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Reply to Comment on “Blood pressure control and treatment status at 1 year after the first health check-up in individuals with observed referral-level blood pressure”

Hypertension Research (2025)Cite this article

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We sincerely thank Fu and Wang for their thoughtful letter regarding our article, “Blood Pressure Control and Treatment Status at 1 Year After the First Health Check-Up in Individuals with Observed Referral-Level Blood Pressure.” Their interest in our work and their constructive comments are greatly appreciated, and we agree that the issues they raise—study design, possible temporal influences during the COVID-19 pandemic, unmeasured lifestyle and socioeconomic factors, and generalizability—are central to advancing hypertension care.

First, we would like to confirm that the primary aim of our analysis was descriptive: to quantify the treatment gap—subsequent medical consultation and antihypertensive initiation—at one year after health check-ups that documented referral-level blood pressure (BP ≥ 160/100 mmHg). Among these individuals, 54.5% visited a medical institution within 3 months after the check-up, but only 23.6% were prescribed antihypertensive medications at 1 year [1]. The choice of a retrospective cohort using an administrative claims database (the JMDC Claims Database) was intentional; it provides scale, uniform ascertainment of prescriptions and encounters, and the ability to follow individuals longitudinally with minimal loss to follow-up. We fully agree with the correspondents that such a design does not establish causality. Rather, our goal was to provide a robust estimate of “what is happening now” in our routine care, identify subgroups in whom the gap appears especially pronounced (e.g., younger adults, individuals with obesity), and thereby motivate targeted, prospective interventions.

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References

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Acknowledgements

We would like to thank ChatGPT for English language editing.

Funding

This work was supported by a grant from the Ministry of Health, Labour and Welfare, Japan (23AA2003).

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Authors and Affiliations

  1. NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan

    Kaori Kitaoka & Katsuyuki Miura

  2. Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan

    Kaori Kitaoka, Hidehiro Kaneko, Yuta Suzuki, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita & Norihiko Takeda

  3. Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan

    Hidehiro Kaneko & Katsuhito Fujiu

  4. Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan

    Yuta Suzuki

  5. Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Akira Okada

  6. Department of Cardiovascular Medicine, St. Luke’s International Hospital, Tokyo, Japan

    Atsushi Mizuno

  7. Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

    Tatsuhiko Azegami & Kaori Hayashi

  8. Department of Cardiovascular Medicine, Saga University, Saga, Japan

    Koichi Node

  9. Healthcare Data Science Research Unit, Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan

    Yuji Furui

  10. Department of Public Health, Shiga University of Medical Science, Otsu, Japan

    Katsuyuki Miura

  11. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

    Hideo Yasunaga

Authors
  1. Kaori Kitaoka
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  2. Hidehiro Kaneko
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Corresponding author

Correspondence to Hidehiro Kaneko.

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Conflict of interest

Research funding and scholarship funds (Hidehiro Kaneko and Katsuhito Fujiu) from Medtronic Japan Co., LTD, Boston Scientific Japan Co., LTD, BIOTRONIK JAPAN INC, SIMPLEX QUANTUM Inc, and UT-Heart Inc. Hidehiro Kaneko holds shares in PrevMed Co., Ltd. and Japan Preventive Medicine Development Institute Co., Ltd.

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Kitaoka, K., Kaneko, H., Suzuki, Y. et al. Reply to Comment on “Blood pressure control and treatment status at 1 year after the first health check-up in individuals with observed referral-level blood pressure”. Hypertens Res (2025). https://doi.org/10.1038/s41440-025-02387-6

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