Achievement Status toward Goal Blood Pressure Levels and Healthy Lifestyles among Japanese Hypertensive Patients; Cross-sectional Survey Results from Fukushima Research of Hypertension (FRESH)

OBJECTIVE: To determine success rates in achieving goal blood pressures by measuring several factors including lifestyle characteristics associated with therapeutic failures for target treatment goals. METHODS AND PATIENTS: This prospective observational cohort study (September 2008 to September 2010) collected information on blood pressure control status and healthy lifestyle practices listed in Belloc and Breslow's seven health practices through medical records and patients' self-administrated questionnaires among 1,264 of 1,753 Japanese hypertensive patients initially registered. Multivariate analysis was performed to estimate the association between lifestyle practices and "therapeutic failures" at the baseline survey. RESULTS: Median age and proportion of males were 74 years and 41.1%. Therapeutic failures were 68.3% in non-elderly patients (<65 years of age) without diabetes mellitus or chronic kidney disease, 62.6% in patients with these diseases or those who had myocardial infarction, 41.8% in elderly patients (≥65 years of age) without these diseases and only 28.6% in patients with cerebrovascular disease. The total number of healthy lifestyle items was inversely associated with therapeutic failures in multivariate analysis among both sexes. CONCLUSION: The study revealed low achievement rates toward treatment goals, especially non-elderly patients without diabetes mellitus or chronic kidney disease, and patients with these diseases or those who had myocardial infarction. Our data indicated the necessity to improve physicians' awareness of the management of hypertension according to treatment guidelines and the importance of a healthy lifestyle to maintain goal blood pressure levels.