Diagnosis and Control of Hypertension in the Elderly Populations of Japan and the United States

Abstract

The Japanese have the highest life expectancy in the world while the United States (U.S.) has relatively low life expectancy. Furthermore, the Americans have relatively poorer health compared to the Japanese. Examination of the treatment of specific conditions such as hypertension in these two countries may provide insights into how the health care system contributes to the relative health in these two countries. In this study, we focus on the treatment of hypertension, as this is the most common condition requiring therapeutic interventions in seniors. This study examines hypertension diagnoses and controls in nationally representative samples of the older populations (68 years-or-older) of Japan and the U.S. Data come from two nationally representative samples: the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA) (n=2,309) and the U.S. Health and Retirement (HRS) Study (n=3,517). The overall prevalence of hypertension is higher in Japan than the U.S. Undiagnosed hypertension is about four times higher in Japan than in the U.S., while the control of blood pressure is more than four times higher in the U.S. than in Japan. Thus, the use of antihypertensive medication is much more frequent and more effective in the U.S. The medical care system seems to be more effective in controlling hypertension in the U.S. than in Japan. This may be due to the more aggressive diagnosis and treatment of hypertension in the U.S.

Keywords: Control; Diagnosis; Hypertension; Older Adults; Public health.

Figures 1

a–b. Distribution of systolic and diastolic blood pressure (SBP) measurement: Japan and US

Figure 2

a–d. Distribution of measured systolic blood pressure (SBP) by hypertensive state