupational Health Study. PLOS ONE. 2016;11:e0159071 https://doi.org/10.1371/journal.pone.0159071

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Diagnosis | ADA. https://www.diabetes.org/a1c/diagnosis. Accessed 13 June 2020

  32. Teramoto T, Sasaki J, Ishibashi S, Birou S, Daida H, Dohi S, et al. Japan Atherosclerosis Society. Executive summary of the Japan Atherosclerosis Society (JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan -2012 version. J Atheroscler Thromb. 2013;20:517–23. https://doi.org/10.5551/jat.15792

    Article  PubMed  Google Scholar 

  33. Parati G, Torlasco C, Pengo M, Bilo G, Ochoa JE. Blood pressure variability: its relevance for cardiovascular homeostasis and cardiovascular diseases. Hypertension Res. 2020;43:609–20. https://doi.org/10.1038/s41440-020-0421-5

    Article  Google Scholar 

  34. Dai L, Song L, Li X, Yang Y, Zheng X, Wu Y, et al. Association of visit-to-visit blood pressure variability with the risk of all-cause mortality and cardiovascular events in general population. J Clin Hypertension. 2018;20:280–8. https://doi.org/10.1111/jch.13192

    Article  CAS  Google Scholar 

  35. Pannier B, Thomas F, Hanon O, Czernichow S, Lemogne C, Simon T, et al. Individual 6-year systolic blood pressure change and impact on cardiovascular mortality in a French general population. J Hum Hypertens. 2016;30:18–23. https://doi.org/10.1038/jhh.2015.44

    Article  CAS  PubMed  Google Scholar 

  36. Muntner Paul, Shimbo Daichi, Tonelli Marcello, Reynolds Kristi, Arnett DonnaK, Oparil Suzanne. The relationship between visit-to-visit variability in systolic blood pressure and all-cause mortality in the general population. Hypertension. 2011;57:160–6. https://doi.org/10.1161/HYPERTENSIONAHA.110.162255

    Article  CAS  PubMed  Google Scholar 

  37. Choi S, Shin J, Choi SY, Sung KC, Ihm SH, Kim K, et al. Impact of Visit-to-visit Variability in Systolic Blood Pressure on Cardiovascular Outcomes in Korean national health insurance service—national sample cohort. Am J Hypertens. 2017;30:577–86. https://doi.org/10.1093/ajh/hpw157

    Article  CAS  PubMed  Google Scholar 

  38. Logue J, Murray HM, Welsh P, Shepherd J, Packard C, Macfarlane P, et al. Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation. Heart. 2011;97:564–8. https://doi.org/10.1136/hrt.2010.211201

    Article  PubMed  Google Scholar 

  39. Sattar N, Murray HM, Welsh P, Blauw GJ, Buckley BM, Cobbe S, et al. Group for the PS of P in the E at R (PROSPER) S. Are Markers of Inflammation More Strongly Associated with Risk for Fatal Than for Nonfatal Vascular Events? PLOS Med. 2009;6:e1000099 https://doi.org/10.1371/journal.pmed.1000099

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Grove JS, Reed DM, Yano K, Hwang L-J. Variability in Systolic Blood Pressure—A Risk Factor for Coronary Heart Disease? Am J Epidemiol. 1997;145:771–6. https://doi.org/10.1093/oxfordjournals.aje.a009169

    Article  CAS  PubMed  Google Scholar 

  41. Brickman AM, Reitz C, Luchsinger JA, Manly JJ, Schupf N, Muraskin J, et al. Long-term blood pressure fluctuation and cerebrovascular disease in an elderly cohort. Arch Neurol. 2010;67:564–9. https://doi.org/10.1001/archneurol.2010.70

    Article  PubMed  PubMed Central  Google Scholar 

  42. Shimbo D, Newman JD, Aragaki AK, LaMonte MJ, Bavry AA, Allison M, et al. Association between Annual Visit-to-Visit Blood Pressure Variability and Stroke in Postmenopausal Women: Data from the Women’s Health Initiative. Hypertension. 2012;60:625–30. https://doi.org/10.1161/HYPERTENSIONAHA.112.193094

    Article  CAS  PubMed  Google Scholar 

  43. Yinon L, Chen Y, Parvez F, Bangalore S, Islam T, Ahmed A, et al. A prospective study of variability in systolic blood pressure and mortality in a rural Bangladeshi population cohort. Preventive Med. 2013;57:807–12. https://doi.org/10.1016/j.ypmed.2013.09.006

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Toshiteru Okubo (Chairperson of Industrial Health Foundation, Director of Radiation Effects Research Foundation) for scientific advice on the conduct of the J-ECOH Study and Nobumi Katayama, Rika Osawa, Mika Shichishima, Haruka Miyake (National Center for Global Health and Medicine) for administrative support.

