Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Clinical studies on pharmacological treatment of hypertension in Japan

Abstract

Differences in the epidemiology and phenotypes of hypertension in Japan compared with Western countries mean that optimal approaches to the pharmacological management of hypertension should be based on local data. Fortunately, there is a large body of evidence from studies conducted in Japanese populations to inform guidelines and treatment decisions. This article highlights treatment recommendations and BP targets for Japanese patients with hypertension, and summarizes key literature supporting these recommendations. The latest version of the Japanese Society of Hypertension (JSH) guidelines is consistent with US and European guidelines in recommending that the general BP target should be <130/80 mmHg for office blood pressure (BP) and <125/75 mmHg for home BP. There is good local evidence to support these targets. The JSH guidelines also strongly recommend that antihypertensive therapy is managed and monitored based on home BP, due to the closer association of this parameter with cardiovascular risk compared with office BP. Japan is a leader in out-of-office BP research, meaning that there is good evidence for the Japanese recommendations. Key features of antihypertensive agents for use in Japanese patients with hypertension include the ability to reduce stroke risk provide antihypertensive efficacy throughout the 24-h dosing period. Calcium channel blockers appear to be particularly effective in Asian populations, and are the most commonly prescribed agents in Japan. Again consistent with international recommendations, antihypertensive therapy should be started with a combination of agents to maximize the chances of achieving target BP.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

    Kario K, Chen CH, Park S, Park CG, Hoshide S, Cheng HM, et al. Consensus document on improving hypertension management in Asian patients, taking Into account Asian characteristics. Hypertension. 2018;71:375–82.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  2. 2.

    Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:2199–269.

    PubMed  Article  PubMed Central  Google Scholar 

  3. 3.

    Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104.

    PubMed  Article  PubMed Central  Google Scholar 

  4. 4.

    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.

    Article  Google Scholar 

  5. 5.

    Sakima A, Satonaka H, Nishida N, Yatsu K, Arima H. Optimal blood pressure targets for patients with hypertension: a systematic review and meta-analysis. Hypertens Res. 2019;42:483–95.

    PubMed  Article  PubMed Central  Google Scholar 

  6. 6.

    Takami Y, Yamamoto K, Arima H, Sakima A. Target blood pressure level for the treatment of elderly hypertensive patients: a systematic review and meta-analysis of randomized trials. Hypertens Res. 2019;42:660–8.

    PubMed  Article  PubMed Central  Google Scholar 

  7. 7.

    Arima H, Yonemoto K, Doi Y, Ninomiya T, Hata J, Tanizaki Y, et al. Development and validation of a cardiovascular risk prediction model for Japanese: the Hisayama study. Hypertens Res. 2009;32:1119–22.

    PubMed  Article  PubMed Central  Google Scholar 

  8. 8.

    Harada A, Ueshima H, Kinoshita Y, Miura K, Ohkubo T, Asayama K, et al. Absolute risk score for stroke, myocardial infarction, and all cardiovascular disease: Japan arteriosclerosis longitudinal study. Hypertension Res. 2019;42:567–79.

    Article  Google Scholar 

  9. 9.

    Lawes CM, Rodgers A, Bennett DA, Parag V, Suh I, Ueshima H, et al. Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens. 2003;21:707–16.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  10. 10.

    The Ministry of Health Labour and Welfare. The results of the 2017 National Health and Nutrition survey in Japan [in Japanese]. Available from: https://www.mhlw.go.jp/content/10904750/000351576.pdf. Accessed 20 Aug 2020.

  11. 11.

    Katsuya T, Ishikawa K, Sugimoto K, Rakugi H, Ogihara T. Salt sensitivity of Japanese from the viewpoint of gene polymorphism. Hypertens Res. 2003;26:521–5.

    PubMed  Article  PubMed Central  Google Scholar 

  12. 12.

    Ramachandran A, Snehalatha C. Rising burden of obesity in Asia. J Obesity. 2010;2010:868573.

  13. 13.

    Ishikawa Y, Ishikawa J, Ishikawa S, Kayaba K, Nakamura Y, Shimada K, et al. Prevalence and determinants of prehypertension in a Japanese general population: the Jichi Medical School Cohort Study. Hypertens Res. 2008;31:1323–30.

    PubMed  Article  PubMed Central  Google Scholar 

  14. 14.

    Asayama K, Thijs L, Li Y, Gu YM, Hara A, Liu YP, et al. Setting thresholds to varying blood pressure monitoring intervals differentially affects risk estimates associated with white-coat and masked hypertension in the population. Hypertension. 2014;64:935–42.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  15. 15.

