title: Predicting failure to follow-up screened high blood pressure in Japan: a cohort study.
abstract: BACKGROUND
  This study aimed to determine the prevalence and predictors of working-age individuals who did not follow-up for possible hypertension that was detected in the population-based screening.
  
  
  METHODS
  We conducted a retrospective cohort study, using the database of health insurance claims and health checkups from several health insurance societies for employees in Japan. Screened participants aged ≥20 years, with possible hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) and without known antihypertensive treatment, were included. The outcome was lack of clinical follow-up for possible hypertension within 6 months of the latest screening. Multivariate logistic regression analysis was performed to identify predictors.
  
  
  RESULTS
  Among 17,173 participants (15,793 males and 1380 females) who were identified as possible hypertensives, 89.7 and 82.3% of them, respectively, did not consult physicians for screened possible hypertension. Predictors of no clinical follow-up for males included younger age, lower body mass index (BMI), lower hemoglobin A1c and milder hypertension. Predictors for females included younger age, lower BMI and being insured.
  
  
  CONCLUSIONS
  Approximately 80% of participants failed to consult physicians even with positive screening results. Younger individuals with lower BMI are at high risk of no clinical follow-up.
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kuriyama
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Tsujimura
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan.
authors.forename: Kikuko
authors.initials: K
authors.lastname: Miyazaki
authors.affiliation: School of Social Informatics, Aoyama Gakuin University, Sagamihara 252-5258, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Satoh
authors.affiliation: Department of Pharmaceutical Sciences, School of Pharmacy, International University and Health Welfare, Ohtawara 324-8501, Japan.
authors.forename: Shunya
authors.initials: S
authors.lastname: Ikeda
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000523:psychology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult
keywords: circulatory disease; health services; secondary and tertiary services