JMA Journal

Figure 1. Eligibility and enrollment of participants for home blood pressure.
The percentage shown was calculated based on the number of participants for home blood pressure (HBP) measurement (n = 21,061)^* and that of participants who received urgent notification letters (excluding 2 withdrawn participants, n = 254)^†.

Figure 2. Diagram of operation time required in each step.
Reports showing high values of blood test and home blood pressure (HBP) were transferred to the urgent notification office (UNO) from the ToMMo integrated database and community support centers, respectively. After assessments, an urgent notification letter was sent via mail to the participant, if necessary. The urgent notification letters arrived at the participants’ address within1 week after return of the sphygmomanometer device to the community support centers.

Figure 3. Workflow of the urgent notification system.
The decision on whether to send an urgent notification letter to a participant was made by the UNO, where several physicians and a specialist comprehensively discussed all the data available in our baseline assessment, including other inspection results, medical history, and medication records. If a decision was made to return the data, an urgent notification letter was prepared within 1 business day, and the letter was confirmed by multiple UNO members.

Figure 4. Example of the urgent notification letter sent to participants with abnormal home blood pressure value.
In addition to the urgent HBP values, we stated the abnormal laboratory values in the letter, if present.

Figure 5. Numbers of participants and their gender distributions.
As for the numbers of participants, two age peaks, 30’s and 60’s years old, were observed both in men and women. The numbers of the female participants were approximately twice more than that of the male participants. Approximately 40% of the participants were aged >60 years.