Study of Medecal Economics on Evaluation of Community care for Mild Hypertension by Cost-benefit Analysis

作为具有中等高血压的人的社区护理，质量健康测试发挥了在日本的重要作用。在这项研究中，首先，对健康测试的有效性进行了调查，在预防和控制中度高血压的方面。作为预防，健康测试的行为可以改善心脏病的饮食习惯，对吸烟或饮酒的习惯没有任何影响。“在控制的方面，健康测试的存在存在是一种趋势，以使其相对于严重的轻度高血压参与健康测试，并减少对高血压的医疗需求，更可能是要检测高血压。在添加中，健康测试的有效性从长时间点的视图中被调查，与健康测试和中风登记系统文件的记录链接。健康测试与中风的发病率和死亡率下降有关。为了评估这一关系，不管怎样，有些要点必须在怀疑中表现出来。参与者中的高血压患者在健康测试、参与后的医疗条件等方面都是：作为自我护理，中等高血压患者需要开始控制血液压力的限制，从盐的摄入和饮酒，并改善超重。这些生活方式和物理状况与生活方式有关的生活方式对于社区护理中的初级预防非常重要，因为它们对预防高血压或高血压爆发的回归有影响。这一研究的回顾性研究表明，青年年龄段的身体锻炼对成人血液压力有不可想象的影响。在订购以澄清这种生活方式对预防高血压的影响时，队列研究应该是有效的。高血压仍然是日本基于社区的主要防治心血管疾病的最重要目标。

As community care of persons with mild hypertension, mass health examination plays an important role in Japan. In this research, at first, effectiveness of the health examination is investigated in the aspects of prevention and control of mild hypertension. As for prevention, the health examination acts to improve eating habits for prevention of cardiovascular diseases, though no effect on smoking nor drinking habits. In the aspect of control, existence of the health examination has a tendency to urge relatively mild hypertensives to participate in the health examination and to decrease the need of medication for hypertension, rather than to detect hypertensives. In addition, the effectiveness of the health examination is investigated from longーterm point of view with record linkage of the files of the health examination and stroke register system. The health examination relates with decrease of incidence and mortality from stroke. For evaluation of this relation, however, some points have to be taken in consideration. Those are proportion of hypertensives among the participants in the health examination, medical condition after the participation and so on.As self care, mild hypertensives need to begin to control blood pressure by restraining from excess salt intake and drinking, and improving overweight. These lifeーstyle and physical conditions related with the life-style are very important for primary prevention in community care, because these are effective for prevention of hypertension or retardation of the outbreak of hypertension. It is pointed up in this research of retrospective study that physical exercise at youth age has desirable effect on blood pressure at adult. In order to clarify how such life-style effects on prevention of hypertension, the cohort study should be performed. Hypertension is still the most important target for community-based primary prevention of cardiovascular diseases in Japan.