Impact of hypertension on medical economics: A 10-year follow-up study of National Health Insurance in Shiga, Japan

Koshi Nakamura, Tomonori Okamura, Hideyuki Kanda, Takehito Hayakawa, Takashi Kadowaki, Akira Okayama, Hirotsugu Ueshima, Shigeo Yamashita, Yoshinori Tominaga, Kazuaki Katsuyama, Fumihiko Kakuno, Machiko Kitanishi, Yukio Tobita, Kanehiro Okamura, Kiminobu Hatta, Takao Okada, Michiko Hatanaka

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)


Hypertension and related cardiovascular diseases may lead to an increase in medical costs for patients. We attempted to clarify the relationship between hypertension and long-term medical costs by a cohort study utilizing existing data as well as baseline blood pressures and medical costs over a 10-year period. The participants included 4,191 Japanese National Health Insurance beneficiaries aged 40-69 years, living in one area, who were not taking anti-hypertensive medication and did not have a history of major cardiovascular disease. They were classified into four categories according to their blood pressure. We evaluated the mean medical costs per month, cumulative hospitalization, and all-cause mortality for each blood pressure category. Hypertension-related medical costs attributable to hypertensive individuals, as compared to normotensive individuals, were estimated. There was a positively graded correlation between blood pressure and personal total medical costs, especially for men. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensive men were also higher than those in normotensive men. However, the hypertension-related medical costs for mild to moderate hypertensives were higher than those for severe hypertensives. The hypertension-related medical costs for all hypertensives accounted for 23.7% of the total, medical costs for the Japanese population. In conclusion, high blood pressure was a useful predictor for excess medical costs; moreover, concomitant hypertension, regardless of the grade, increased the medical costs of Japanese National Health Insurance beneficiaries.

Original languageEnglish
Pages (from-to)859-864
Number of pages6
JournalHypertension Research
Issue number11
Publication statusPublished - Nov 2005
Externally publishedYes


  • Hypertension
  • Japan
  • Medical costs
  • National Health Insurance

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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