Introduction.
In 2025, the Japanese Society of Hypertension (JSH) published "Guideline 2025," a major evolution in the management of hypertension. The purpose behind this is to enable patients to proceed to treatment more quickly, safely, and with greater peace of mind. In this issue, we have compiled an easy-to-understand summary of the five points that Guideline 2025 depicts, including "blood pressure target setting," "measurement methods," and "compatibility with lifestyle," which patients in particular need to understand.
(1) The blood pressure target is unified as "less than 130/80 mmHg for all persons".
In the new edition, regardless of age or complications,Uniformly, clinic room blood pressure less than 130/80 mmHgWe recommend that you use the following (tsunekawa-heart.com, Nature)。
This goal is based on strong evidence that it reduces the risk of developing cardiovascular events. Also, in home blood pressure (Home BP),Less than 125/75 mmHgThe goal should be to achieve the following.
(2) More important to measure blood pressure at home
Guideline 2025 places more emphasis on "home blood pressure (morning and evening measurements)" than in the past. This is because "white coat hypertension" and "mask hypertension" are more likely to affect hospital measurements, and home measurements are more in line with daily realities (tsunekawa-heart.com)。
Through home records, you will be able to have more specific discussions with your doctor.
(iii) Elaboration of cardiovascular risk assessment
JSH2025 takes into account not only blood pressure but also "age, gender, diabetes, renal function, smoking history, etc.Stratified cardiovascular risk assessmentis recommended (Nature)。
For those at higher risk, a more aggressive initiation of treatment is suggested to ensure a safe and optimal response.
4) Stepwise integration of lifestyle modification (salt reduction, exercise, etc.) and drug treatment
Guideline 2025 begins with.Salt reduction, exercise, weight control, smoking cessationEmphasis is placed on improving lifestyle habits such as If the goal is not reached after 3 to 6 months of progress on that basis,Early drug combination policyThe clarification was made to (tsunekawa-heart.com)。
In addition, for the elderly and those with complications, treatment should be adjusted after an individualized assessment of risks and benefits (tsunekawa-heart.com)。
(5) Strengthen the use of digital technology and behavioral support
In the guidelines,Evaluation of urinary sodium/potassium ratioand ...,Smartphone applications and home blood pressure recording devicesThe use of tools to support patient behavior change is widely recommended, such as blood pressure management using the (tsunekawa-heart.com)。
Daily records are turned into "meaningful data," improving the accuracy of testing and treatment.
How is it actually practiced in the clinic?
Meguro-ku, TokyoIkejiri-Ohashi Sera Clinicpromotes hypertension management based on Guideline 2025 as follows
- Support for home blood pressure measurementThe following is a brief overview of the program: We will carefully instruct you on the correct method of measurement and provide you with a record sheet.
- Risk Assessment Personalization: Treatment plans are individually designed according to stratified risk. Discussions range from lifestyle focus to drug selection.
- Continuous Support System: Increase continuity through regular follow-up and medical care that utilizes home blood pressure data.
- IT utilization and lifestyle support: Advice on blood pressure management applications, use of urinary indicators, and continued lifestyle support are also actively provided.
Summary Table: Key Points of Guideline 2025
| point | Contents |
| 1. target blood pressure | Clinic: <130/80 mmHg; Home: <125/75 mmHg |
| 2. measurement method | Emphasis on home blood pressure measurement and daily blood pressure monitoring |
| 3. risk assessment | To individualized treatment by integrating age, lifestyle, etc. |
| 4. gradation of treatment | Lifestyle improvement → Initiate drug treatment when necessary |
| 5. digital and behavioral support | Improve management accuracy with apps, urine indicators, and ongoing support |
References
- Japanese Society of Hypertension. JSH2025 Guidelines (Nature)
- Kai H. The new blood pressure target, a new era: ... Hypertens Res. 2025 (Nature)
- Key highlights of JSH2025.(PubMed summarization)
- Achievement rate of BP control <130/80 mmHg (Kario et al., 2008)
Symptoms and Causes of Hypertension