Perspectives on the management of hypertension in Japan

Hypertension is the most prevalent disease in Japan. However, it is estimated that only 50% of hypertensive patients receiving antihypertensive drug treatment achieve blood pressure of less than 140/90 mmHg. Consequently, hypertension is the leading cause of cardiovascular death in Japan. Innovative high-risk strategies are necessary to reduce hypertension-related morbidity and mortality in Japan.

This perspective summarizes the current prescription status of antihypertensive drug treatment, the clinical role of antihypertensive drug treatment in the management of hypertension and provides future perspectives in the management of hypertension in Japan.

Earlier and lower blood pressure control throughout 24 h is currently recommended for the management of hypertension. Management of nighttime blood pressure is clinically important since nighttime blood pressure has been shown to be more closely associated than daytime blood pressure with cardiovascular events in patients receiving antihypertensive drug treatment. An appropriate selection of antihypertensive drugs and bedtime dosing of antihypertensive drugs may be effective for reducing nighttime blood pressure. The development and advancement of home blood pressure monitoring would enable tailor-made antihypertensive drug treatment.