AGE-RELATED TRENDS IN BLOOD PRESSURE BASED ON LARGE-SCALE HEALTH CHECKUP DATA USING LONGITUDINAL ANALYSIS

Abstract

Objective: Information on the change in blood pressure (BP) during the life course is essential from both clinical and public health standpoints. Most studies demonstrating age-related trends in BP were based on cross-sectional data. Since an elevated BP at a younger age results in fatal cardiovascular events in later life, the cross-sectional study design contributes to an underestimation of BP in elderly individuals. The present study involved longitudinal analysis to assess age-related trends in BP, using large-scale data. Design and method: We received data of health check-up conducted between 2008–2017 and used a total of 2,235,055 observations from 386,760 individuals aged between 30–74 years in the JMDC database, which contains multiple health checkup data from the Japanese health insurance societies. The age-related trends in BP were estimated using a repeated-measures mixed linear model including age, sex, and an interaction between age and sex. We cross-sectionally summarized the prevalence rate of hypertension and antihypertensive treatment rate among hypertensives in each age group. Results: The number of follow-up examinations without baseline visit was < 2, 3, 4, or > = 5 in 14,453 (3.8%), 33,468 (8.7%), 139,961 (36.2%), and 198,878 (51.4%), respectively. Systolic BP increased consistently from 121.1 mmHg at 36 years to 129.7 mmHg at 66 years in men and from 109.7 mmHg at 33 year to 131.9 mmHg at 74 years in women. The diastolic BP increased from 72.1 mmHg mmHg at 30 years to 80 mmHg at 56 years in men and from 64.7 mmHg at 30 years to 74.6 mmHg at 64 years but decreased after the peak. The prevalence rate of hypertension increased linearly with age; the rates at the age of 60 years were 51.8% for men and 39.5% for women. The antihypertensive treatment rate increased with age but was less than 50% before 50 years.Conclusions: Systolic BP increased linearly with age. There was an inverse-U shaped age-related trend in diastolic BP and the time of the peak in women was approximately ten years later than that in men. The present findings also suggest that the antihypertensive treatment rate in young adults should be enhanced.