What are lifestyle-related diseases and chronic illnesses?
Lifestyle-related diseases are a general term for a group of illnesses where daily habits such as diet, exercise, smoking, alcohol consumption, and stress play a role in their development. Hypertension, diabetes, dyslipidemia, hyperuricemia, and chronic kidney disease are typical examples. These conditions often progress without subjective symptoms, and if left untreated, can lead to serious complications such as myocardial infarction, stroke, kidney failure, and blindness.
It is said that one in two Japanese adults has some form of lifestyle-related disease, and these conditions can be prevented from developing complications with proper management.
If your health check-up recommends "further examination," seek medical attention immediately.
For lifestyle-related diseases, early detection and early intervention are key to preventing complications. If you neglect these conditions because you don't have any symptoms, it can lead to serious problems 10 or 20 years down the line. If your health check-up reveals any concerns, please consult us immediately.
Hypertension
The estimated number of people with hypertension in Japan is approximately 43 million. Hypertension is diagnosed when systolic blood pressure is 140 mmHg or higher, or diastolic blood pressure is 90 mmHg or higher.
Blood Pressure Classification (Office Blood Pressure)
| Classification | Systolic | Diastolic |
|---|---|---|
| Normal blood pressure | <120 | <80 |
| Normal high blood pressure | 120-129 | <80 |
| High blood pressure | 130-139 | 80-89 |
| Stage I hypertension | 140-159 | 90-99 |
| Stage II hypertension | 160-179 | 100-109 |
| Stage III hypertension | ≧180 | ≧110 |
Treatment Goals
- Younger adults/middle-aged adults (under 75): <130/80 mmHg
- Elderly (75 and older): <140/90 mmHg (individualized)
- Comorbid diabetes, chronic kidney disease, history of stroke: strict management
Main Antihypertensive Drugs
| Classification | Representative drugs | Characteristics |
|---|---|---|
| ARBs | Telmisartan, Olmesartan, Azilsartan | Kidney and heart protective effects, for those with comorbid diabetes |
| ACE inhibitors | Enalapril, Perindopril | Similar to ARBs, side effect of dry cough |
| Calcium channel blockers | Amlodipine, Cilnidipine | One of the first-line treatments, stable antihypertensive effect |
| Diuretics | Hydrochlorothiazide, Indapamide | Salt-sensitive hypertension, comorbid heart failure |
| β-blockers | Bisoprolol, Carvedilol | Comorbid arrhythmia, heart disease |
Diabetes
Diabetes is a condition characterized by chronic hyperglycemia due to insufficient insulin action, and the estimated number of patients and pre-diabetics in Japan is approximately 20 million.
Diagnostic Criteria for Diabetes
| Test Item | Normal | Borderline | Diabetic |
|---|---|---|---|
| Fasting Blood Glucose | <110 | 110-125 | ≧126 mg/dL |
| 75g OGTT 2-hour value | <140 | 140-199 | ≧200 mg/dL |
| Random Blood Glucose | - | - | ≧200 mg/dL |
| HbA1c | <5.6% | 5.6-6.4% | ≧6.5% |
Treatment Goals (HbA1c)
- Blood glucose normalization target: <6.0% (for eligible individuals)
- Complication prevention target: <7.0% (for most individuals)
- When treatment intensification is difficult: <8.0% (elderly, hypoglycemia risk)
Main Diabetes Medications
| Classification | Representative Drugs | Characteristics |
|---|---|---|
| Biguanides | Metformin | First-line, less weight gain, inexpensive |
| SGLT2 inhibitors | Dapagliflozin, Empagliflozin | Cardio-renal protective effects, weight loss |
| DPP-4 inhibitors | Sitagliptin, Linagliptin | Low risk of hypoglycemia, safe for elderly |
| GLP-1 receptor agonists | Dulaglutide (weekly injection), Semaglutide (oral/injection) | Weight loss, cardioprotective effect |
| Sulfonylureas (SU) | Glimepiride | Potent but high risk of hypoglycemia |
| Insulin | Basal/Bolus | Reliable effect, when blood glucose control is difficult with other methods |
Complications of Diabetes
- Microangiopathy: Retinopathy (cause of blindness) / Nephropathy (cause of dialysis) / Neuropathy
- Macroangiopathy: Myocardial infarction / Cerebral infarction / Peripheral artery disease
- Infections (foot gangrene, periodontal disease, urinary tract infection)
- Increased risk of dementia
- Increased risk of cancer
Dyslipidemia
Dyslipidemia is an imbalance of lipids in the blood, and it is the biggest risk factor for atherosclerosis. Since there are almost no subjective symptoms, it is often discovered during health check-ups.
Diagnostic Criteria and Management Goals
| Item | Diagnostic Criteria | Management Goals (Primary prevention of coronary artery disease) |
|---|---|---|
| LDL-cholesterol | ≧140 mg/dL | <120〜140 (depending on risk) |
| HDL-cholesterol | <40 mg/dL | ≧40 |
| Triglycerides (TG) | ≧150 mg/dL (fasting) | <150 |
| non-HDL cholesterol | ≧170 mg/dL | <150〜170 |
Medications
- Statins: Rosuvastatin, Pitavastatin, Atorvastatin, etc. — First-line for LDL reduction
- Ezetimibe: Additional reduction when combined with statins
- Fibrates: For particularly high triglycerides
- PCSK9 inhibitors: For intractable familial hypercholesterolemia (specialized institutions)
About statin-induced myalgia
Statins can rarely cause muscle pain and elevated CK levels. If mild, it can be managed by reducing the dose or switching to another drug. Rhabdomyolysis is very rare, but if you experience severe muscle pain and dark urine, seek medical attention immediately.
