title: Association between social participation and hypertension among older people in Japan: the JAGES Study.
abstract: Hypertension is an important risk factor for cardiovascular disease, the leading cause of mortality in the world. Although previous studies have focused on individual-level behavioral risk factors associated with hypertension, there has been little research on how interacting with others, that is social participation, affects hypertension. To address this research gap, this study examined the association between social participation and hypertension in Japan, a country with a high prevalence of hypertension possibly linked to rapid population aging. Data were used from 4582 participants aged more than 65 years who participated in the Japan Gerontological Evaluation Survey (JAGES) with blood pressure data collected during a health check-up. The frequency of participation in vertical organizations (characterized by hierarchical relationships) and horizontal organizations (characterized by non-hierarchical, egalitarian relationships) was measured by a questionnaire. In a Poisson regression analysis, participation in vertical organizations was not associated with hypertension, whereas participation in horizontal organizations at least once a month was inversely associated with hypertension (prevalence ratio: 0.941). This association remained significant after adjusting for social support variables, although further adjustment for health behaviors attenuated the association. As the frequency of going out and average time spent walking were both associated with hypertension, physical activity may be a possible pathway that connects social participation and hypertension. The results of this study suggest that expanding social participation programs, especially those involving horizontal organizations, may be one way to promote better health among older people in Japan.
authors.affiliation: Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Yazawa
authors.affiliation: Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.|The Stockholm Center for Health and Social Change (Scohost), Södertörn University, Stockholm, Sweden.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stickley
authors.affiliation: Department of Human Sciences, School of Law and Letters, University of the Ryukyus, Okinawa, Japan.
authors.forename: Kokoro
authors.initials: K
authors.lastname: Shirai
authors.affiliation: Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Airi
authors.initials: A
authors.lastname: Amemiya
authors.affiliation: Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan.|Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kondo
authors.affiliation: Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Chiho
authors.initials: C
authors.lastname: Watanabe
authors.affiliation: Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.|Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kondo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D015444:Exercise; D005260:Female; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000523:psychology; D007564:Japan / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D058992:Social Participation; D016138:Walking