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Diagnosis and control of hypertension in the elderly populations of Japan and the United States

Figure 2. Distribution of measured systolic blood pressure (SBP) by hypertensive state.

different drug regimens (Singer, Izhar and Black, 2002), drug titration, patient compliance
with medication (Cushman and Basile, 2006), physician compliance with recommended

blood pressure levels (Oliveria, Lapuerta and McCarthy et al., 2002), or resistance of
hypertension to treatment (Singer, Izhar and Black, 2002).

4. Discussion

This study examined differences in hypertensive states and the levels of blood pressure
among older persons in Japan and the U.S. Older Japanese persons have more hyperten-
sion arising from higher levels of both systolic and diastolic blood pressure. We find Japan
has more undiagnosed hypertension and less controlled hypertension among those who
take medications. The lower level of diagnosis, treatment, and effective control of blood
pressure in Japan is somewhat surprising given the impressively high life expectancy and
universal health care. However, previous studies in Japan had indicated that 80% to 90%
of hypertensives aged 30 to 40 were not treated (Ministry of Health, Labor and Welfare,

2009). Other studies in Japan have reported a lack of control for about half of those taking
antihypertensive medication (Hozawa, Ohkubo, Kikuya et al., 2002; Ohkubo, Obara, and

Funahashi, 2004). There are two sources of published data on measured hypertension in
the Japanese population 70 years of age and older. Both of these indicate lower levels of
measured hypertension than found here. The Fifth Japanese National Survey of Circulato-
ry Disorders in 2000 reports 67% of those aged 70 and older have measured hypertension

(Ministry of Health, Labor and Welfare, 2009); in the National Health and Nutrition Sur-

vey (NHNS) for 2006 the figure is 55% (Ministry of Health, Labor and Welfare, 2009); we
report 74% among those aged over 68. We should note that in the NUJLSOA, blood pres-

International Journal of Population Studies | 2015, Volume 1, Issue 1 24