Hyperuricemia and Gout
Hyperuricemia is diagnosed when serum uric acid levels are 7.0 mg/dL or higher. If left untreated, it can lead to gout attacks, kidney damage, and urinary tract stones.
Treatment Policy
- If there is a history of gout attacks, kidney damage, or urinary tract stones, drug treatment is necessary (target <6.0 mg/dL).
- Asymptomatic hyperuricemia (below 8.0) primarily focuses on lifestyle guidance.
- During an attack, NSAIDs and colchicine should be used (as early as possible after onset).
- In the chronic phase, febuxostat and allopurinol are used to suppress uric acid production.
Lifestyle Guidance
- Reduce purine-rich foods (liver, dried fish, cod roe).
- Limit alcohol (especially beer and sake).
- Drink more than 2 liters of water per day.
- Correct obesity.
- Limit fructose (soft drinks).
Chronic Kidney Disease (CKD)
Chronic kidney disease is a condition where kidney function is reduced for three months or more, diagnosed by an eGFR <60 or persistent proteinuria. It is said that approximately 1 in 8 adults are affected, and it poses a significant risk for dialysis initiation and cardiovascular disease.
CKD Staging Classification
| Stage | eGFR (ml/min/1.73㎡) | Condition |
|---|---|---|
| G1 | ≧90 | Normal or high (with abnormal urine findings) |
| G2 | 60-89 | Mild decrease |
| G3a | 45-59 | Mild to moderate decrease |
| G3b | 30-44 | Moderate to severe decrease |
| G4 | 15-29 | Severe decrease |
| G5 | <15 | End-stage renal failure (dialysis consideration) |
Key points for preventing progression
- Blood pressure management (<130/80)
- Blood sugar management (if diabetic)
- Salt restriction (less than 6g per day)
- Protein restriction (depending on disease stage)
- Smoking cessation
- Avoid nephrotoxic drugs (NSAIDs, certain antibiotics)
- Kidney protection with SGLT2 inhibitors, ARBs, etc.
What happens if lifestyle-related diseases are left untreated?
Understand the complications 10 or 20 years from now
Even if lifestyle-related diseases don't cause problems "now," they progress steadily over years. Many of the following complications are irreversible. Let's prevent them with proper management.
| Complication | Main underlying disease |
|---|---|
| Myocardial infarction | Hypertension, dyslipidemia, diabetes, smoking |
| Stroke (infarction/hemorrhage) | Hypertension, atrial fibrillation, diabetes |
| Chronic renal failure (dialysis) | Diabetes, hypertension, CKD progression |
| Blindness | Diabetic retinopathy, hypertensive retinopathy |
| Amputation of foot | Diabetic foot, peripheral artery disease |
| Dementia | Vascular dementia, Alzheimer's (vascular factors involved) |
| Cancer | Increased risk with obesity, diabetes |
Please consult us if you have any of the following concerns:
- You were told to get "further examination" or "medical treatment" at your health check-up.
- You are concerned about your blood pressure, blood sugar, cholesterol, or uric acid levels.
- You are currently prescribed medication at another hospital, but the clinic hours don't suit you.
- You want to start with lifestyle changes before taking medication.
- You have a family history and are worried about the future.
- You are obese, have a history of smoking, or lack exercise.
- You want to continue treatment for hypertension, diabetes, or dyslipidemia.
Benefits of continuous management at our clinic
- Immediate blood tests, urinalysis, and electrocardiogram to understand your current condition.
- Comprehensive management of multiple lifestyle-related diseases in one visit.
- Open daily from 9 AM to 9 PM, making it easy to visit after work.
- No appointment necessary, making it easy to continue treatment.
- Referral to appropriate specialized institutions for specialized complications.
- Detailed lifestyle guidance.
Key points for lifestyle improvement
Diet
- Salt: less than 6g per day (for hypertension/kidney disease)
- Vegetables: 350g or more per day
- Eat a balanced diet of fish, soybeans, and chicken.
- Limit refined sugars, sweets, and soft drinks.
- Actively consume dietary fiber (vegetables, seaweed, whole grains).
- Limit fatty foods and processed foods.
- Don't skip breakfast and reduce snacking.
Exercise
- Aerobic exercise: 150 minutes or more per week (brisk walking, swimming, cycling)
- Strength training: 2 or more times per week (especially for the elderly)
- Avoid prolonged sitting (stand up every 30-60 minutes)
- If you dislike exercise, start by "taking the stairs" or "walking one train station."
Other
- Smoking cessation (greatest risk reduction effect)
- Moderate alcohol consumption (men <20g/day, women <10g/day)
- 7 hours of sleep
- Stress management and relaxation time
- Regular medical visits (do not self-discontinue)
Features of our clinic's lifestyle-related disease treatment
- Comprehensive management of hypertension, diabetes, dyslipidemia, gout, and CKD
- Blood tests, urine tests, electrocardiograms, and chest X-rays can be performed on the same day.
- Guideline-based treatment backed by evidence
- Handles new treatment options such as SGLT2 inhibitors, GLP-1, and new statins.
- Smooth acceptance of transfers from other clinics/hospitals.
- Referral to specialized institutions if specialized diabetes management is required.
- Coordination with ophthalmology, nephrology, and cardiology specialists.
- No appointment needed, same-day consultation OK / Open daily from 9 AM to 9 PM / 1-minute walk from Jujo Station.
Lifestyle-related diseases are managed by a team.
Treating lifestyle-related diseases is a team effort involving the doctor, patient, family, diet, and exercise. It's not just about "taking medication"; let's work together to improve your lifestyle. Our clinic will support you as a long-term primary care physician.
