BACKGROUND: Although the age-adjusted incidence and mortality of cancer and cardiovascular disease (CVD) have been decreasing steadily in Japan, both diseases remain major contributors to morbidity and mortality along with the aging society. Herein, we aim to provide a prescription of 10 health tips for long and healthy life named the "Lifelong Health Support 10 (LHS10)." METHOD: The LHS10 was developed by the preventive medicine specialists at the National Cerebral and Cardiovascular Center in Suita, where it has been used for health guidance to prevent CVD, cancer, and cognitive decline in addition to their major risk factors such as hypertension, diabetes, and obesity. It consisted of the lifestyle modification recommendations of the 2014 Japanese Society of Hypertension guidelines and the 2017 Japan Atherosclerosis Society Guidelines for preventing atherosclerotic CVD. Further, it came in line with other international lifestyle modification guidelines. In this narrative review, we summarized the results of several Japanese epidemiological studies investigating the association between the LHS10 items and the risk of cancer, CVD, and other chronic diseases including dementia, diabetes, and chronic kidney disease. RESULTS: The LHS10 included avoiding smoking and secondhand smoke exposure, engaging in physical activity, refraining from excessive alcohol drinking, reducing fried foods and sugary soft drinks, cutting salt in food, consuming more vegetables, fruits, fish, soy foods, and fibers, and maintaining proper body weight. All items of the LHS10 were shown to reduce the risk of cancer, CVD, and other chronic diseases. CONCLUSIONS The LHS10 can be a helpful tool for health guidance.
Cardiovascular Diseases/prevention & control* ; Humans ; Hypertension/prevention & control* ; Japan/epidemiology* ; Life Style ; Neoplasms ; Prescriptions ; Risk Factors

Risk factors for hypertension consist of lifestyle and genetic factors. Family history and twin studies have yielded heritability estimates of BP in the range of 34-67%. The most recent paper of BP GWAS has explained about 20% of the population variation of BP. An overestimation of heritability may have occurred in twin studies due to violations of shared environment assumptions, poor phenotyping practices in control cohorts, failure to account for epistasis, gene-gene and gene-environment interactions, and other non-genetic sources of phenotype modulation that are suspected to lead to underestimations of heritability in GWAS. The recommendations of hypertension guidelines in major countries consist of the following elements: weight reduction, a healthy diet, dietary sodium reduction, increasing physical activity, quitting smoking, and moderate alcohol consumption. The hypertension guidelines are mostly the same for each country or region, beyond race and culture. In this review, we summarize gene-environmental interactions associated with hypertension by describing lifestyle modifications according to the hypertension guidelines. In the era of precision medicine, clinicians who are responsible for hypertension management should consider the gene-environment interactions along with the appropriate lifestyle components toward the prevention and treatment of hypertension. We briefly reviewed the interaction of genetic and environmental factors along the constituent elements of hypertension guidelines, but a sufficient amount of evidence has not yet accumulated, and the results of genetic factors often differed in each study.
Gene-Environment Interaction ; Humans ; Hypertension ; epidemiology ; genetics ; prevention & control ; therapy ; Life Style ; Practice Guidelines as Topic ; Precision Medicine ; standards ; Risk Factors

Objective: To understand the current situation on management of diabetes mellitus patients aged 35 and above in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases, in China. Methods: Local residents, aged 18 years and above were randomly selected by a complex, multistage, probability sampling method. Face-to-face questionnaire survey was carried out between November and December 2016. Rates regarding prevalence, treatment and management of diabetes were calculated, and influencing factors of diabetes were analyzed by using the non-conditional logistic regression model. Results: A total of 3 213 residents aged ≥35 years were included in this study, of which 11.48% (369/3 213) reported that they had ever been informed by a doctor or other health worker that their blood sugar level was high or being diabetic. The rate of self-reported treatment among the diabetic patients was 83.20% (307/369). Rates on overall management and standardized management were 69.92% (258/369) and 53.66% (198/369), respectively. Higher rates were seen in residents aged 55 to 64 years, 76.32% for overall management and 59.65% for standardized management. Through multiple logistic regression analysis, we found that standardized management for diabetes was much higher in the Demonstration Areas located in the eastern areas (OR=2.942, 95%CI: 1.547-5.594), or patients with characteristics including high implementation score (OR=3.499, 95%CI: 1.865-6.563), already signed family doctors (OR=5.661, 95%CI: 3.237-9.899), or without hypertension (OR=1.717, 95%CI: 1.010- 2.920). Residents who were living in the first and second batch areas of implementation or responding to the NCDs with positive attitude were more likely to accept standardized management. Conclusion: Prevention and management programs on diabetes had met the requirements set for the Demonstration Areas which had promoted the specific implementation and further development of standardized management on diabetes.
Adult ; Aged ; Asian People/statistics & numerical data* ; China/epidemiology* ; Diabetes Mellitus/therapy* ; Humans ; Hypertension/epidemiology* ; Logistic Models ; Middle Aged ; Noncommunicable Diseases/prevention & control* ; Population Surveillance ; Prevalence ; Risk Factors ; Self Care ; Surveys and Questionnaires

OBJECTIVETo describe hypertension screening and follow-up management among Chinese population aged 35 years and above within the primary health care system.

