Prevalence and Correlates of Hypertension among Japanese Adults, 1975 to 2010

Access to mechanical thrombectomy and ischemic stroke mortality in Japan: a spatial ecological study

Background

Advances in stroke treatment have greatly improved outcomes; however, disparities in access to treatment might increase. Achieving equitable access to stroke treatment is a health policy challenge, as rapid treatment is essential for positive outcomes. This ecological cross-sectional study aimed to determine the relationship between the disparities in spatial accessibility to mechanical thrombectomy (SAMT) and stroke mortality rates in Japan, hypothesizing that disparities in SAMT may increase the differences in stroke mortality between regions.

Methods

We used the average number of ischemic stroke (IS) deaths between 2020 and 2021 as the response variable; and SAMT, medical resources, and socioeconomic characteristics of each municipality as explanatory variables. A conditional autoregressive model was used to examine the association between the risk of stroke mortality and SAMT. The standardized mortality ratio (SMR) was mapped to understand the nationwide disparities in stroke mortality risk.

Results

The median number of IS deaths was 17.5 persons per year in the municipalities (2020 to 2021). The study also found that municipalities with low SAMT were located in the northern part of Japan. The non-spatial regression model results indicated that poor accessibility, a small proportion of bachelor's degrees or higher, and a high proportion of workers in secondary industries were related to high IS mortality. Three models were evaluated using spatial analysis; Model 1 with accessibility indicators alone, Model 2 with medical resources added to Model 1, and Model 3 with socioeconomic characteristics added to Model 2. In Models 1 and 2, the population-weighted spatial accessibility index (PWSAI) showed a significant negative relationship with stroke mortality. However, this was not evident in Model 3. Mapping using Model 3 showed that the high-risk areas were predominantly located in northern Japan, excluding Hokkaido.

Conclusion

Access to mechanical thrombectomy was estimated, and regional differences were observed. The relationship between accessibility and IS mortality is unknown; however, regardless of accessibility, municipalities with a high proportion of workers in secondary industries and a small proportion with bachelor's degrees or above are at risk of death from stroke.

Suboptimal control status of young hypertensive population

The prevalence of hypertension (HT) among young adults aged 18 to 39 years is estimated to be 3.7% to 8.6% worldwide. Although the prevalence of HT in young adults is lower than that of the overall population, those with HT are at substantially increased risk of cardiovascular events compared to those without HT. HT in young adults should be taken with even more caution as longer exposure to higher blood pressure leads to a higher lifetime risk of HT-mediated organ damage. However, young patients with HT show low awareness of HT compared to older patients. Also, they are more prone to show low treatment adherence despite the good efficacy of the treatment. Other risk factors that hinder HT control among young adults include alcohol intake, smoking, low physical activity, emotional stress, job stress, metabolic syndrome, and obesity. This review aimed to illustrate the suboptimal control status of the young hypertensive population and to propose strategies for improvement.

Prevalence, awareness, treatment, and control of hypertension and their risk factors in Shaanxi Province in 2004-18

To investigate trends in the prevalence, awareness, treatment and control of hypertension and their demographic determinants in Shaanxi Province. Six successive cross-sectional surveys on non-communicable chronic diseases and their risk factors were conducted between 2004 and 2018 in Shaanxi. Complex multistage stratified sampling was adopted to select participants. The information was collected through face-to-face interviews and on-site health examinations. Changes in hypertension prevalence and its management across survey years were estimated. Demographics associated with hypertension prevalence and its management was explored by multivariable logistic regression using pooled data from 2004 to 2018. The prevalence of hypertension increased from 16.71% in 2004 to 31.96% in 2018 with an estimated increase of 1.09% (95% CI 0.31-1.87) per year. However, the rate of awareness, treatment and control among these with hypertension was unexpectedly low and there were no significant change from 2004 to 2018. The corresponding changes were - 0.08% (95% CI - 0.85-0.69) per year for awareness, - 0.06% (95% CI - 1.11-1.00) per year for treatment, and - 0.23% (95% CI - 0.53-0.07) per year for control, respectively. Sensitivity analysis showed the same trend. Adults who were old, male, divorced/Widowed/Separated, retired were more likely to develop hypertension. Among these with hypertension, those who were more educated and retired were more likely to manage their hypertension compared with their counterparts. The overall hypertension prevalence from 2004 to 2018 increased rapidly, while awareness, treatment and control of hypertension remained unexpectedly low. This suggested urgent intervention should be implemented to improve hypertension control in Shaanxi Province.

