Fig. 1

Flowchart. From a large-scale health check-up database in Japan, we identified individuals who underwent a baseline health check-up. We excluded individuals for the following reasons: a history of hypertension (n = 1,298,887); use of antihypertensive medication within 6 months prior to baseline (n = 58,194); presence of hypertension at the baseline check-up (n = 361,623); an insufficient follow-up period (0 days; n = 3008); and missing data on key lifestyle factors such as smoking status, alcohol consumption, physical activity, or sleep quality (total n = 429,521). After these exclusions, 1,069,948 participants were included in the final analysis