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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 read with great interest the article by Kizuka et al. [1], published in Hypertension Research, titled “Blood Pressure Control and Treatment Status at 1 Year After the First Health Check-Up in Individuals with Observed Referral-Level Blood Pressure.” This study utilizes the JMDC Claims Database (2005–2022) to analyze blood pressure (BP) control and treatment adherence in 63,785 individuals with grade II or severer hypertension (SBP ≥ 160 mmHg or DBP ≥ 100 mmHg) identified during health check-ups [1]. The findings highlight a significant treatment gap, particularly among younger individuals, those with obesity, or those with unhealthy lifestyles, who often fail to initiate antihypertensive therapy despite recommendations. The study’s use of a large-scale dataset and descriptive statistical analyses provides valuable insights into real-world hypertension management in Japan. However, several aspects of the methodology and interpretation merit further discussion.

First, the retrospective observational design, while leveraging a robust dataset, limits the ability to establish causality between patient characteristics (e.g., younger age, obesity) and the failure to initiate antihypertensive therapy [2]. The study notes that these groups are less likely to seek medical consultation post-check-up, but the underlying reasons—such as socioeconomic factors, health literacy, or access to care—remain unexplored. Prospective studies incorporating patient interviews or surveys could clarify barriers to treatment initiation and adherence.

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References

  1. Kitaoka K, Kaneko H, Suzuki Y, Okada A, Mizuno A, Fujiu K, et al. 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/s41440-025-02284-y. Online ahead of print.

  2. Morotti A, Boulouis G, Dowlatshahi D, Li Q, Shamy M, Al-Shahi Salman R, et al. Intracerebral haemorrhage expansion: definitions, predictors, and prevention. Lancet Neurol. 2023;22:159–71.

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Author notes

  1. These authors contributed equally: Yuru Fu, Yuanyuan Wang

Authors and Affiliations

  1. Department of Intensive Care Unit, Fuyang People’s Hospital of Anhui Medical University, Fuyang, China

    Yuru Fu

  2. Department of Cardiology, Fuyang People’s Hospital of Anhui Medical University, Fuyang, China

    Yuanyuan Wang

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  1. Yuru Fu
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  2. Yuanyuan Wang
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Correspondence to Yuanyuan Wang.

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Fu, Y., Wang, Y. 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/s41440-025-02394-7

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  • DOI: https://doi.org/10.1038/s41440-025-02394-7

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