No abstract

Background and Objective: Hypertension (HT) is one of the most important risk factors for cardiovascular disease; however, about 30% of hypertensive subjects in Japan are estimated to be left unaware-untreated. The authors studied clinical characteristics of unaware-untreated HT (UAUT-HT) subjects using data of a large health checkup and public medical insurance. Methods:In a Japanese city, 54,287 persons underwent a public health checkup for 40-74 years old in 2017. The information on their medical diagnosis were obtained from the national medical insurance system. Among all examinees, 28,167 (51.9%) were hypertensive (systolic blood pressure (SBP) > = 140 mmHg, diastolic BP (DBP) > = 90 mmHg, took antihypertensive agents, or had diagnosis of hypertension on the national medical insurance system). If subjects took antihypertensive agents or had HT diagnosis, they were considered as aware HT. If not, the subjects were considered as UAUT-HT. Demographic factors were compared between UAUT-HT and aware HT.Results: Of all HT subjects, 13,426 (47.7%) were SBP < 140 and DBP < 90 mmHg (well controlled) under treatment, 6,727 (23.9%) were BP > = 140 /90 mmHg (poorly controlled) under treatment, 3,147 (11.2%) were aware of HT but untreated, and 4,867 (17.3%) were UAUT-HT. Compared with aware HT, the UAUT-HT group was younger (age < 65y; UAUT-HT, 25%; aware HT, 16%), leaner (BMI> = 25; 27%, 36%), had more female (57%, 52%), more subjects without proteinuria (82%, 75%), higher SBP and DBP (SBP, 148 ± 11, 136 ± 16; DBP, 85 ± 10, 78 ± 11), lower fasting blood glucose (99 ± 34, 103 ± 23, mg/ dl), lower HbA1c (5.8 ± 0.7, 5.9 ± 0.8, %), higher LDL-cholesterol (133 ± 33, 120 ± 30, mg/dl), lower serum uric acid (5.2 ± 1.3, 5.4 ± 1.3, mg/dl), and higher eGFR (71 ± 13, 67 ± 14, ml/min/1.73^2). These were all significant differences (p < 0.01). Conclusion:These results suggest that the UAUT-HT subjects are young and have favorable health condition except for high BP and LDL-cholesterol level compared with aware HT. In such relatively healthy subjects, blood pressure may not be paid enough attention to consult and treat. Social enlightenment on HT for broader population may be needed.