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  • Correspondence
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Response to: “Distinct associations of blood pressure phenotypes with subclinical cerebrovascular disease and coronary artery calcification in Japanese men”

Hypertension Research (2026) Cite this article

We thank the correspondent for the thoughtful and constructive commentary on our recent publication [1]. The points raised are important and align closely with the methodological considerations inherent to studies of blood pressure (BP) phenotypes and subclinical cardiovascular disease. We appreciate the opportunity to clarify these aspects and further contextualize our findings.

We fully agree that the cross-sectional nature of our analysis precludes causal inference between BP phenotypes and subclinical cerebrovascular disease (SCVD) or coronary artery calcification (CAC). As noted in our original manuscript, our primary objective was to characterize phenotype-specific associations rather than establish temporality. Although our analysis is cross-sectional in nature, it is embedded within the broader framework of the SESSA cohort, which includes repeated examinations over time. Future studies incorporating longitudinal BP phenotyping alongside sequential imaging will be essential to clarify temporal relationships and disease progression.

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References

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for the SESSA Research Group Members

Principal investigator Katsuyuki Miura12, Past-principal investigator Hirotsugu Ueshima12, Research members Yoshihisa Nakagawa12, Yasutaka Nakano12, Emiko Ogawa12, Shinji Kume12, Katsutaro Morino12, Itsuko Miyazawa12, Yoshiyuki Watanabe12, Kazuhiko Nozaki12, Kazumichi Yoshida12, Satoshi Shitara12, Ikuo Tooyama12, Akihiko Shiino12, Masaki Nishimura12, Shigeki Banba12, Susumu Kageyama12, Hisakazu Ogita12, Naomi Miyamatsu12, Yasuyuki Nakamura12, Yuichiro Yano12, Aya Kadota12, Keiko Kondo12, Sayuki Torii12, Takashi Kadowaki12, Sayaka Kadowaki12, Takahiro Ito12, Ayako Kunimura12, Hiroyoshi Segawa12, Yukiko Okami12, Takeshi Shibukawa12, Azusa Shima12, Mizuki Ohashi12, Megumi Kawashima12, Yuuichi Sawayama12, Yousuke Higo12, Maya Oki12, Kaori Kitaoka12, Akira Fujiyoshi13, Aya Higashiyama13, Tomonori Okamura14, Naoko Miyagawa14, Tatsuya Sawamura15, Yasuharu Tabara16, Akira Sekikawa17, Emma J. M. Barinas-Mitchell17, Daniel Edmundowicz18, Takayoshi Ohkubo19, Atsushi Hozawa20, Yoshitaka Murakami21, Nagako Okuda22, Hisatomi Arima23, Yoshikuni Kita24, Takashi Hisamatsu25, Masahiko Yanagita26, Seiko Ohno27, Naoyuki Takashima28, Takashi Yamamoto29, Koichiro Azuma30, Yoshino Saito31

Author information

Authors and Affiliations

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

    Nomin Bayaraa, Yuichiro Yano, Aya Kadota, Nazar Mohd Azahar, Keiko Kondo & Sayuki Torii

  2. Department of Public Health, Shiga University of Medical Science, Shiga, Japan

    Nomin Bayaraa, Aya Kadota, Keiko Kondo & Sayuki Torii

  3. Division for University Hospital Development, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia

    Nomin Bayaraa

  4. Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan

    Yuichiro Yano

  5. Faculty of Health Sciences, Universiti Teknologi MARA, Cawangan Pulau Pinang, Kampus Bertam, Kepala Batas, Malaysia

    Nazar Mohd Azahar

  6. National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan

    Tran Ngoc Hoang Phap

  7. Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Takashi Hisamatsu

  8. Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan

    Akira Fujiyoshi

  9. Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan

    Takayoshi Ohkubo

  10. Molecular Neuroscience Research Center, Shiga University of Medical Science, Shiga, Japan

    Akihiko Shiino

  11. Department of Neurosurgery, Shiga University of Medical Science, Shiga, Japan

    Kazuhiko Nozaki

  12. Shiga University of Medical Science, Otsu, Japan

    Katsuyuki Miura, Hirotsugu Ueshima, Yoshihisa Nakagawa, Yasutaka Nakano, Emiko Ogawa, Shinji Kume, Katsutaro Morino, Itsuko Miyazawa, Yoshiyuki Watanabe, Kazuhiko Nozaki, Kazumichi Yoshida, Satoshi Shitara, Ikuo Tooyama, Akihiko Shiino, Masaki Nishimura, Shigeki Banba, Susumu Kageyama, Hisakazu Ogita, Naomi Miyamatsu, Yasuyuki Nakamura, Yuichiro Yano, Aya Kadota, Keiko Kondo, Sayuki Torii, Takashi Kadowaki, Sayaka Kadowaki, Takahiro Ito, Ayako Kunimura, Hiroyoshi Segawa, Yukiko Okami, Takeshi Shibukawa, Azusa Shima, Mizuki Ohashi, Megumi Kawashima, Yuuichi Sawayama, Yousuke Higo, Maya Oki & Kaori Kitaoka

