Is Location Associated With High Risk of Hypertension? Shimane COHRE Study

BACKGROUND There is growing evidence that residential environment is associated with hypertension. Recently, interest has also turned toward examining the possible influence of remoteness on hypertension. The aim of this study is to explore the effect of remoteness, the shortest path between the subject location and the population center, on hypertension prevalence in a rural region in Japan. METHODS We analyzed data from the Shimane COHRE Study conducted from 2006 to 2009 in rural mountainous regions of Japan. After excluding the missing data, we conducted a logistic regression analysis of the data for 1,348 individuals. Geographic information systems (GIS) were used in the network analysis. Network analysis determined the distance between subject's location and population center on road networks, and the distance was divided into tertiles: 0-26,685.8 m = close distance, 26,685.9 m-38,350.6 m = moderate distance, 38,350.7 m-68,070.1 m = far distance. RESULTS According to self-reported hypertension, the odds ratios for hypertension (taking antihypertensive medication or under treatment for hypertension without medication) were 1.44(95% confidence interval (CI): 1.04-1.99) and 1.78(95% CI: 1.29-2.46) in moderate and far distances, respectively, after adjustment for potential confounders. The odds ratios no longer remained significant after considering the measurement of blood pressure (BP) to define hypertension (taking antihypertensive medication or under treatment for hypertension without medication or BP >= 140/90 mm Hg for systolic BP (SBP)/diastolic BP (DBP)). CONCLUSIONS Our findings show that residential remoteness might be associated with a higher risk of hypertension in a rural region in Japan.