Relationships between Lifestyle, Living Environments, and Incidence of Hypertension in Japan (in Men): Based on Participant’s Data from the Nationwide Medical Check-Up

Abstract

This study aims to investigate factors that contribute to the differences in incidence of hypertension between different regions in Japan, by accounting for not only individual lifestyles, but also their living environments. The target participants of this survey were individuals who received medical treatment for hypertension, as well as hypertension patients who have not received any treatment. The objective variable for analysis was the incidence of hypertension as data aggregated per prefecture. We used data (in men) including obesity, salt intake, vegetable intake, habitual alcohol consumption, habitual smoking, and number of steps walked per day. The variables within living environment included number of rail stations, standard/light vehicle usage, and slope of habitable land. In addition, we analyzed data for the variables related to medical environment including, participation rate in medical check-ups and number of hospitals. We performed multiple stepwise regression analyses to elucidate the correlation of these variables by using hypertension incidence as the objective variable. Hypertension incidence showed a significant negative correlation with walking and medical check-ups, and a significant positive correlation with light-vehicle usage and slope. Between the number of steps and variables related to the living environment, number of rail stations showed a significant positive correlation, while, standard- and light-vehicle usage showed significant negative correlation. Moreover, with stepwise multiple regression analysis, walking showed the strongest effect. The differences in daily walking based on living environment were associated with the disparities in the hypertension incidence in Japan.

Hilly environment and physical activity among community-dwelling older adults in Japan: a cross-sectional study

“…Hilly environments are a typical feature of Japanese cities and suburbs,11 with 72.8% of the country’s land area being mountainous or hilly and only 14% considered flat (eg, less than 3% slope) 12. Previous studies have reported that a hilly environment was positively associated with hypertension13 and weight gain 14. By contrast, a hilly environment was reported to be negatively associated with diabetes 15 16.…”

Does Hypertension Knowledge Influence Levels of Physical Activity in Hypertensive Patients From a Southern Brazilian Community?

“…14 These results became relevant since the number of daily steps seems to be inversely correlated with the incidence of HP and, possibly, other cardiovascular outcomes. 14,15 Hypertensive patients with low level PA are a concern, since insufficient PA represents the fourth risk factor for mortality worldwide, with more than 3.2 million deaths per year and 32.1 million quality-adjusted life years (QALYs). 33 Therefore, the benefits of regular PA are significant for individuals with cardiovascular risk factors, such as HP, as it can reduce mortality by up to 16%.…”

“…8,9 Some studies have shown that walking between 10,000 and 13,000 steps/day contributes to blood pressure lowering. [10][11][12][13] Thus, increases in PA are an important strategy in the prevention and treatment of HP, 7,[13][14][15] although there is still a lack of studies investigating the effect of the use of pedometer-assessed PA in hypertensive patients.…”

Assessing the Impact of a Hilly Environment on Depressive Symptoms among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

“…To date, several studies have shown associations between slope and health outcomes. Using an ecological study design, Oka et al found that the slope of habitable land is positively associated with the incidence rate of hypertension based on the data from the nationwide medical checkups in Japan [ 35 ]. The village with the highest standardized mortality ratio of suicide had the highest slope of habitable land (15.4°) [ 36 ].…”