title: Is location associated with high risk of hypertension? Shimane COHRE Study.
abstract: BACKGROUND
  There is growing evidence that residential environment is associated with hypertension. Recently, interest has also turned toward examining the possible influence of remoteness on hypertension. The aim of this study is to explore the effect of remoteness, the shortest path between the subject location and the population center, on hypertension prevalence in a rural region in Japan.
  
  
  METHODS
  We analyzed data from the Shimane COHRE Study conducted from 2006 to 2009 in rural mountainous regions of Japan. After excluding the missing data, we conducted a logistic regression analysis of the data for 1,348 individuals. Geographic information systems (GIS) were used in the network analysis. Network analysis determined the distance between subject's location and population center on road networks, and the distance was divided into tertiles: 0-26,685.8 m = close distance, 26,685.9 m-38,350.6 m = moderate distance, 38,350.7 m-68,070.1 m = far distance.
  
  
  RESULTS
  According to self-reported hypertension, the odds ratios for hypertension (taking antihypertensive medication or under treatment for hypertension without medication) were 1.44 (95% confidence interval (CI): 1.04-1.99) and 1.78 (95% CI: 1.29-2.46) in moderate and far distances, respectively, after adjustment for potential confounders. The odds ratios no longer remained significant after considering the measurement of blood pressure (BP) to define hypertension (taking antihypertensive medication or under treatment for hypertension without medication or BP ≥ 140/90 mm Hg for systolic BP (SBP)/diastolic BP (DBP)).
  
  
  CONCLUSIONS
  Our findings show that residential remoteness might be associated with a higher risk of hypertension in a rural region in Japan.
authors.affiliation: Center for Community based Health Research and Education (COHRE), Organization for the Promotion of Project Research, Shimane University, Izumo, Japan. thamano@med.shimane-u.ac.jp
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hamano
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Kimura
authors.forename: Miwako
authors.initials: M
authors.lastname: Takeda
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Toru
authors.initials: T
authors.lastname: Nabika
authors.forename: Kuninori
authors.initials: K
authors.lastname: Shiwaku
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012423:Rural Health