METHODSData from 2010 China Chronic Disease and Risk Factor Surveillance System were used. We investigated previous hypertension diagnosis, screening, and follow-up assessments within the primary health care system. The prevalence of self-reported and criterion-based hypertension, screening rates, demographic and socioeconomic characteristics associated with screening, and patterns of follow-up assessments were recorded. The SAS software system was used for statistical analyses.

RESULTSAbout 17.1% reported a previous hypertension diagnosis. The rate difference between the two measures of prevalence was 27.2%. Among those without self-reported hypertension, 27.7% reported never visiting a clinic during the past 1 year and 60.4% of those attending a clinic reported ever being screened. Younger age group was associated with lower screening proportion; odds ratios of 35-, 45-, 55-, and ⋝65 years were 1.7 (95% CI: 1.5-1.9), 1.5 (95% CI: 1.3-1.7), 1.3 (95% CI: 1.2-1.4), and 1.0, respectively. About 35.1% of the patients had undergone follow-up assessments four or more times during the past 1 year.

CONCLUSIONMajority of the Chinese population aged 35 years and above, particularly the less educated, elderly population, and rural residents were unaware of that they were suffering from hypertension. Most patients did not receive enough management services by the primary health care system. Thus, strengthening both the screening and follow-up management is needed.

Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; prevention & control ; Male ; Middle Aged ; Population Surveillance ; methods ; Primary Health Care ; organization & administration

This study was aimed to evaluate the agreement between the self-reported sodium intake level and 24-h urine sodium excretion level in Chinese. The 24-h urine collection was conducted among 2112 adults aged 18-69 years randomly selected in Shandong Province, China. The subjects were asked whether their sodium intake was low, moderate, or high. The weighted kappa statistics was calculated to assess the agreement between 24-h urine sodium excretion level and self-reported sodium intake level. One third of the subjects reported low sodium intake level. About 70% of the subjects had mean 24-h sodium excretion>9 g/d, but reported low or moderate sodium intake. The agreement between self-reported sodium intake level and 24-h urine sodium excretion level was low in both normotensive subjects and hypertensive subjects. These findings suggested that many subjects who reported low sodium intake had actual urine sodium excretion>9 g/d. Sodium intake is often underestimated in both hypertensive and normotensive participants in China.
Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; Awareness ; China ; epidemiology ; Diet Records ; Diet Surveys ; Diet, Sodium-Restricted ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hypertension ; epidemiology ; prevention & control ; Male ; Rural Population ; Sodium ; urine ; Sodium Chloride ; adverse effects ; Sodium, Dietary ; administration & dosage ; Surveys and Questionnaires ; Young Adult

OBJECTIVES: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. METHODS: This cross-sectional study analyzed data from 653 Koreans aged > or =60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. RESULTS: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). CONCLUSIONS: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.
Aged ; *Aging ; Asian Continental Ancestry Group ; Awareness ; Blood Pressure ; Body Mass Index ; Cross-Sectional Studies ; Female ; *Health Status ; Humans ; Hypertension/diagnosis/epidemiology/*prevention & control ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea/epidemiology ; Sex Factors

OBJECTIVETo analyze the relationship between birth weight and elevated blood pressure among schoolchildren aged 6-11 years in 8 provinces of China.

METHODA stratified random cluster sampling was used from sampling frame of eight provinces in the mainland of China. A total of 18 920 students aged 6-11 years eventually participated in this study. Height, weight, waist circumference (WC) and blood pressure of all the subjects were measured. Korotkoff I and V were recorded as systolic blood pressure (SBP) and diastolic blood pressure (DBP). Elevated blood pressure was considered for SBP and/or DBP equal to or above the reference sex-, age- and height-specific 95th percentile. Birth weight and family history of hypertension were collected by self-administered questionnaire. Analysis of variance was used to compare body measure indicators among 3 birth weight groups. Multivariate Logistic regression analysis was performed to identify the relationship between birth weight, current BMI and elevated blood pressure among children.

RESULTThe level of height, weight, WC, BMI, SBP and DBP were on the rise with the increase of the birth weight groups among boys (P < 0.05), except for WC among boys aged 6-8 years. The level of height, weight, WC, BMI and DBP showed a trend of escalation among girls (P < 0.05). But, SBP among 3 birth weight groups in girls was not significantly different (P = 0.099). After adjusting for age and family history of hypertension, compared with the normal birth weight group, the odds ratio and 95%CI of having elevated blood pressure among boys and girls in high birth weight group were 1.23 (1.06-1.43) and 0.89 (0.71-1.10), respectively; and the ORs(95%CI) were 1.06 (0.90-1.24) for boys and 0.73 (0.58-0.91) for girls after adjusting for age, family history of hypertension and current BMI of students. The relative risk of elevated blood pressure for boys and girls in low birth weight group were not significantly different as compared with normal birth weight group.

