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Is location associated with high risk of hypertension? Shimane COHRE Study
Tsuyoshi Hamano1, Yoshinari Kimura, Miwako Takeda
1Center for Community based Health Research and Education (COHRE), Organization for the Promotion of Project Research, Shimane University, Izumo, Japan. thamano@med.shimane-u.ac.jp
Background:
There is growing evidence that residential environment is associated with hypertension. Recently, interest has also turned toward examining the possible influence of remoteness on hypertension. The aim of this study is to explore the effect of remoteness, the shortest path between the subject location and the population center, on hypertension prevalence in a rural region in Japan.
Methods:
We analyzed data from the Shimane COHRE Study conducted from 2006 to 2009 in rural mountainous regions of Japan. After excluding the missing data, we conducted a logistic regression analysis of the data for 1,348 individuals. Geographic information systems (GIS) were used in the network analysis. Network analysis determined the distance between subject's location and population center on road networks, and the distance was divided into tertiles: 0-26,685.8 m = close distance, 26,685.9 m-38,350.6 m = moderate distance, 38,350.7 m-68,070.1 m = far distance.
Results:
According to self-reported hypertension, the odds ratios for hypertension (taking antihypertensive medication or under treatment for hypertension without medication) were 1.44 (95% confidence interval (CI): 1.04-1.99) and 1.78 (95% CI: 1.29-2.46) in moderate and far distances, respectively, after adjustment for potential confounders. The odds ratios no longer remained significant after considering the measurement of blood pressure (BP) to define hypertension (taking antihypertensive medication or under treatment for hypertension without medication or BP ≥ 140/90 mm Hg for systolic BP (SBP)/diastolic BP (DBP)).
Conclusions:
Our findings show that residential remoteness might be associated with a higher risk of hypertension in a rural region in Japan.
Related Concept Videos
Hypertension II: Pathophysiology
Hypertension and Regulation of Blood Pressure
Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension I: Introduction
Factors affecting Blood pressure
Physiological Factors:
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