Low Level of Serum Cadmium in Relation to Blood Pressures Among Japanese General Population

Hypertension (HT) is an important risk factor for mortality and morbidity. Previous studies showed that cadmium (Cd) was associated with increased blood pressures and the prevalence of HT. This study hypothesized that Cd, regardless of its level, may increase blood pressures/HT. The objective of this study was to examine the associations between a low level of serum Cd concentration and blood pressures/HT among a general population in the Iwaki area, Japan. This was a cross-sectional study, conducted in the Aomori prefecture with 1144 volunteers aged over 19 years old, who were participants of the Iwaki health check-up in 2014. The study assessed questionnaire survey, body composition, and serum Cd concentrations. Median serum Cd concentration was 0.06 ng/mL (interquartile range 0.05-0.08 ng/mL) among our study population. Compared to the lowest quintile of serum Cd concentration group, the highest quintile of serum Cd concentration group had 4.9 mmHg higher systolic blood pressure (SBP) (95% confidence interval [CI] 1.53-8.31, p < 0.01) and 2.4 mmHg higher diastolic blood pressure (DBP) (95% CI 0.36-4.34, p < 0.05), compared to the lowest quintile group. Similarly, the highest quintile of serum Cd concentration group had 1.7 times higher prevalence of HT (95% CI 1.10-2.51, p < 0.05) than the lowest quintile group. This study identified that higher serum Cd concentration was significantly, positively, associated with SBP and DBP and HT prevalence. This study provided evidence for the associations between environmental exposure to Cd and blood pressures/HT which should be considered for future preventive measures.

Background Factors Affecting Visual Acuity at Initial Visit in Eyes with Central Retinal Vein Occlusion: Multicenter Study in Japan

PURPOSE

To determine the baseline characteristics of patients with central retinal vein occlusion (CRVO) that were significantly associated with the best-corrected visual acuity (BCVA) at the initial examination.

METHODS

This was a retrospective multicenter study using the medical records registered in 17 ophthalmological institutions in Japan. Patients with untreated CRVO (≥20-years-of-age) who were initially examined between January 2013 and December 2017 were studied. The patients' baseline factors that were significantly associated with the BCVA at the initial examination were determined by univariate and multivariate linear regression analyses.

RESULTS

Data from 517 eyes of 517 patients were analyzed. Univariate analyses showed that an older age (r = 0.194, p < 0.001) and the right eye (r = -0.103, p < 0.019) were significantly associated with poorer BCVA at the initial visit. Multivariate analyses also showed that an older age (β = 0.191, p < 0.001) and the right eye (β = -0.089, p = 0.041) were significantly associated with poorer BCVA at the initial visit.

CONCLUSIONS

The results indicate that an older age, a known strong factor, and the right eye were significantly associated with poorer BCVA at the initial visit to the hospital. These results suggest that functional and/or anatomical differences between the right and left eyes may be involved in these results.

The influencing factors of health-related quality of life among rural hypertensive individuals: a cross-sectional study

Background

Previous reports regarding health-related quality of life (HRQoL) of hypertensive individuals commonly concentrated on urban population. This study focused on rural population and aimed to explore the influencing factors of HRQoL.

Methods

Date were derived from Henan Rural Cohort study. The HRQoL of participants were assessed via European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) instrument. Tobit regression model and generalized linear model were employed to explore the influencing factors of HRQoL. Another binary logistic regression was utilized to examine the robustness of our results.

Results

Among 23,485 rural population, 8128 participants were identified with hypertension. The mean (SD) utility index and VAS score of non-hypertension group were 0.96 (0.09) and 79.66 (14.20), respectively, while in hypertension group were 0.94 (0.14) and 75.88 (15.50), respectively. Pain/discomfort was the most common self-reported problem (23.05%) for patients. Aging and suffering with other diseases were negatively associated with HRQoL among rural patients, while high socioeconomic status and healthy lifestyles corresponded with high HRQoL.

Conclusions

Hypertension did push considerable pressures on patients’ HRQoL. Maintaining healthy lifestyles and improving the socioeconomic status of patients were advisable ways to reduce this burden.

