Blood pressure control and treatment status at 1 year after the first health check-up in individuals with observed referral-level blood pressure

Hypertension is a major risk factor for cardiovascular diseases. This study aimed to clarify blood pressure (BP) management after the health check-up among individuals with grade II or severer hypertension, defined as systolic BP (SBP) ≥ 160 mmHg or diastolic BP (DBP) ≥ 100 mmHg in Japan. This retrospective study used the JMDC Claims Database (2005-2022) in Japan, including 63,785 individuals (median age 50 years; men 75.3%) with BP above grade II hypertension thresholds during the health check-up. We evaluated the BP control and treatment status at 1 year after the first check-up. Poisson regression with robust error variance analyses were performed to assess the association with grade II or severer hypertension at 1 year after the first check-up. Notably, 45.4% continued to have grade II or severer hypertension at 1 year after the first check-up. Among the individuals, 54.5% visited a medical institution within 3 months after undergoing a health check-up, only 23.6% were prescribed antihypertensive medications at 1 year after the first check-up. Factors associated with sustained grade II or severer hypertension included per 5 years lower in age (relative risk [RR]: 1.01, 95% confidence interval [CI]: 1.01-1.02), obesity (RR: 1.04, 95% CI: 1.02-1.06), and skipping breakfast ≥3 times per week (RR: 1.06, 95% CI: 1.04-1.08). Despite strong recommendations for medical consultation, BP control remains inadequate among individuals with grade II or severer hypertension, nearly half of individuals had SBP ≥ 160 mmHg or DBP ≥ 100 mmHg at 1 year after the first check-up in our study. The findings highlight the need for prompt follow-up, particularly among younger adults and those with unhealthy lifestyles.