    Ohkubo T, Imai Y, Tsuji I, Nagai K, Kato J, Kikuchi N, et al. Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement: a population-based observation in Ohasama, Japan. J Hypertens. 1998;16:971–5.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  16. 16.

    Sega R, Facchetti R, Bombelli M, Cesana G, Corrao G, Grassi G, et al. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation. 2005;111:1777–83.

    PubMed  Article  PubMed Central  Google Scholar 

  17. 17.

    Niiranen TJ, Hanninen MR, Johansson J, Reunanen A, Jula AM. Home-measured blood pressure is a stronger predictor of cardiovascular risk than office blood pressure: the Finn-Home study. Hypertension. 2010;55:1346–51.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  18. 18.

    Kario K, Park S, Buranakitjaroen P, Chia YC, Chen CH, Divinagracia R, et al. Guidance on home blood pressure monitoring: a statement of the HOPE Asia Network. J Clin Hypertens. 2018;20:456–61.

    Article  Google Scholar 

  19. 19.

    Kario K, Shin J, Chen CH, Buranakitjaroen P, Chia YC, Divinagracia R, et al. Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: the HOPE Asia Network. J Clin Hypertens (Greenwich). 2019:in press.

  20. 20.

    Park S, Buranakitjaroen P, Chen CH, Chia YC, Divinagracia R, Hoshide S, et al. Expert panel consensus recommendations for home blood pressure monitoring in Asia: the Hope Asia Network. J Hum Hypertens. 2018;32:249–58.

    PubMed  Article  PubMed Central  Google Scholar 

  21. 21.

    Yasui D, Asayama K, Ohkubo T, Kikuya M, Kanno A, Hara A, et al. Stroke risk in treated hypertension based on home blood pressure: the Ohasama study. Am J Hypertens. 2010;23:508–14.

    PubMed  Article  PubMed Central  Google Scholar 

  22. 22.

    Watabe D, Asayama K, Hanazawa T, Hosaka M, Satoh M, Yasui D, et al. Predictive power of home blood pressure indices at baseline and during follow-up in hypertensive patients: HOMED-BP study. Hypertens Res. 2018;41:622–8.

    PubMed  Article  PubMed Central  Google Scholar 

  23. 23.

    Asayama K, Ohkubo T, Metoki H, Obara T, Inoue R, Kikuya M, et al. Cardiovascular outcomes in the first trial of antihypertensive therapy guided by self-measured home blood pressure. Hypertens Res. 2012;35:1102–10.

    PubMed  Article  PubMed Central  Google Scholar 

  24. 24.

    Kario K, Saito I, Kushiro T, Teramukai S, Tomono Y, Okuda Y, et al. Morning home blood pressure Is a strong predictor of coronary artery disease: The HONEST study. J Am Coll Cardiol. 2016;67:1519–27.

    PubMed  Article  PubMed Central  Google Scholar 

  25. 25.

    Kario K, Saito I, Kushiro T, Teramukai S, Ishikawa Y, Mori Y, et al. Home blood pressure and cardiovascular outcomes in patients during antihypertensive therapy: primary results of HONEST, a large-scale prospective, real-world observational study. Hypertension. 2014;64:989–96.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  26. 26.

    Kario K, Iwashita M, Okuda Y, Sugiyama M, Saito I, Kushiro T, et al. Morning home blood pressure and cardiovascular events in Japanese hypertensive patients. Hypertension. 2018;72:854–61.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  27. 27.

    Hoshide S, Yano Y, Kanegae H, Kario K. Effect of lowering home blood pressure on subclinical cardiovascular disease in masked uncontrolled hypertension. J Am Coll Cardiol. 2018;71:2858–9.

    PubMed  Article  PubMed Central  Google Scholar 

  28. 28.

    Nishizawa M, Hoshide S, Okawara Y, Matsuo T, Kario K. Strict blood pressure control achieved using an ICT-based home blood pressure monitoring system in a catastrophically damaged area after a disaster. J Clin Hypertens (Greenwich). 2017;19:26–9.

    Article  Google Scholar 

  29. 29.

    Yano Y, Briasoulis A, Bakris GL, Hoshide S, Wang JG, Shimada K, et al. Effects of antihypertensive treatment in Asian populations: a meta-analysis of prospective randomized controlled studies (CARdiovascular protectioN group in Asia: CARNA). J Am Soc Hypertens. 2014;8:103–16.