Trial registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01879-6.

Incidental findings of typical iNPH imaging signs in asymptomatic subjects with subclinical cognitive decline

Background

The etiology of idiopathic normal pressure hydrocephalus (iNPH) remains unclear. Little is known about the pre-symptomatic stage. This study aimed to investigate the association of neuropsychological data with iNPH-characteristic imaging changes compared to normal imaging and unspecific atrophy in a healthy population.

Methods

We extracted data from the community-dwelling Austrian Stroke Prevention Family Study (ASPS-Fam) database (2006–2010). All subjects underwent a baseline and identical follow-up examination after 3–5 years with MR imaging and an extensive neuropsychological test battery (Trail Making Test B, short physical performance balance, walking speed, memory, visuo-practical skills, composite scores of executive function and g-factor). We categorized the subjects into “iNPH”-associated, non-specific “atrophy,” and “normal” based on the rating of different radiological cerebrospinal fluid (CSF) space parameters. We noted how the categories developed over time. We assessed the association of the image categories with the neuropsychological data, different demographic, and lifestyle parameters (age, sex, education, alcohol intake, arterial hypertension, hypercholesterolemia), and the extent of white matter hyperintensities. We investigated whether neuropsychological data associated with the image categories were independent from other parameters as confounders.

Results

One hundred and thirteen subjects, aged 50–70 years, were examined. The imaging category “iNPH” was only present at follow-up. A third of subjects with “atrophy” at baseline changed to the category “iNPH” at follow-up. More white matter hyperintensities (WMH) were present in later “iNPH” subjects. Subjects with “iNPH” performed worse than “normal” subjects on executive function (p = 0.0118), memory (p = 0.0109), and Trail Making Test B (TMT-B. p < 0.0001). Education, alcohol intake, diabetes, arterial hypertension, and hypercholesterolemia had no effect. Age, number of females, and the extent of white matter hyperintensities were higher in “iNPH” than in “normal” subjects but did not significantly confound the neuropsychological results.

Conclusions

Apparent asymptomatic subjects with “iNPH” imaging characteristics presented with subclinical cognitive decline and showed worse executive function, memory, and TMT-B results than “normal” subjects. WMH seem to play a role in the etiology before ventriculomegaly. Clinical screening of individuals with incidental iNPH-characteristic imaging and conspicuous results sof these neurocognitive tests needs further validation.

Blood pressure and adiposity in midlife Singaporean women

Hypertension is a major risk factor for cardiac events and stroke. Visceral adipose tissue (VAT) is known to increase the risk of incident hypertension in adults. Although adiposity has been linked to markers of inflammation, few studies have examined these markers as potential mediators of the association between visceral adiposity and elevated blood pressure. We evaluated sociodemographic, reproductive, and lifestyle risk factors for elevated blood pressure among midlife Singaporean women. A total of 1189 women, with a mean age of 56.3 ± 6.2 years, from the Integrated Women's Health Program (IWHP) at National University Hospital, Singapore were studied. Hypothesized risk factors and levels of inflammatory markers were examined in relation to systolic blood pressure (SBP) and diastolic blood pressure (DBP) using multivariable linear regression models. Prehypertension (SBP 120-139 mmHg and/or DBP 80-89 mmHg) and hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg) were observed in 518 (43.6%) and 313 (26.3%) women, respectively. Compared to women in the lowest tertiles, women in the middle and upper tertiles of VAT had 7.1 (95% CI, 4.4, 9.8) mmHg and 10.2 (95% CI, 6.7, 13.7) mmHg higher adjusted SBP, respectively. Nulliparous older women with a lower education level and those with no or mild hot flashes also had a significantly higher adjusted SBP. No significant independent risk factors were observed for DBP. Adjustments for IL-6, TNF-α, and hs-CRP did not attenuate the association between VAT and SBP. In summary, we found an independent positive association between VAT and SBP. Elevated levels of inflammatory markers did not mediate the increase in SBP in women with high VAT.