Funding

This study was financially supported by the Industrial Health Foundation (140202-01, 150903-01, 170301-01), the Japan Society for the Promotion of Science (JSPS KAKENHI JP16H05251) and the National Center for Global Health and Medicine (28-Shi-1206).

The J-ECOH study group

Seitaro Dohi5, Hiroko Okazaki5, Isamu Kabe14, Tohru Nakagawa3, Shuichiro Yamamoto3, Toru Honda3, Toshiaki Miyamoto6, Takeshi Kochi4, Masafumi Eguchi4, Taiki Shirasaka4, Isagi Mizuta10, Makoto Yamamoto10, Naoko Sasaki8, Takayuki Ogasawara8, Makiko Shimizu7, Naoki Gonmori7, Akihiko Uehara9, Kayo Kitahara15, Toshitaka Yokoya15, Ai Hori12, Chihiro Nishiura16, Teppei Imai17, Akiko Nishihara18, Kenji Fukasawa19, Kenya Yamamoto20, Reiko Kuroda20, Noritada Kato21, Masatoshi Kawashima22, Kentaro Tomita11, Chihiro Kinugawa23, Takafumi Totsuzaki24, Masashi Masuda25, Nobuaki Sakamoto26, Yohei Ohsaki26, Aki Tomizawa26, Satsue Nagahama27, Mayumi Ohtsu28, Motoki Endo29, Hiroshi Nakashima30, Masauyki Tatemichi31, Kota Fukai31, Megumi Kawashima32, Naoki Kunugita33, Tomofumi Sone34, Toshiteru Ohkubo35, Tetsuya Mizoue31, Yosuke Inoue1, Takako Miki1, Ami Fukunaga1, Shohei Yamamoto1, Maki Konishi1, Nobumi Katayama1, Rika Osawa1, Keisuke Kuwahara1,2

Author information

Authors and Affiliations

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

    Yosuke Inoue, Keisuke Kuwahara, Huan Hu, Tetsuya Mizoue, Tetsuya Mizoue, Yosuke Inoue, Takako Miki, Ami Fukunaga, Shohei Yamamoto, Maki Konishi, Nobumi Katayama & Rika Osawa

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

    Keisuke Kuwahara

  3. Hitach, Ltd., Ibaraki, Japan

    Shuichiro Yamamoto, Tohru Nakagawa, Toru Honda, Tohru Nakagawa, Shuichiro Yamamoto & Toru Honda