    PubMed  Article  PubMed Central  Google Scholar 

  30. 30.

    Hoshide S, Kario K, de la Sierra A, Bilo G, Schillaci G, Banegas JR, et al. Ethnic differences in the degree of morning blood pressure surge and in its determinants between Japanese and European hypertensive subjects: data from the ARTEMIS study. Hypertension. 2015;66:750–6.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  31. 31.

    Wang JG, Kario K, Lau T, Wei YQ, Park CG, Kim CH, et al. Use of dihydropyridine calcium channel blockers in the management of hypertension in Eastern Asians: a scientific statement from the Asian Pacific Heart Association. Hypertens Res. 2011;34:423–30.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  32. 32.

    The CARENET Annual Report of Hypertension 2018. Available from: https://www.carenet.com/series/hakusho/cg002384_index.html. Accessed 19 Apr 2019 [Japanese].

  33. 33.

    Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016;387:957–67.

    PubMed  Article  PubMed Central  Google Scholar 

  34. 34.

    Kario K, Tomitani N, Kanegae H, Ishii H, Uchiyama K, Yamagiwa K, et al. Comparative effects of an angiotensin II receptor blocker (ARB)/diuretic vs. ARB/calcium-channel blocker combination on uncontrolled nocturnal hypertension evaluated by information and communication technology-based nocturnal home blood pressure monitoring - The NOCTURNE Study. Circ J. 2017;81:948–57.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  35. 35.

    JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008;31:2115–27.

    Article  Google Scholar 

  36. 36.

    Kitagawa K, Yamamoto Y, Arima H, Maeda T, Sunami N, Kanzawa T, et al. Effect of standard vs intensive blood pressure control on the risk of recurrent stroke: a randomized clinical trial and meta-analysis. JAMA Neurol. 2019;76:1309–18.

    PubMed  PubMed Central  Article  Google Scholar 

  37. 37.

    Ogihara T, Nakao K, Fukui T, Fukiyama K, Fujimoto A, Ueshima K, et al. The optimal target blood pressure for antihypertensive treatment in Japanese elderly patients with high-risk hypertension: a subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial. Hypertens Res. 2008;31:1595–601.

    PubMed  Article  PubMed Central  Google Scholar 

  38. 38.

    Ogihara T, Saruta T, Rakugi H, Matsuoka H, Shimamoto K, Shimada K, et al. Target blood pressure for treatment of isolated systolic hypertension in the elderly: valsartan in elderly isolated systolic hypertension study. Hypertension. 2010;56:196–202.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  39. 39.

    Burnier M, Wuerzner G. What is the hypertension “phenotype”? Curr Cardiovasc Risk Rep. 2015;9:9.

    Article  Google Scholar 

  40. 40.

    Ogihara T, Nakao K, Fukui T, Fukiyama K, Ueshima K, Oba K, et al. Effects of candesartan compared with amlodipine in hypertensive patients with high cardiovascular risks: candesartan antihypertensive survival evaluation in Japan trial. Hypertension. 2008;51:393–8.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  41. 41.

    Ogawa H, Kim-Mitsuyama S, Matsui K, Jinnouchi T, Jinnouchi H, Arakawa K. Angiotensin II receptor blocker-based therapy in Japanese elderly, high-risk, hypertensive patients. Am J Med. 2012;125:981–90.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  42. 42.

    Matsui Y, Eguchi K, O’Rourke MF, Ishikawa J, Miyashita H, Shimada K, et al. Differential effects between a calcium channel blocker and a diuretic when used in combination with angiotensin II receptor blocker on central aortic pressure in hypertensive patients. Hypertension. 2009;54:716–23.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  43. 43.

    Matsuzaki M, Ogihara T, Umemoto S, Rakugi H, Matsuoka H, Shimada K, et al. Prevention of cardiovascular events with calcium channel blocker-based combination therapies in patients with hypertension: a randomized controlled trial. J Hypertens. 2011;29:1649–59.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  44. 44.

    Ogihara T, Saruta T, Rakugi H, Saito I, Shimamoto K, Matsuoka H, et al. Combination therapy of hypertension in the elderly: a subgroup analysis of the Combination of OLMesartan and a calcium channel blocker or diuretic in Japanese elderly hypertensive patients trial. Hypertens Res. 2015;38:89–96.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  45. 45.

