What are lifestyle diseases and chronic illnesses?
Lifestyle diseases are a general term for a group of diseases whose onset is influenced by daily lifestyle habits such as diet, exercise, smoking, drinking, and stress. Hypertension, diabetes, dyslipidemia, hyperuricemia, and chronic kidney disease are typical examples. These diseases progress without 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 people has some form of lifestyle disease, and these diseases can be prevented from causing complications with proper management.
If your health checkup says "further examination required," see a doctor immediately.
For lifestyle diseases, early detection and early intervention are key to preventing complications. If you leave it untreated because you have no symptoms, it will become a serious problem 10 or 20 years later. If you are advised to do so in a health checkup, please consult us immediately.
Hypertension
The estimated number of patients with hypertension in Japan is approximately 43 million. Systolic blood pressure of 140 mmHg or higher and diastolic blood pressure of 90 mmHg or higher are the diagnostic criteria for hypertension.
Classification of Blood Pressure (Office Blood Pressure)
| Classification | Systolic | Diastolic |
|---|---|---|
| Normal Blood Pressure | <120 | <80 |
| High-Normal 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
- Young and Middle-aged (under 75): <130/80 mmHg
- Elderly (75 or older): <140/90 mmHg (individualized)
- Comorbid diabetes, chronic kidney disease, history of stroke: Strict management
Main Antihypertensive Drugs
| Classification | Representative Drug | Characteristics |
|---|---|---|
| ARB | Telmisartan, Olmesartan, Azilsartan | Renal and cardiac protective effects, for patients with comorbid diabetes |
| ACE inhibitor | Enalapril, Perindopril | Similar to ARBs, side effect of dry cough |
| Calcium Channel Blocker | Amlodipine, Cilnidipine | One of the first-line treatments, stable antihypertensive effect |
| Diuretic | Hydrochlorothiazide, Indapamide | Salt-sensitive hypertension, comorbid heart failure |
| β-blocker | Bisoprolol, Carvedilol | Comorbid arrhythmia, heart disease |
For more information about hypertension, please refer to the article 【What to do first if you're told you have high blood pressure in a checkup】
Diabetes
Diabetes is a disease in which chronic hyperglycemia persists 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 Plasma Glucose | <110 | 110-125 | ≥126 mg/dL |
| 75g OGTT 2-hour value | <140 | 140-199 | ≥200 mg/dL |
| Random Plasma Glucose | - | - | ≥200 mg/dL |
| HbA1c | <5.6% | 5.6-6.4% | ≥6.5% |
Treatment Goals (HbA1c)
- Glycemic Normalization Target: <6.0% (for eligible individuals)
- Complication Prevention Target: <7.0% (for most individuals)
- When Intensive Treatment is Difficult: <8.0% (elderly, risk of hypoglycemia)
Main Diabetes Medications
| Classification | Representative Drug | Characteristics |
|---|---|---|
| Biguanide | Metformin | First-line, less weight gain, inexpensive |
| SGLT2 inhibitor | Dapagliflozin, Empagliflozin | Cardio-renal protective effects, weight loss |
| DPP-4 inhibitor | Sitagliptin, Linagliptin | Low risk of hypoglycemia, safe for elderly |
| GLP-1 receptor agonist | Dulaglutide (weekly injection), Semaglutide (oral/injection) | Weight loss, cardioprotective effect |
| Sulfonylurea (SU) | Glimepiride | Potent but high risk of hypoglycemia |
| Insulin | Basal/Bolus | Definitely effective, when blood glucose control is difficult with other methods |
Complications of Diabetes
- Microvascular complications: Retinopathy (cause of blindness) / Nephropathy (cause of dialysis) / Neuropathy
- Macrovascular complications: Myocardial infarction / Cerebral infarction / Peripheral arterial disease
- Infections (foot gangrene, periodontal disease, urinary tract infection)
- Increased risk of dementia
- Increased risk of cancer
For more information about diabetes, please refer to the article Continuing Diabetes Treatment in Jujo, Kita Ward!
