AccScience Publishing / IJPS / Volume 1 / Issue 1 / DOI: 10.18063/IJPS.2015.01.008

Diagnosis and control of hypertension in the elderly populations of Japan and the United States

Yasuhiko Saito1,2* Shieva Davarian3 Atsuhiko Takahashi4 Edward Schneider5 Eileen M. Crimmins5
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1 University Research Center, Nihon University, 12-5 Gobancho, Chiyoda-ku, Tokyo, 102-8251, Japan
2 School of Medicine, Nihon University, 30-1 Ooyaguchi Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
3 Orange County Social Services Agency, 500 N. State College Blvd., Orange, CA 92868, USA
4 Department of Food and Nutrition, Advanced Course of Food and Nutrition, Junior College, Nihon University, 2-31-145 Bunkyo-cho, Mishima-shi, Shizuoka, 411-8555, Japan
5 Davis School of Gerontology, University of Southern California, 3715 McClintock Ave. Los Angeles, CA 90089-0191, USA
© 2015 by the Authors. Licensee AccScience Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-Noncommercial 4.0 International License (CC BY-NC 4.0) (

The Japanese have the highest life expectancy in the world while the United States (U.S.) has relatively low life expectancy. Furthermore, the Americans have relatively poorer health compared to the Japanese. Examination of the treatment of specific conditions such as hypertension in these two countries may provide insights into how the health care system con-tributes to the relative health in these two countries. In this study, we focus on the treatment of hypertension, as this is the most common condition requiring therapeutic interventions in se-niors. This study examines hypertension diagnoses and controls in nationally representative samples of the older populations (68 years old or older) of Japan and the U.S. Data come from two nationally representative samples: the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA) (n = 2,309) and the U.S. Health and Retirement (HRS) Study (n = 3,517). The overall prevalence of hypertension is higher in Japan than the U.S. Undiagnosed hyperten-sion is about four times higher in Japan than in the U.S., while the control of blood pressure is more than four times higher in the U.S. than in Japan. Thus, the use of antihypertensive medi-cation is much more frequent and more effective in the U.S. The medical care system seems to be more effective in controlling hypertension in the U.S. than in Japan. This may be due to the more aggressive diagnosis and treatment of hypertension in the U.S.

public health
older adults

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