  13. Wakayama Medical University, Wakayama, Japan

    Akira Fujiyoshi & Aya Higashiyama

  14. Keio University, Tokyo, Japan

    Tomonori Okamura & Naoko Miyagawa

  15. Shinshu University, Matsumoto, Nagano, Japan

    Tatsuya Sawamura

  16. Shizuoka Graduate University of Public Health, Shizuoka, Japan

    Yasuharu Tabara

  17. University of Pittsburgh, Pittsburgh, PA, USA

    Akira Sekikawa & Emma JM Barinas-Mitchell

  18. Temple University, Philadelphia, PA, USA

    Daniel Edmundowicz

  19. Teikyo University, Tokyo, Japan

    Takayoshi Ohkubo

  20. Tohoku University, Sendai, Japan

    Atsushi Hozawa

  21. Toho University, Tokyo, Japan

    Yoshitaka Murakami

  22. Kyoto Prefectural University, Kyoto, Japan

    Nagako Okuda

  23. Fukuoka University, Fukuoka, Japan

    Hisatomi Arima

  24. Tsuruga Nursing University, Tsuruga, Japan

    Yoshikuni Kita

  25. Okayama University, Okayama, Japan

    Takashi Hisamatsu

  26. Doshisha University, Kyotanabe, Kyoto, Japan

    Masahiko Yanagita

  27. National Cerebral and Cardiovascular Center, Suita, Japan

    Seiko Ohno

  28. Kyoto Prefectural University of Medicine, Kyoto, Japan

    Naoyuki Takashima

  29. Kohka Public Hospital, Shiga, Japan

    Takashi Yamamoto

  30. Nerima General Hospital, Tokyo, Japan

    Koichiro Azuma

  31. Aino University, Ibaraki, Japan

    Yoshino Saito

Authors
  1. Nomin Bayaraa
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  2. Yuichiro Yano
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  3. Aya Kadota
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  4. Nazar Mohd Azahar
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  5. Tran Ngoc Hoang Phap
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  6. Takashi Hisamatsu
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  7. Keiko Kondo
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  8. Sayuki Torii
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  9. Akira Fujiyoshi
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  10. Takayoshi Ohkubo
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  11. Akihiko Shiino
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  12. Kazuhiko Nozaki
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Consortia

for the SESSA Research Group Members

  • Principal investigator

    • Katsuyuki Miura

  • Past-principal investigator

    • Hirotsugu Ueshima

  • Research members

    • Yoshihisa Nakagawa
    • , Yasutaka Nakano
    • , Emiko Ogawa
    • , Shinji Kume
    • , Katsutaro Morino
    • , Itsuko Miyazawa
    • , Yoshiyuki Watanabe
    • , Kazuhiko Nozaki
    • , Kazumichi Yoshida
    • , Satoshi Shitara
    • , Ikuo Tooyama
    • , Akihiko Shiino
    • , Masaki Nishimura
    • , Shigeki Banba
    • , Susumu Kageyama
    • , Hisakazu Ogita
    • , Naomi Miyamatsu
    • , Yasuyuki Nakamura
    • , Yuichiro Yano
    • , Aya Kadota
    • , Keiko Kondo
    • , Sayuki Torii
    • , Takashi Kadowaki
    • , Sayaka Kadowaki
    • , Takahiro Ito
    • , Ayako Kunimura
    • , Hiroyoshi Segawa
    • , Yukiko Okami
    • , Takeshi Shibukawa
    • , Azusa Shima
    • , Mizuki Ohashi
    • , Megumi Kawashima
    • , Yuuichi Sawayama
    • , Yousuke Higo
    • , Maya Oki
    • , Kaori Kitaoka
    • , Akira Fujiyoshi
    • , Aya Higashiyama
    • , Tomonori Okamura
    • , Naoko Miyagawa
    • , Tatsuya Sawamura
    • , Yasuharu Tabara
    • , Akira Sekikawa
    • , Emma JM Barinas-Mitchell
    • , Daniel Edmundowicz
    • , Takayoshi Ohkubo
    • , Atsushi Hozawa
    • , Yoshitaka Murakami
    • , Nagako Okuda
    • , Hisatomi Arima
    • , Yoshikuni Kita
    • , Takashi Hisamatsu
    • , Masahiko Yanagita
    • , Seiko Ohno
    • , Naoyuki Takashima
    • , Takashi Yamamoto
    • , Koichiro Azuma
    •  & Yoshino Saito

Corresponding author

Correspondence to Nomin Bayaraa.

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The authors declare no competing interests.

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Cite this article

Bayaraa, N., Yano, Y., Kadota, A. et al. Response to: “Distinct associations of blood pressure phenotypes with subclinical cerebrovascular disease and coronary artery calcification in Japanese men”. Hypertens Res (2026). https://doi.org/10.1038/s41440-026-02668-8

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  • DOI: https://doi.org/10.1038/s41440-026-02668-8

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