CONCLUSIONCurrent BMI but not birth weight was found to be a strong determinant of elevated blood pressure among children aged 6-11 years in China.

Birth Weight ; Blood Pressure ; physiology ; Blood Pressure Determination ; Body Mass Index ; Body Weight ; Child ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; prevention & control ; Male ; Overweight ; epidemiology ; physiopathology ; Risk Factors ; Sampling Studies ; Surveys and Questionnaires ; Waist Circumference

The object of this study was to evaluate the effect of uric acid lowering therapy in reducing the new development of comorbidities and the frequency of acute attacks in gout patients. We retrospectively reviewed patients who were diagnosed to have gout with at least 3 yr of follow up. They were divided into 2 groups; 53 patients with mean serum uric acid level (sUA)<6 mg/dL and 147 patients with mean sUA> or =6 mg/dL. Comorbidities of gout such as hypertension (HTN), type II diabetes mellitus (DM), chronic kidney disease, cardiovascular disease (CVD) and urolithiasis were compared in each group at baseline and at last follow-up visit. Frequency of acute gout attacks were also compared between the groups. During the mean follow up period of 7.6 yr, the yearly rate of acute attack and the new development of HTN, DM, CVD and urolithiasis was lower in the adequately treated group compared to the inadequately treated group. Tight control of uric acid decreases the incidence of acute gout attacks and comorbidities of gout such as HTN, DM, CVD and urolithiasis.
Adult ; Allopurinol/therapeutic use ; Antimetabolites/therapeutic use ; Benzbromarone/therapeutic use ; Cardiovascular Diseases/epidemiology/prevention & control ; Comorbidity ; Diabetes Mellitus, Type 2/epidemiology/prevention & control ; Enzyme Inhibitors/therapeutic use ; Female ; Gout/*drug therapy/*prevention & control ; Gout Suppressants/*therapeutic use ; Humans ; Hypertension/epidemiology/prevention & control ; Male ; Middle Aged ; Renal Insufficiency, Chronic/epidemiology/prevention & control ; Retrospective Studies ; Thiazoles/therapeutic use ; Uric Acid/*blood/metabolism ; Uricosuric Agents/therapeutic use ; Urolithiasis/epidemiology/prevention & control

With the rapid aging of the population in Korea, the number of older people with dementia is projected to increase, forecasting an epidemic of dementia. Recent trends in dementia in several western countries, however, depict a gradual decline in prevalence and incidence. This decrease has been attributed to an improvement in education and living environments, engagement in healthy behaviors, and reduction in the prevalence of vascular risk factors. In Korea, however, trends in modifiable risk factors do not favor an optimistic outlook due to the continuous increase in the prevalence of hypertension, diabetes mellitus, and obesity. Given these observations, there is much to be gained through the promotion of healthy lifestyles. Moreover, public health resources need to be directed toward the provision of health promotion and preventive services, control and management of vascular risk factors, and improvement in the standard of living. Nationwide initiatives to develop and implement policies and strategies to protect cognitive health throughout the lifespan should be considered a public health priority.
Cost of Illness ; Dementia/economics/*epidemiology/prevention & control ; Developed Countries ; Diabetes Mellitus/epidemiology ; Health Behavior ; Humans ; Hypertension/epidemiology ; Obesity/epidemiology ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors

OBJECTIVES: We examined the trends in prevalence, awareness, treatment, and control of hypertension in Korea as a basis for improving hypertension control programs. METHODS: 12 598 participants of the Korean National Health and Nutrition Examination Survey were included in this study. Weighted linear regression to test time trends from 2007 to 2011 was performed. RESULTS: The prevalence of hypertension was 20.7% in 2007, 29.4% in 2009, and 26.2% in 2011. Awareness of hypertension was 64.8% in 2007 and 61.1% in 2011. Awareness in those aged 65 and over was greater than in younger groups (age 19 to 44 and 45 to 64; p<0.001). The treatment rates were 58.4% in 2007 and 56.8% in 2011. The treatment rate was greater for those 65 and over than for younger age groups (p<0.001). The percentage of controlled hypertension was 37.6% in 2011. The percentage of controlled hypertension in those 65 and over was higher than in younger age groups (p<0.001). The treatment-control rates were 65.9% in 2007 and 67.7% in 2011. The prevalence of hypertension was higher in the males (p<0.001), while the awareness (p<0.001), treatment (p<0.001), and control (p<0.001) rates were higher in the females. CONCLUSIONS: The prevalence of hypertension was increasing and the hypertension awareness, treatment, and control rates were low in younger age groups and males.
Adult ; Age Factors ; Aged ; Antihypertensive Agents/*therapeutic use ; Blood Pressure ; Body Mass Index ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Hypertension/*drug therapy/*epidemiology/prevention & control ; Linear Models ; Male ; Middle Aged ; Nutrition Surveys ; Prevalence ; Risk Factors ; Sex Factors ; Therapeutics/*trends