While the life expectancy of a person born in Japan is among the highest in the world at 82.9 years, tobacco smoking and high blood pressure remain the biggest risk factor of death among Japanese adults.

A new study published in PLoS Medicine, suggest that Japan should emphasize the need to reduce tobacco smoking and to improve ongoing programs designed to help people manage multiple cardiovascular risk factors.

Nayu Ikeda from the University of Tokyo in Japan and colleagues found that in Japan tobacco smoking and high blood pressure accounted for 129,000 and 104,000 deaths, respectively, in 2007 among adults 30 years and older.

The researchers suggest that in order to maintain the longevity trend of Japan additional efforts are needed.

A first step will be to powerfully promote effective programs for smoking cessation, said the authors.

Health care professionals, including physicians, who are highly conscious of the harms of tobacco will play the primary role in treatment of smoking and creating an environment for implementation of stringent tobacco control policies, the authors argued.

Regarding high blood pressure the authors said that it is urgent to establish a monitoring system for management of high blood pressure at the national level. Further investigation through national health surveys will help understand factors that contribute to the inadequate control of blood pressure in the Japanese population.

The authors conclude that additional efforts through interventions and policies should take place in order to sustain Japan's long life expectancy.

Measuring the quality of the care that is actually delivered by interventions will be of paramount importance in the assessment of current policies and programs for the treatment of multiple cardiovascular risks including hypertension. These concerted actions in research, public health, clinical practice, and policymaking will be the key for maintaining good population health in the aging society.