title: Relationship between outpatient visit frequency and hypertension control: a 9-year occupational cohort study.
abstract: The purpose of this study was to investigate the relationship between the frequency of outpatient visits and hypertension control as determined from health insurance records. This 9-year cohort study in Japan was based on 518 participants with hypertension who underwent health checkups in 2004. Participants were aged 35-56 years and none had a history of cardiovascular or cerebrovascular disease. All were covered by the same employee health insurer. Mean annual outpatient visit days at a hospital/clinic during the 9-year period were classified within four quartiles (Q1, Q2, Q3, Q4). Uncontrolled hypertension was defined as a systolic blood pressure (BP) ⩾140 mm Hg and a diastolic BP ⩾90 mm Hg. Logistic regression analysis was used to estimate the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of uncontrolled hypertension in groups Q1, Q2 and Q3 vs. Q4. The median (25th-75th percentile) annual outpatient visit days was 9.4 (4.0-15.5). Uncontrolled hypertension was observed in 62.4% of the participants in 2013. The multivariable-adjusted ORs and 95% CIs for uncontrolled hypertension in Q1, Q2 and Q3 vs. Q4 were 4.03 (2.28-7.12), 1.67 (0.99-2.81) and 1.44 (0.86-2.41), respectively. Uncontrolled hypertension increased significantly as the number of outpatient visits decreased (P for trend <0.001). This tendency was maintained when participants taking antihypertensive agents at baseline were excluded. Our study showed an inverse relationship between outpatient visit frequency and uncontrolled hypertension.
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan.|Occupational Health Care Office, Heiwado Co., Ltd., Shiga, Japan.
authors.forename: Azusa
authors.initials: A
authors.lastname: Shima
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan.|Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Tatsumi
authors.affiliation: Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishizaki
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Godai
authors.affiliation: Occupational Health Care Office, Heiwado Co., Ltd., Shiga, Japan.|Department of Health Policy and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kawatsu
authors.affiliation: Preventive Medicine and Public Health, Keio University, Tokyo, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Department of Health and Nutrition, Kyoto Koka Women's University, Kyoto, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Nishikawa
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Morimoto
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Morino
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Miyamatsu
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D015331:Cohort Studies; D019468:Disease Management; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents