Figure 1.

Flowchart. We extracted 3,621,942 individuals with available health check-up data including physical examination and blood test from the JMDC Claims Database between January 2005 and April 2020. We excluded individuals with CVD history of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation or hemodialysis (n = 166,144), and those having missing data on medications for hypertension, diabetes mellitus, or dyslipidemia (n = 222,496), cigarette smoking (n = 15,404), alcohol consumption (n = 370,041), and physical inactivity (n = 107,079). Finally, we included 2,740,778 participants in this study.