Vascular events from carotid artery atherosclerosis after radiation therapy for laryngeal and hypopharyngeal cancer: the incidence and risk factors

In this retrospective cohort study, we evaluated the incidence of vascular events from carotid artery atherosclerosis after radiotherapy indication for laryngeal and hypopharyngeal cancer. From January 2007 to December 2016, we investigated 111 laryngeal/hypopharyngeal cancer patients who underwent curative radiotherapy and were followed up for ≥1 year (median follow-up duration, 60 months). We evaluated the incidence of vascular events from carotid artery atherosclerosis, defined as a transient ischemic attack or an atherothrombotic cerebral infarction, or from undergoing treatment such as carotid artery stenting for carotid artery stenosis. The median radiation dose was 66 Gy (range, 60–74); 48 patients (43.2%) received concurrent chemotherapy. The 5-year overall survival was 86.2%. Six patients required treatment for carotid artery disease. Carotid stenting was performed in three patients with carotid artery stenosis; three patients developed atherosclerotic cerebral infarction and received medical treatment, with a median of 51.7 months (range, 0.3–78.3) after radiotherapy initiation. The vascular event occurrence rate was 5.4% within 5 years and 10.7% within 8 years. In the univariate analysis, dyslipidemia, diabetes mellitus, and carotid calcification were significant factors for event occurrence. Because three out of six cases occurred out of the irradiated field, no carotid artery or carotid bulb dosimetric parameters showed significant correlation. As laryngeal/hypopharyngeal cancer patients, particularly with complications including dyslipidemia and diabetes mellitus, are at a high risk of carotid artery stenosis after radiotherapy, long-term carotid artery evaluation is necessary. Early intervention by stroke specialists can reduce the risk of fatal cerebral infarction.

The "Healthy Akame!" community - government - university collaboration for health: a community-based participatory mixed-method approach to address health issue in rural Japan

Background

Although Japan has a decentralized public health system, local governments have considered expert opinions over those of the community in decisions about public health programs. Differences in communities’ interests may create gaps between health program objectives and implementation. We hypothesized that community-based participatory research (CBPR), which involves the community at every step, promotes effective program implementation and community empowerment. This study addressed the first step of CBPR, assessing community needs and developing tailored health program for a rural community in Japan.

Methods

In this sequential exploratory mixed-method study (qualitative followed by quantitative), we first formed a community advisory board (CAB) representing community organizations, city officials, and university researchers. The CAB conducted group discussions with community residents to identify the community’s health issues and strengths. These group discussions were analyzed using thematic analysis, and the results were used to develop a questionnaire, which was subsequently sent to all households in the community to obtain priority scores for health issues and proposed action and to assess willingness to participate in community health program. The CAB then designed a program using the overall study results.

Results

Ten group discussions with 68 participants identified the following health issues: 1) diseases; 2) unhealthy behaviors; and 3) unsupportive environment. Nature, vacant lots, and local farms were considered local strengths. Of a total of 1470 households in the community, questionnaires were collected from 773 households. Cancer, lifestyle-related diseases, and cerebrovascular diseases were ranked as the most important health problems. Improving services and access to medical checkups, use of public space for exercise, local farming, and collaboration with the community health office were considered necessary to address these health problems. Considering feasibility and the availability of resources in the community, the CAB decided to focus on lifestyle-related diseases and designed activities centered on health awareness, nutrition, and exercise. These activities drew on community’s strengths and were adapted to Japanese culture.

Conclusions

The community’s priority health problem was closely related to the epidemiology of diseases. The CBPR approach was useful for identifying community’s needs and for designing a unique community health program that made use of local strengths.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-020-05916-w.

An Age-Period-Cohort Analysis of Biomarkers of Lifestyle-Related Diseases Using the National Health and Nutrition Survey in Japan, 1973-2018

Studies of biomarkers of lifestyle-related diseases in Japanese cohorts are scarce. This study aimed to analyze trends in risk markers of lifestyle-related diseases using age-period-cohort (APC) analysis. Data on systolic blood pressure and BMI from 1973 to 2018 and serum glucose, triglyceride, and high-density lipoprotein cholesterol levels from 1989 to 2018 available from the National Health and Nutrition Survey were used. Values for each of the risk markers for each age, period, and cohort were estimated using APC analysis. For women, a decrease in all the risk markers of lifestyle-related diseases was observed in individuals born between the 1930s and approximately 1970. Therefore, female individuals born in approximately 1970 were considered to have the lowest risk of developing lifestyle-related and cardiovascular diseases. Meanwhile, the cohort effect on all the risk markers deteriorated for the younger cohorts, and changes in lifestyle behavior are needed for cohorts born more recently. For men, the trends in risk markers across the cohorts differed, and the relative risk of lifestyle-related diseases for each cohort differed according to disease. These results could help understand cohort-specific risks for lifestyle-related disease and enable identification of high-risk populations who could benefit from preventive measures.

