title: Association between control to target blood pressures and healthy lifestyle factors among Japanese hypertensive patients: longitudinal data analysis from Fukushima Research of Hypertension (FRESH).
abstract: OBJECTIVE
  To determine success rates in controlling target blood pressures longitudinally by measuring several factors, including lifestyle characteristics associated with uncontrolled blood pressures for target treatment goals.
  
  
  METHODS
  This prospective observational cohort study (September 2008-September 2010) collected information on blood pressure control status and healthy lifestyle factors listed in Breslow's seven health practices through medical records and self-administered questionnaires from 884 of the 1264 Japanese hypertensive patients initially registered in the FRESH study. Multivariate analysis adjusted for associated factors was performed to estimate the association between lifestyle change and "uncontrolled blood pressures" at the final follow-up survey.
  
  
  RESULTS
  Median age and proportion of men were 73 years and 39.1%, respectively. All survey failure rates were 37.6% among non-elderly patients (<65 years of age) without diabetes mellitus or chronic kidney disease, and 35.0% among patients with these diseases or myocardial infarction. Maintaining a healthy lifestyle was a protective factor against uncontrolled blood pressures in multivariate analysis. Obesity and smoking status were associated with uncontrolled blood pressures, and exercise frequency was borderline significance. The number of participants with healthy responses for these factors remained relatively low during follow up.
  
  
  CONCLUSIONS
  Our study revealed low rates of controlled blood pressures, especially in non-elderly patients without diabetes mellitus or chronic kidney disease, and patients with these diseases or myocardial infarction. Our data indicate the need to maintain a healthy lifestyle, in particular, ideal body weight and adequate exercise frequency, for better hypertension management according to treatment guidelines.
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan; Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan. Electronic address: yokokawa@pa3.so-net.ne.jp.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Yokokawa
authors.affiliation: Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan; Takemi Program in International Health, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Aya
authors.initials: A
authors.lastname: Goto
authors.affiliation: Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, Fukushima, Japan; Division of Nephrology, Hypertension, Endocrinology, and Diabetology/Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sanada
authors.affiliation: Division of Nephrology, Hypertension, Endocrinology, and Diabetology/Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Pathology, The University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Robin A
authors.initials: RA
authors.lastname: Felder
authors.affiliation: Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Jose
authors.affiliation: Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001794:Blood Pressure; D001795:Blood Pressure Determination; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy*; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000628:therapy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055105:Waist Circumference
keywords: Epidemiology; Guideline; Hypertension; Lifestyle; Management; Obesity