Evidence mapPaperPMID 41249844Full record

ArticleHypertension research : official journal of the Japanese Society of Hypertension2026

Regional disparities in blood pressure control after hypertension treatment initiation in Japan: a real-world data analysis.

Yutaro Iwabe, Michihiro Satoh, Hiroki Nobayashi, Seiya Izumi, Takahisa Murakami, Maya Toyama, Takahito Yagihashi, Yuya Suzuki, Tomoko Muroya, Shingo Nakayama and 2 more

Abstract read
In one paragraph

Article in Hypertension research : official journal of the Japanese Society of Hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. It is indeed necessary to go back to basics.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  3. Current hypertension epidemiology and contemporary approaches using the "Real-World Evidence Cycle" framework.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yutaro IwabeCenter for Clinical Research Promotion and Development, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan.
Michihiro SatohDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan. satoh.mchr@tohoku-mpu.ac.jp.
Hiroki NobayashiDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Seiya IzumiDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Takahisa MurakamiDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Maya ToyamaDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Takahito YagihashiDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Yuya SuzukiDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Tomoko MuroyaDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Shingo NakayamaDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Takayoshi OhkuboDepartment of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
Hirohito MetokiDivision of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study assessed regional variations in blood pressure (BP) control after antihypertensive treatment and explored the associations with healthcare resource indicators across Japan. Using nationwide health check-up data from the Japan Health Insurance Association between 2015 and 2022, we analyzed 1,318,437 individuals aged 40-74 who initiated antihypertensive treatment based on consecutive health check-ups. We evaluated prefecture-level differences in post-treatment BP control rates (systolic BP [SBP]/diastolic BP [DBP] <130/<80 mmHg). Prefecture-level ecological analyses examined the associations between adjusted BP control rates and cerebrovascular disease mortality rates and six healthcare resource indicators, including the Physician Uneven Distribution Index (PUDI). Mean SBP/DBP decreased from 148.3/92.4 mmHg to 134.1/83.1 mmHg following treatment initiation. Only 26.7% of patients achieved the target BP (<130/<80 mmHg). This level is the universal target in the Japanese Society of Hypertension Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025, highlighting a significant public health challenge. Unadjusted BP control rates varied by 10.2% across prefectures, narrowing to 7.4% after adjusting for individual-level patient characteristics. Pre-treatment SBP was the strongest predictor of post-treatment BP control. Ecological analysis revealed that each 1% increase in patients achieving the target BP of <130/<80 mmHg was associated with 3.5 fewer cerebrovascular disease deaths per 100,000 population in both sexes. PUDI showed a significant positive association with BP control rate (weighted Pearson's r = 0.47; p < 0.001). In conclusion, substantial regional disparities in BP control persist across Japan, which are significantly influenced by physician availability and associated with differences in stroke mortality. Using Japanese nationwide health check-up data from 1.3 million individuals initiating antihypertensive treatment, only 26.7% achieved the target BP (<130/<80 mmHg). Adjusted BP control rates varied by 7.4% across prefectures and were positively associated with physician availability and inversely with stroke mortality, indicating the impact of regional healthcare resource disparities.

Indexed as

Antihypertensive AgentsBlood PressureHealthcare DisparitiesHypertensionAdultAgedFemaleHumansJapanMaleMiddle AgedAntihypertensive AgentsBlood pressureClinical inertiaDigital hypertensionHealthcare disparitiesImplemental hypertension

Identifiers

PMID41249844
PMCPMC12823396

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.