Isometric handgrip training reduces blood pressure and wave reflections in East Asian, non-medicated, middle-aged and older adults: a randomized control trial

PURPOSE

The aim of this study was to investigate the effects of isometric handgrip (IHG) training on central and peripheral blood pressure (BP) and wave reflections in East Asian non-medicated middle-aged and older adults.

METHODS

Twenty-two men and women (mean age 65 ± 11 years) who were not actively involved in regular resistance or endurance training were randomly assigned to a group that did IHG and a control (CON) group. The IHG training was comprised of four unilateral 2-min isometric contractions at 30% of maximal voluntary contraction using a programmed handgrip dynamometer with 1-min rest periods for 5 days per week for 8 weeks.

RESULTS

Baseline central systolic BP (cSBP), brachial systolic BP (bSBP), brachial diastolic BP (bDBP), and the augmentation index (AIx) (via an automated applanation tonometric system) did not differ significantly between the groups. Compared to baseline, cSBP, bSBP, bDBP, and AIx decreased significantly after the 8-week study period in the IHG group (P < 0.05). No significant changes in central and peripheral BP and AIx were observed in the CON group.

CONCLUSIONS

These results suggest that IHG training could reduce central and peripheral BP and wave reflections in East Asian non-medicated middle-aged and older adults.

Concordance of hypertension, diabetes and dyslipidaemia in married couples: cross-sectional study using nationwide survey data in Japan

OBJECTIVE

Because married couples have many environmental influences in common, spouses may develop similar diseases. This study aimed to determine the concordance of hypertension, diabetes and dyslipidaemia, which are major risk factors for cardiovascular disease, among married couples in Japan.

RESEARCH DESIGN AND METHODS

We conducted a cross-sectional study of married couples who were both aged ≥40 years using the 2016 Comprehensive Survey of Living Conditions, which is a Japanese national survey. We first determined the proportions of wives and husbands who were receiving therapy for each of the diseases of interest. We then conducted logistic regression analyses using the wives undergoing therapy for each disease as outcomes and the husbands undergoing therapy for the same disease as the principal exposure, adjusting for covariates.

RESULTS

The subjects of the analyses were 86 941 married couples. The wives of male patients were significantly more likely to be receiving therapy for the same disease. Logistic regression revealed that when husbands were undergoing therapy for these diseases their wives had ORs (95% CIs) of 1.79 (1.72-1.86) for hypertension, 1.45 (1.34-1.58) for diabetes, 2.58 (2.41-2.75) for dyslipidaemia and 1.87 (1.80-1.93) for any of these diseases.

CONCLUSIONS

If men have hypertension, diabetes or dyslipidaemia, their wives were also more susceptible to the same disease. Medical professionals and couples may need to recognise these results and consider couple-based interventions to help the prevention, early detection and treatment of these diseases.

Physician and patient perspectives on hypertension management and factors associated with lifestyle modifications in Japan: results from an online survey

We conducted a survey to examine the gaps between Japanese physician and patient perspectives on hypertension management and to investigate important factors that may help solve the “hypertension paradox” in Japan. Web-based surveys of patients and physicians were conducted in Japan between October 19 and 31, 2017. The data collected included physician and patient perspectives on hypertension education, adherence to lifestyle modifications and antihypertensive medication, and reasons for treatment adherence/nonadherence. Factors relating to specific patient behaviors (e.g., monitoring their home blood pressure [BP] daily) were analyzed by multivariate logistic regression analysis. Of the 541 physicians and 881 patients included in the analyses, both groups recognized that the extent of lifestyle changes was insufficient. Approximately 80% of physicians reported that they fully or sufficiently provided education to patients about reasons for hypertension treatment and its associated risks, target BP levels, and lifestyle modifications. Only 40–50% of patients considered those topics having been fully or sufficiently discussed. Logistic regression analyses revealed that positive lifestyle modifications (daily home BP monitoring, salt intake <6 g/day, and daily aerobic exercise for ≥30 min) were positively associated with receiving feedback from physicians about specific lifestyle modifications and patient motivation for maintaining their target BP. In conclusion, perception of the amount of education provided by physicians on hypertension management was lower in patients than in physicians. In addition to effective regular follow-up regarding lifestyle modifications, patient motivation by physicians is an important factor for improving lifestyle modifications and achieving effective hypertension management in Japan.

