Diagnosis and control of hypertension in the elderly populations of Japan and the United States

Abstract

The Japanese have the highest life expectancy in the world while the United States (U.S.) has relatively low life expectancy. Furthermore, the Americans have relatively poorer health compared to the Japanese. Examination of the treatment of specific conditions such as hypertension in these two countries may provide insights into how the health care system contributes to the relative health in these two countries. In this study, we focus on the treatment of hypertension, as this is the most common condition requiring therapeutic interventions in seniors. This study examines hypertension diagnoses and controls in nationally representative samples of the older populations (68 years-or-older) of Japan and the U.S. Data come from two nationally representative samples: the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA) (n=2,309) and the U.S. Health and Retirement (HRS) Study (n=3,517). The overall prevalence of hypertension is higher in Japan than the U.S. Undiagnosed hypertension is about four times higher in Japan than in the U.S., while the control of blood pressure is more than four times higher in the U.S. than in Japan. Thus, the use of antihypertensive medication is much more frequent and more effective in the U.S. The medical care system seems to be more effective in controlling hypertension in the U.S. than in Japan. This may be due to the more aggressive diagnosis and treatment of hypertension in the U.S.

Examining the prevalence, correlates and inequalities of undiagnosed hypertension in Nepal: a population-based cross-sectional study

“…Findings from studies conducted in countries with more developed healthcare systems and advanced screening processes such as Japan, Korea, England, Ireland, Egypt, Brazil and the USA were also found to have lower levels of undiagnosed hypertension than Nepal as found in this study. [40][41][42][43][44][45][46] The prevalence of undiagnosed hypertension in Nepal is relatively closer with that of Bangladesh. 19 This might be due to the less advanced healthcare systems of these two countries with both countries displaying low Health Care Index values.…”

Blood Metabolite Signatures of Metabolic Syndrome in Two Cross-Cultural Older Adult Cohorts

“…Large, longitudinal studies including the Honolulu-Asia Aging Study (HAAS) [6] and the International Population Study on Macronutrients and Blood Pressure (INTERMAP) Study [7] have explored factors that affect metabolic risk as well as how cardiovascular risk factors may affect other health outcomes including dementia and cognitive impairment across Japanese, American, and other populations. Broadly, these studies have found a higher prevalence of metabolic diseases and conditions in the U.S compared to Japan, including higher body mass index (BMI) [8], diabetes [9], atherosclerosis [10], cardiovascular disease mortality [11], as well as higher blood cholesterol levels [12] and a differing prevalence of hypertension [13,14]. Lifestyle factors play key roles in mediating these differences [15].…”