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

    Masafumi Eguchi, Takeshi Kochi & Taiki Shirasaka

  5. Mitsui Chemicals, Inc., Tokyo, Japan

    Hiroko Okazaki & Seitaro Dohi

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

    Toshiaki Miyamoto

  7. East Japan Works (Keihin), JFE Steel Corporation, Kanagawa, Japan

    Makiko Shimizu, Makiko Shimizu & Naoki Gonmori

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

    Takayuki Ogasawara & Naoko Sasaki

  9. Hidaka Tokushukai Hospital, Hokkaido, Japan

    Akihiko Uehara

  10. YAMAHA CORPORATION, Shizuoka, Japan

    Makoto Yamamoto & Isagi Mizuta

  11. Healthplant Co., Ltd., Tokyo, Japan

    Kentaro Tomita

  12. Department of Global Public Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan

    Ai Hori

  13. All Japan Labor Welfare Foundation, Tokyo, Japan

    Satsue Nagahama

  14. KUBOTA Corporation, Tokyo, Japan

    Isamu Kabe

  15. Mitsubishi Heavy Industries, Ltd., Tokyo, Japan

    Kayo Kitahara & Toshitaka Yokoya

  16. Tokyo Gas Co., Ltd., Tokyo, Japan

    Chihiro Nishiura

  17. OH Support, Tokyo, Japan

    Teppei Imai

  18. Azbil Corporation, Tokyo, Japan

    Akiko Nishihara

  19. Advantage Risk Management Co., Ltd., Tokyo, Japan

    Kenji Fukasawa

  20. The University of Tokyo, Tokyo, Japan

    Kenya Yamamoto & Reiko Kuroda

  21. Fuji Electric Co., Ltd., Tokyo, Japan

    Noritada Kato

  22. Central Japan Railway Company, Tokyo, Japan

    Masatoshi Kawashima

  23. Healc Co., Ltd., Tokyo, Japan

    Chihiro Kinugawa

  24. Uchisaiwaicho Medical Center, Mizuho Health Insurance Society, Tokyo, Japan

    Takafumi Totsuzaki

  25. AEON Co., Ltd., Chiba, Japan

    Masashi Masuda

  26. Health Design Inc., Tokyo, Japan

    Nobuaki Sakamoto, Yohei Ohsaki & Aki Tomizawa

  27. Tokyo Gas Customer Support Co., Ltd., Tokyo, Japan

    Satsue Nagahama

  28. Himawari LLC., Saitama, Japan

    Mayumi Ohtsu

  29. Juntendo University, Tokyo, Japan

    Motoki Endo

  30. National Defense Medical College, Saitama, Japan

    Hiroshi Nakashima

  31. Tokai University, Kanagawa, Japan

    Masauyki Tatemichi & Kota Fukai

  32. Shiga University of Medical Science, Shiga, Japan

    Megumi Kawashima

  33. University of Occupational and Environmental Health, Fukuoka, Japan

    Naoki Kunugita

  34. National Institute of Public Health, Tokyo, Japan

    Tomofumi Sone

  35. The Industrial Health Foundation, Tokyo, Japan

    Toshiteru Ohkubo

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  1. Yosuke Inoue
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  21. Seitaro Dohi
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Consortia

and the J-ECOH study group

  • Seitaro Dohi
  • , Hiroko Okazaki
  • , Isamu Kabe
  • , Tohru Nakagawa
  • , Shuichiro Yamamoto
  • , Toru Honda
  • , Toshiaki Miyamoto
  • , Takeshi Kochi
  • , Masafumi Eguchi
  • , Taiki Shirasaka
  • , Isagi Mizuta
  • , Makoto Yamamoto
  • , Naoko Sasaki
  • , Takayuki Ogasawara
  • , Makiko Shimizu
  • , Naoki Gonmori
  • , Akihiko Uehara
  • , Kayo Kitahara
  • , Toshitaka Yokoya
  • , Ai Hori
  • , Chihiro Nishiura
  • , Teppei Imai
  • , Akiko Nishihara
  • , Kenji Fukasawa
  • , Kenya Yamamoto
  • , Reiko Kuroda
  • , Noritada Kato
  • , Masatoshi Kawashima
  • , Kentaro Tomita
  • , Chihiro Kinugawa
  • , Takafumi Totsuzaki
  • , Masashi Masuda
  • , Nobuaki Sakamoto
  • , Yohei Ohsaki
  • , Aki Tomizawa
  • , Satsue Nagahama
  • , Mayumi Ohtsu
  • , Motoki Endo
  • , Hiroshi Nakashima
  • , Masauyki Tatemichi
  • , Kota Fukai
  • , Megumi Kawashima
  • , Naoki Kunugita
  • , Tomofumi Sone
  • , Toshiteru Ohkubo
  • , Tetsuya Mizoue
  • , Yosuke Inoue
  • , Takako Miki
  • , Ami Fukunaga
  • , Shohei Yamamoto
  • , Maki Konishi
  • , Nobumi Katayama
  •  & Rika Osawa

Corresponding author

Correspondence to Yosuke Inoue.

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Inoue, Y., Kuwahara, K., Hu, H. et al. Visit-to-visit variability of blood pressure and cardiovascular events among the working-age population in Japan: findings from the Japan Epidemiology Collaboration on Occupational Health Study. Hypertens Res 44, 1017–1025 (2021). https://doi.org/10.1038/s41440-021-00654-w

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