A retrospective, cross-sectional study of real-world values of cardiovascular risk factors using a healthcare database in Japan

Abstract

Background: Data collected by the Japanese Ministry of Health, Labour and Welfare (MHLW), namely data from the Specific Health Checkups and Specific Health Guidance (MHLW-SH) and the National Health and Nutrition Survey (MHLW-H&N) allow assessment of blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c) in Japan. Recently, a large database of employment-based health insurance has been developed by MinaCare Co. Ltd.Methods: A retrospective, cross-sectional study using the Japanese healthcare checkup database developed by MinaCare Co. Ltd. was designed to investigate the distribution of real-world values of BP, LDL-C, and HbA1c in Japan. Data in the MinaCare database were also compared with those in the two national data sources to assess the extent to which the health status in Japan is reflected in each data source.Results: Of the healthcare checkup results of 232515 subjects in the 2011 MinaCare database, 49.9% were male and 50.1% were female. The age of the subjects ranged from <20 to >70 years. The proportion of subjects with systolic BP (SBP) ≥140 mmHg, LDL-C ≥140 mg/dL, and HbA1c ≥6.1% generally increased with increasing age. If one focused on the upper-end age group representing the majority of the MinaCare study population (i.e. age range, 55-59 years), the proportions of subjects with SBP ≥140 mmHg, LDL-C ≥140 mg/dL, and HbA1c ≥6.1% were 19.0%/12.2% (males/females), 27.2%/42.7%, and 13.5%/5.4%, respectively. The MinaCare database was mostly comparable with the two national data sources; however, some notable differences in BP and lipid parameters were found between MHLW-H&N and the other two data sources.Conclusions: Analysis of the MinaCare database indicated that a substantial proportion of subjects did not achieve the target BP, LDL-C, and HbA1c levels to reduce the risk of future cardiovascular and cerebrovascular disease events. The results were generally consistent with those of the national data sources. Considering its characteristics of low selection bias, large sample size, wide age distribution, and high flexibility in analysis of subject-level data, the MinaCare database is highly valuable for studying the health status of the population covered by employment-based health insurance.