title: Achievement of Target Blood Pressure Levels among Japanese Workers with Hypertension and Healthy Lifestyle Characteristics Associated with Therapeutic Failure.
abstract: BACKGROUND
  Few studies have examined Japanese with regard to the achievement rates for target blood pressure levels, or the relationship between these rates and healthy lifestyle characteristics in patients with hypertension as defined by the newly established hypertension management guidelines (JSH2014). The aim of this study was to elucidate achievement rates and examine healthy lifestyle characteristics associated with achievement status among Japanese.
  
  
  METHODS
  This cross-sectional study, conducted in January-December 2012, examined blood pressure control and healthy lifestyle characteristics in 8,001 Japanese workers with hypertension (mean age, 57.0 years; 78.8% were men) who participated in a workplace health checkup. Data were collected from workplace medical checkup records and participants' self-administered questionnaires. We divided into 5 groups [G1; young, middle-aged, and early-phase elderly patients (65-74 years old) without diabetes mellitus or chronic kidney disease (CKD) (<140/90 mmHg), G2; late-phase elderly patients (≥75 years old) without diabetes mellitus or CKD (<150/90 mmHg), G3; diabetic patients (<130/80 mmHg), G4; patients with CKD (<130/80 mmHg), and G5; patients with cerebrovascular and/or coronary artery diseases (<140/90 mmHg)] according to JSH2014. And then, achievement rates were calculated in each group. Multivariate analysis identified healthy lifestyle characteristics associated with "therapeutic failure" of target blood pressure.
  
  
  RESULTS
  Target blood pressures were achieved by 60.2% of young, middle-aged, and early-phase elderly patients (G1), 71.4% of late-phase elderly patients (G2), 30.5% of diabetic patients (G3), 33.4% of those with chronic kidney disease (G4), and 66.0% of those with cerebrovascular and/or coronary artery diseases (G5). A body mass index of 18.5-24.9 and non-daily alcohol consumption were protective factors, and adequate sleep was found to contribute to therapeutic success.
  
  
  CONCLUSIONS
  We found low achievement rates for treatment goals among patients with chronic kidney disease and diabetes mellitus. Maintaining an ideal body weight and adequate alcohol consumption may help with blood pressure control. Lifestyle modification may be necessary for better management of hypertension.
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan; Tokorozawa Medical Clinic, Tokorozawa City, Saitama, Japan.
authors.forename: Nagako
authors.initials: N
authors.lastname: Kudo
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Yokokawa
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukuda
authors.affiliation: Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, Aizubange Town, Fukushima, Japan; Department of Tumor and Host Bioscience, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sanada
authors.affiliation: Department of Health Screening, Tokyo Health Service Association, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Miwa
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Hisaoka
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Isonuma
mesh_terms: D000124:Achievement; D000368:Aged; D000428:Alcohol Drinking / Q000503:physiopathology; D044466:Asian People; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology; D017211:Treatment Failure