Dyslipidemia
Dyslipidemia is an imbalance of lipids in the blood and is the biggest risk factor for arteriosclerosis. Since there are almost no subjective symptoms, it is often discovered during health checkups.
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: Refractory familial hypercholesterolemia (specialized institutions)
About Statin-induced Muscle Pain
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 or dark urine, seek medical attention immediately.
For more information about dyslipidemia, please refer to the article Cholesterol and Dyslipidemia Treatment in Jujo!
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 initiated (target <6.0 mg/dL).
- Asymptomatic hyperuricemia (under 8.0) primarily involves lifestyle guidance.
- During an attack, NSAIDs and colchicine are used (as early as possible after the onset of the attack).
- In the chronic phase, febuxostat and allopurinol are used to suppress uric acid production.
Lifestyle Guidance
- Limit foods high in purine (liver, dried fish, shirako)
- Limit alcohol (especially beer and sake)
- Drink at least 2 liters of water per day
- Correct obesity
- Limit fructose (soft drinks)
For more information about gout and hyperuricemia, please refer to the article here: Gout and Hyperuricemia Treatment in Jujo
Chronic Kidney Disease (CKD)
Chronic kidney disease is a condition where kidney function has been decreased for three months or more, and it is diagnosed when eGFR is <60 or urine protein positivity continues. It is said that about 1 in 8 adults are affected, and it is a major risk for dialysis initiation and cardiovascular disease.
CKD Stage 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 (consider dialysis) |
Points for Preventing Progression
- Blood pressure management (<130/80)
- Blood sugar management (if diabetic)
- Salt restriction (less than 6g/day)
- Protein restriction (depending on stage of disease)
- Smoking cessation
- Avoid using nephrotoxic drugs (NSAIDs, certain antibiotics)
- Renal protection with SGLT2 inhibitors, ARBs, etc.
What happens if lifestyle diseases are left untreated?
Know the complications 10 and 20 years from now.
Even if lifestyle diseases do not cause problems "now," they progress steadily over the years. Many of the following complications are irreversible. Let's prevent them with proper management.
| Complication | Main Causal 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 the foot | Diabetic foot, peripheral arterial disease |
| Dementia | Vascular dementia, Alzheimer's (vascular factors involved) |
| Cancer | Increased risk due to obesity, diabetes |
Please consult us if any of the following apply to you:
- Your health check-up indicated "further examination required" or "medical treatment required."
- You are concerned about your blood pressure, blood sugar, cholesterol, or uric acid levels.
- You are prescribed medication at another clinic, but the consultation hours are inconvenient.
- 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 diseases in a single visit
- Open daily from 9 AM to 9 PM, making it easy to visit after work.
- Walk-ins welcome, 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
- Balance 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, reduce snacking
Exercise
- Aerobic exercise: 150 minutes or more per week (brisk walking, swimming, cycling)
- Strength training: Twice a week or more (especially for seniors)
- Don't sit continuously (stand up once every 30-60 minutes)
- If you dislike exercise, start by "taking the stairs" or "walking one train stop"
Other
- Smoking cessation (greatest risk reduction effect)
- Moderate alcohol consumption (men <20g/day, women <10g/day)
- Around 7 hours of sleep
- Stress management and relaxation time
- Regular clinic visits (do not self-discontinue)
Characteristics of our clinic's lifestyle disease treatment
- Comprehensive management of hypertension, diabetes, dyslipidemia, gout, and CKD
- Blood, urine, ECG, and chest X-rays can be performed on the same day
- Guideline-based treatment supported by evidence
- 対応 SGLT2 inhibitors, GLP-1, new statins, and other new treatment options available
- Smooth acceptance of transfers from other clinics
- Referral to specialist institutions when specialized diabetes management is required
- Cooperation system with ophthalmology, nephrology, and cardiology specialists
- Walk-ins and same-day appointments welcome / Open daily from 9 AM to 9 PM / 1-minute walk from Jujo Station
Lifestyle diseases are managed by a team.
The treatment of lifestyle 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 adjust your lifestyle. Our clinic will support you as your long-term family doctor.
