Ps-bpp05-2: treatment status of hypertension detected in health checkups: an observational study of japanese employees

Objective: Despite the clear evidence for lowering blood pressure in hypertensive patients, control rates are insufficient, especially among younger adults. The first step in improving control rates is patient behavior to visit an outpatient when hypertension is detected at annual health checkups. The present study aims to explore the demographic and lifestyle characteristics related to the outpatient visits among employees who had untreated grade II or grade III hypertension. Design and method: An observational study was conducted using the data of annual health checkups and medical claims from 2012 to 2020 in an employee's health insurance society in Japan. We included participants if they were 20–69 years of age and had untreated grade II or grade III hypertension (blood pressure (BP)> = 160/100 mmHg and no use of BP-lowering medications) at the time of health checkups (first measurement) and had BP > = 140/90 mmHg in the previous years, to exclude transient hypertension. If more than one year of data met the criteria, the data from the first year was used to remove duplicates of individuals. Multilevel logistic regression with random effects of health checkup years was used to estimate odds ratios (ORs) with 95% confidence intervals (95%CIs) of demographics and lifestyle characteristics for newly outpatient visits (completing a clinic visit within 6 months). Results: The number of employees who had annual health checkups was approximately 10,000, and the number of applicable individuals for the present study was approximately 6% each year. In 2013–2020, after duplicate removal, 993 individuals (mean age 51.5 years, 63% women) had untreated grade II or grade III hypertension. Of these, 200 (20%) had an outpatient visit within 6 months. Among the independent variables, diabetes (ORs and 95% CI: 1.97, 1.19–3.26), body mass index (per 1-BMI increment: 1.04, 1.00–1.08), age (per 1-year increment: 1.03, 1.00–1.05), and systolic BP (per 1- mmHg increment: 1.04, 1.03–1.06) had significantly positive ORs for outpatient visits. The results of a similar analysis for antihypertensive medication after outpatient visits, no other factors besides systolic BP were associated with medication. Conclusion: Only 20% of individuals who detected grade II or grade III hypertension in annual health checkups visited outpatients within 6 months. The present findings suggested the necessity for more aggressive promotion of outpatient visits to younger adults without chronic illnesses or obesity.