Key highlights of the Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025)

Yusuke Ohya^{1

2

3}, Atsushi Sakima^{4

5}, Hisatomi Arima^{4

6}, Ako Fukami^{4

7

8}, Masato Furuhashi^{4

9}, Mari Ishida^{4

10}, Toshihiko Ishimitsu^{4

11}, Hisashi Kai^{4

12}, Kiyoshi Matsumura^{4

13}, Katsuyuki Miura^{4

14}, Masashi Mukoyama^{4

15}, Masanori Munakata^{4

16}, Takatoshi Ohkubo^{4

17}, Hiromi Rakugi^{4

18}, Takeshi Takami^{4

19}, Takuya Tsuchihashi^{4

20}, Nobuhito Hirawa^{4

21}

Affiliations

¹ University of the Ryukyus Hospital, Okinawa, Japan. ohya@cs.u-ryukyu.ac.jp.
² Okinawa Hokubu Medical Foundation, Okinawa, Japan. ohya@cs.u-ryukyu.ac.jp.
³ Japanese Society of Hypertension, Tokyo, Japan. ohya@cs.u-ryukyu.ac.jp.
⁴ Japanese Society of Hypertension, Tokyo, Japan.
⁵ Health Administration Center, University of the Ryukyus, Okinawa, Japan.
⁶ Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
⁷ Preventive Health and Screening Center, Kurume University Hospital, Kurume, Japan.
⁸ Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.
⁹ Division of Cardiovascular-Kidney-Metabolic Medicine, Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan.
¹⁰ Department of Health and Nutrition, Faculty of Health Sciences, Hiroshima Shudo University, Hiroshima, Japan.
¹¹ Utsunomiya Chuo Hospital, Tochigi, Japan.
¹² Yokokura Hospital, Fukuoka, Japan.
¹³ Kitakyushu Wakasugi Hospital, Fukuoka, Japan.
¹⁴ NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan.
¹⁵ Department of Nephrology, Omuta Tenryo Hospital, Fukuoka, Japan.
¹⁶ Research Center for the Promotion of Health and Employment Support, Tohoku Rosai Hospital, Miyagi, Japan.
¹⁷ Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
¹⁸ Osaka Rosai Hospital, Osaka, Japan.
¹⁹ Department of Internal Medicine, Clinic Jingumae, Nara, Japan.
²⁰ Steel Memorial Yawata Hospital, Fukuoka, Japan.
²¹ Department of Nephrology and Hypertension, Yokohama City University Medical Center, Kanagawa, Japan.

PMID: 40877471
DOI: 10.1038/s41440-025-02331-8

Editorial

Key highlights of the Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025)

Yusuke Ohya et al. Hypertens Res. 2025 Oct.

. 2025 Oct;48(10):2500-2511.

doi: 10.1038/s41440-025-02331-8. Epub 2025 Aug 29.

Authors

Affiliations

¹ University of the Ryukyus Hospital, Okinawa, Japan. ohya@cs.u-ryukyu.ac.jp.
² Okinawa Hokubu Medical Foundation, Okinawa, Japan. ohya@cs.u-ryukyu.ac.jp.
³ Japanese Society of Hypertension, Tokyo, Japan. ohya@cs.u-ryukyu.ac.jp.
⁴ Japanese Society of Hypertension, Tokyo, Japan.
⁵ Health Administration Center, University of the Ryukyus, Okinawa, Japan.
⁶ Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
⁷ Preventive Health and Screening Center, Kurume University Hospital, Kurume, Japan.
⁸ Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.
⁹ Division of Cardiovascular-Kidney-Metabolic Medicine, Department of Internal Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan.
¹⁰ Department of Health and Nutrition, Faculty of Health Sciences, Hiroshima Shudo University, Hiroshima, Japan.
¹¹ Utsunomiya Chuo Hospital, Tochigi, Japan.
¹² Yokokura Hospital, Fukuoka, Japan.
¹³ Kitakyushu Wakasugi Hospital, Fukuoka, Japan.
¹⁴ NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan.
¹⁵ Department of Nephrology, Omuta Tenryo Hospital, Fukuoka, Japan.
¹⁶ Research Center for the Promotion of Health and Employment Support, Tohoku Rosai Hospital, Miyagi, Japan.
¹⁷ Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
¹⁸ Osaka Rosai Hospital, Osaka, Japan.
¹⁹ Department of Internal Medicine, Clinic Jingumae, Nara, Japan.
²⁰ Steel Memorial Yawata Hospital, Fukuoka, Japan.
²¹ Department of Nephrology and Hypertension, Yokohama City University Medical Center, Kanagawa, Japan.

PMID: 40877471
DOI: 10.1038/s41440-025-02331-8

Abstract

Japan has long maintained a robust national health system with universal health coverage and accessible antihypertensive therapy. Nevertheless, population-level blood pressure (BP) control remains suboptimal. To address this public health challenge, the Japanese Society of Hypertension published the Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025 (JSH2025), integrating evidence-based recommendations and practical approaches to improve hypertension care. JSH2025 introduces a dual-format structure comprising clinical question sections developed through systematic reviews and consensus-based narrative chapters. The key updates include universal BP targets of <130/80 mmHg across populations, promotion of home BP monitoring, stratified cardiovascular risk assessment, expanded guidance on digital health and behavioral interventions, and condition-specific management strategies for older adults, women, and cancer survivors. We outline the major updates and innovations in JSH2025 and show their clinical and public health implications.

Keywords: Clinical practice; Elevated blood pressure; Guidelines; Hypertension; Japanese Society of Hypertension.

PubMed Disclaimer

Conflict of interest statement

Compliance with ethical standards. Conflict of interest: The Task Force Committee for the JSH2025 was established in accordance with the Guidance on Eligibility Criteria for Participation in Clinical Practice Guideline Development 2023 issued by the Japan Medical Association. The committee members were selected based on the Conflict of Interest (COI) Management Policy for JSH2025. Declarations of COI for all committee members over the past 3 fiscal years (2022–2024) have been disclosed and are publicly available on the website of the Japanese Society of Hypertension. https://www.jpnsh.jp/data/jsh2025/jsh2025_coi.pdf

References

1. NCD Risk Factor Collaboration (NCD-RisC). Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. Lancet. 2019;394:639–51. - DOI
1. Japanese Society of Hypertension Guidelines Committee. The Japanese Society of Hypertension Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025 (JSH2025). Tokyo: Life Science Publishing Co., Ltd.; 2025.
1. Umemura S, Arima H, Arima S, Asayama K, Dohi Y, Hirooka Y, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res. 2019;42:1235–481. - DOI - PubMed
1. Maruhashi T, Tatsumi Y, Satoh M, Kobayashi Y, Ogoyama Y, Sakima A, et al. Updated meta-analysis for antihypertensive treatment guided by home blood pressure compared to treatment based on office blood pressure: systematic review. Hypertens Res. 2025;48:1839–45. - DOI - PubMed
1. Satoh M, Tatsumi Y, Nakayama S, Shinohara Y, Kawazoe M, Nozato Y, et al. Self-measurement of blood pressure at home using a cuff device for change in blood pressure levels: systematic review and meta-analysis. Hypertens Res. 2025;48:574–91. - DOI - PubMed

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Key highlights of the Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025)

Affiliations

Key highlights of the Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025)

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Substances

Supplementary concepts

LinkOut - more resources

Full Text Sources

Medical