Treatment patterns of antihypertensive fixed‐dose combinations according to age and number of agents prescribed: Retrospective analysis using a Japanese claims database

Aim

To determine the real‐world use of fixed‐dose combinations (FDC) of antihypertensive agents using data collected from a nationwide medical database of acute hospitals in Japan.

Methods

We carried out a retrospective analysis of data from the Medical Data Vision database for patients with hypertension who received an antihypertensive drug prescription between April 2014 and March 2015. The prescription rate of antihypertensive FDC were assessed by class, age and according to combinations.

Results

In total, data from 59 867 patients aged 70.0 ± 11.9 years (mean ± SD) were analyzed. Patients were prescribed 1.9 ± 1.0 oral antihypertensive agents (mean ± SD). Overall, 58.6% of patients were prescribed two or more antihypertensive agents, and the most frequently prescribed classes were calcium channel blockers (CCB) and angiotensin II receptor blockers (ARB). As the number of concomitant antihypertensive agents prescribed increased, the prescription rate of a CCB + an ARB FDC decreased, whereas the prescription rate of an ARB + a diuretic FDC increased. This trend was the same regardless of age. Of the 12 222 patients who were prescribed a CCB + an ARB, 26.0% received a FDC. In contrast, of the 922 patients prescribed an ARB + a thiazide diuretic, 80.6% received a FDC. Medium doses of both CCB and ARB agents, and low doses of diuretics were the most frequently prescribed for each class.

Conclusions

Our analyses show that the real‐world use of FDC varies depending on the combination of agent class and the number of prescriptions; the latter was similar regardless of age. Geriatr Gerontol Int 2019; 19: 1077–1083.

A risk score predicting new incidence of hypertension in Japan

The prevention of hypertension starts with the awareness of risk. Our aim was to construct a simple and well-validated risk model for nonhypertensive people in Japan consisting of basic clinical variables, using a dataset for two areas derived from the Japan Multi-Institutional Collaborative Cohort Study. We constructed a continuous-value model using data on 5105 subjects participating in both the baseline survey and a second survey conducted after 5 years. The area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow χ² statistic for the entire cohort were 0.826 and 7.06, respectively. For validation, the entire cohort was randomly divided 100 times into derivation and validation sets at a ratio of 6:4. The summarized median AUC and the Hosmer-Lemeshow χ² statistic were 0.83 and 12.2, respectively. The AUC of a point-based model consisting of integer scores assigned to each variable was 0.826 and showed no difference, compared with the continuous-value model. This simple risk model may help the general population to assess their risks of new-onset hypertension.

A Community-Based Intervention for Improving Medication Adherence for Elderly Patients with Hypertension in Korea

The chronic disease management program, a community-based intervention including patient education, recall and remind service, and reduction of out-of-pocket payment, was implemented in 2005 in Korea to improve patients’ adherence for antihypertensive medications. This study aimed to assess the effect of a community-based hypertension intervention intended to enhance patient adherence to prescribed medications. This study applied a non-equivalent control group design using the Korean National Health Insurance Big Data. Hongcheon County has been continuously implementing the intervention program since 2012. This study involved a cohort of patients with hypertension aged >65 and <85 years, among residents who lived in the study area for five years (between 2010 and 2014). The final number of subjects was 2685 in both the intervention and control region. The indirect indicators were analyzed as patients’ adherence and level of continuous treatment using the difference-in-difference regression. The proportion of hypertensive patients who continuously received insurance benefits for >240 days in 2014 was 81.0% in the intervention region and 79.7% in the control region. The number of dispensations per prescription and the dispensation days per hypertensive patient in the intervention region increased by approximately 10.88% and 2.2 days on average by month, respectively, compared to those in the control region. The intervention program encouraged elderly patients with hypertension to receive continuous care. Another research is needed to determine whether further improvement in the continuity of comprehensive care will prevent the progression of cardiovascular diseases.