Evidence map›Paper›PMID 41781766›Full record

ArticleHypertension research : official journal of the Japanese Society of Hypertension2026

Population attributable fraction of modifiable risk factors for incident hypertension: an analysis of large-scale epidemiological cohort.

Masachika Nishikawa, Yuta Suzuki, Hidehiro Kaneko, Akira Okada, Norifumi Takeda, Hiroyuki Morita, Katsuhito Fujiu, Tatsuhiko Azegami, Kaori Hayashi, Kaori Kitaoka and 9 more

Abstract read
In one paragraph

Article in Hypertension research : official journal of the Japanese Society of Hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Masachika NishikawaDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Yuta SuzukiDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Hidehiro KanekoDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. kanekohidehiro@gmail.com.
Akira OkadaDepartment of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Norifumi TakedaDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Hiroyuki MoritaDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Katsuhito FujiuDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Tatsuhiko AzegamiDivision of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Kaori HayashiDivision of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Kaori KitaokaDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Katsuyuki MiuraNCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan.
Atsushi MizunoDepartment of Cardiology, St Luke's International Hospital, Tokyo, Japan.
Akihiro NomuraDepartment of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan.
Kazuomi KarioDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Koichi NodeDepartment of Cardiovascular Medicine, Saga University, Saga, Japan.
Hideo YasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Masaomi NangakuDivision of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Hisatomi ArimaDepartment of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Norihiko TakedaDepartment of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Identifying and prioritizing modifiable risk factors is crucial for the primary prevention of hypertension. However, large-scale data on the population attributable fraction (PAF) for a comprehensive range of modifiable risk factors for incident hypertension in the Japanese population have been scarce. This study analyzed 1,069,948 participants (median age 56, 43.7% men) without a history of hypertension from the DeSC database. Using Cox proportional hazards models, we evaluated the association between modifiable risk factors (obesity, diabetes mellitus, dyslipidemia, smoking, habitual alcohol consumption, physical inactivity, and sleep disorders) and incident hypertension to calculate their PAFs. Over a median follow-up of 3.64 years, 116,690 new hypertension diagnoses were recorded. Obesity had the highest PAF at 6.36%, followed by sleep disorder (4.11%), current smoking (3.39%), dyslipidemia (2.74%), habitual alcohol consumption (2.10%), physical inactivity (1.93%), and diabetes mellitus (1.55%). The PAF of obesity for incident hypertension decreased with age, from 15.10% among individuals aged <40 years to 7.93% among those aged 40-64 years and 3.70% among those aged ≥65 years. Similarly, obesity's PAF was higher in men (7.93%) than in women (5.02%). The total PAF for all evaluated modifiable risk factors showed a more pronounced contribution among younger adults and men. In conclusion, this research reveals that obesity is the largest modifiable contributor to incident hypertension in the Japanese population. Furthermore, the impact of modifiable risk factors for hypertension is more significant in younger adults and men. These findings offer valuable insights for developing effective public health policies aimed at preventing hypertension.

Indexed as

HypertensionAdultAgedAlcohol DrinkingCohort StudiesFemaleHumansIncidenceJapanMaleMiddle AgedObesityRisk FactorsSmokingAgeHypertensionObesityPopulation attributable fractionRisk factors

Identifiers

PMID41781766
PMCPMC13148980

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.