Korean Circ J.  2019 Dec;49(12):1123-1135. 10.4070/kcj.2019.0246.

Key Points of the 2019 Japanese Society of Hypertension Guidelines for the Management of Hypertension

• Kario K

• KMID: 2464292
• DOI: http://doi.org/10.4070/kcj.2019.0246

Abstract

The new 2019 Japanese Society of Hypertension (JSH) guidelines for the management of hypertension are now available; these update the previous guidelines published in 2014. The primary objective of the guideline is to provide all healthcare professionals with a standard management strategy and appropriate antihypertensive treatments to prevent hypertension-related target organ damage and cardiovascular events. The major changes in the new guideline relate to the definition of normal blood pressure (BP) and target BP. The terms "˜normal BP' and "˜high normal BP' used in the JSH 2014 guidelines are replaced with terms "˜high normal BP' and "˜elevated BP,' respectively. There was no change to the office BP diagnostic threshold for hypertension (140/90 mmHg). Recommended target office and home BP values for patients with hypertension aged <75 years and/or high-risk patients are <130/80 mmHg and <125/75 mmHg, respectively. Corresponding targets for elderly patients with hypertension (age≥75 years) are 140/90 and 135/85 mmHg, respectively. The goal is that these changes will contribute to reducing cardiovascular events, especially stroke and heart failure, in Japan. The dissemination of the JSH 2019 guidelines and implementation of a home BP-based approach by all general practitioners in Japan might be facilitated by digital hypertension management using health information technology.

Keyword

Hypertension; Evidence-based practice; Antihypertensive agents; Japan

MeSH Terms

Aged
Antihypertensive Agents
Asian Continental Ancestry Group*
Blood Pressure
Delivery of Health Care
Evidence-Based Practice
General Practitioners
Heart Failure
Humans
Hypertension*
Japan
Medical Informatics
Stroke
Antihypertensive Agents

Figure

• 

  Figure 1 Cerebro- and CVD risk stratification based on clinic BP based on the JSH 2014 and 2019 guidelines. Changes from 2014 to 2019 are shown in red. BP = blood pressure; CKD = chronic kidney disease; CVD = cardiovascular disease; GL = guideline; JSH = Japanese Society of Hypertension. *The prognostic factors used for stratification are BP, age (≥65), sex (man), dyslipidemia, smoking, history of cardiovascular diseases (cerebral hemorrhage, cerebral infarction, myocardial infarction), non-valvular atrial fibrillation, diabetes mellitus and CKD with proteinuria.

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