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The JSH Morning Hypertension Eradication Program Project
Kazuomi Kario1, Akira Nishiyama2, Shigeru Shibata3
1Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. kkario@jichi.ac.jp.
Insights
Managing early morning hypertension is crucial for cardiovascular health in Japan. The Japanese Society of Hypertension
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Public Health Initiatives
Background:
- Hypertension is a leading risk factor for cardiovascular diseases and mortality.
- In Japan, 43 million people have hypertension, with only 27% achieving controlled blood pressure (BP).
- Major cardiovascular events often occur in the early morning hours.
Discussion:
- The Japanese Society of Hypertension (JSH) guidelines emphasize home BP monitoring for managing early morning hypertension.
- Despite multiple medications, fewer than 30% of hypertensive patients achieve morning BP targets (<130/80 mmHg).
- JSH declared 2025 the year for eradicating morning hypertension, releasing new guidelines.
Key Insights:
- The Asakatsu BP Action Plan encourages widespread morning BP monitoring.
- JSH's Systematic Review and Data Science Projects aim to increase awareness and leverage digital health.
- Focus on personalized and anticipatory medicine through "digital hypertension" research.
Outlook:
- The initiative aims to significantly improve morning BP control nationwide.
- International collaboration will be sought to address early morning hypertension globally.
- Digital technology integration promises advancements in hypertension management and prevention.
Abstract:
Hypertension is the greatest risk factor for cardiovascular diseases and significantly contributes to cardiovascular mortality. In Japan, the hypertensive population is estimated at 43 million, with only 27% achieving well-controlled blood pressure (BP). The onset of major cardiovascular events, including stroke, myocardial infarction, heart failure, and aortic dissection, frequently occurs during the early morning hours. Accordingly, for over 20 years, the Japanese Society of Hypertension (JSH) has prioritized the management of early morning hypertension and has emphasized the importance of antihypertensive treatment guided by home BP in its treatment guidelines. However, even among hypertensive patients with multiple medications, control of morning BP remains suboptimal, with fewer than 30% achieving target levels below 130/80 mmHg. To address this serious situation, JSH announced their Declaration for the Eradication of Morning Hypertension in 2025, in conjunction with the release of the Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025. The primary specific measure of the declaration involves the Asakatsu BP Action Plan - the Morning Blood Pressure 130 Campaign - which encourages individuals to monitor their morning blood pressure (BP) in various settings, such as homes, workplaces, and BP kiosks set up in public spaces. Additionally, JSH is promoting a Systematic Review Project to raise awareness of the importance of early morning hypertension management nationally and internationally, and a Data Science Project to examine how digital technology can contribute to the promotion of personalized and anticipation medicine through "digital hypertension" research.
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