The JSH Morning Hypertension Eradication Program Project

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.

Keywords: Asakatsu; Morning Hypertension Eradication Program; guideline; implementation hypertension; kiosk blood pressure.