    Makino H, Haneda M, Babazono T, Moriya T, Ito S, Iwamoto Y, et al. Prevention of transition from incipient to overt nephropathy with telmisartan in patients with type 2 diabetes. Diabetes Care. 2007;30:1577–8.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  46. 46.

    Fujita T, Ando K, Nishimura H, Ideura T, Yasuda G, Isshiki M, et al. Antiproteinuric effect of the calcium channel blocker cilnidipine added to renin-angiotensin inhibition in hypertensive patients with chronic renal disease. Kidney Int. 2007;72:1543–9.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  47. 47.

    Kario K, Hoshide S, Shimizu M, Yano Y, Eguchi K, Ishikawa J, et al. Effect of dosing time of angiotensin II receptor blockade titrated by self-measured blood pressure recordings on cardiorenal protection in hypertensives: the Japan Morning Surge-Target Organ Protection (J-TOP) study. J Hypertens. 2010;28:1574–83.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  48. 48.

    Fukutomi M, Hoshide S, Eguchi K, Watanabe T, Shimada K, Kario K. Differential effects of strict blood pressure lowering by losartan/hydrochlorothiazide combination therapy and high-dose amlodipine monotherapy on microalbuminuria: the ALPHABET study. J Am Soc Hypertens. 2012;6:73–82.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  49. 49.

    Kario K, Matsui Y, Shibasaki S, Eguchi K, Ishikawa J, Hoshide S, et al. An alpha-adrenergic blocker titrated by self-measured blood pressure recordings lowered blood pressure and microalbuminuria in patients with morning hypertension: the Japan Morning Surge-1 Study. J Hypertens. 2008;26:1257–65.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  50. 50.

    Ueda S, Morimoto T, Ando S, Takishita S, Kawano Y, Shimamoto K, et al. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study. BMJ Open. 2014;4:e004576.

    PubMed  PubMed Central  Article  Google Scholar 

  51. 51.

    Boggia J, Li Y, Thijs L, Hansen TW, Kikuya M, Bjorklund-Bodegard K, et al. Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study. Lancet. 2007;370:1219–29.

    PubMed  Article  PubMed Central  Google Scholar 

  52. 52.

    Kario K. Nocturnal hypertension: new technology and evidence. Hypertension 2018;71:997–1009.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  53. 53.

    Salles GF, Reboldi G, Fagard RH, Cardoso CR, Pierdomenico SD, Verdecchia P, et al. Prognostic effect of the nocturnal blood pressure fall in hypertensive patients: the ambulatory blood pressure collaboration in patients with hypertension (ABC-H) meta-analysis. Hypertension. 2016;67:693–700.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  54. 54.

    Kario K, Pickering TG, Umeda Y, Hoshide S, Hoshide Y, Morinari M, et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation. 2003;107:1401–6.

    PubMed  Article  PubMed Central  Google Scholar 

  55. 55.

    Metoki H, Ohkubo T, Kikuya M, Asayama K, Obara T, Hashimoto J, et al. Prognostic significance for stroke of a morning pressor surge and a nocturnal blood pressure decline: the Ohasama study. Hypertension. 2006;47:149–54.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  56. 56.

    Pierdomenico SD, Pierdomenico AM, Cuccurullo F. Morning blood pressure surge, dipping, and risk of ischemic stroke in elderly patients treated for hypertension. Am J Hypertens. 2014;27:564–70.

    PubMed  Article  PubMed Central  Google Scholar 

  57. 57.

    Sogunuru GP, Kario K, Shin J, Chen CH, Buranakitjaroen P, Chia YC, et al. Morning surge in blood pressure and blood pressure variability in Asia: evidence and statement from the HOPE Asia Network. J Clin Hypertens (Greenwich). 2018;21:324–34.

    Google Scholar 

  58. 58.

    Kuroda T, Kario K, Hoshide S, Hashimoto T, Nomura Y, Saito Y, et al. Effects of bedtime vs. morning administration of the long-acting lipophilic angiotensin-converting enzyme inhibitor trandolapril on morning blood pressure in hypertensive patients. Hypertens Res. 2004;27:15–20.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  59. 59.

    Fujiwara T, Hoshide S, Yano Y, Kanegae H, Kario K. Comparison of morning vs bedtime administration of the combination of valsartan/amlodipine on nocturnal brachial and central blood pressure in patients with hypertension. J Clin Hypertens (Greenwich). 2017;19:1319–26.

    CAS  Article  Google Scholar 

  60. 60.

    Kario K, Hoshide S, Uchiyama K, Yoshida T, Okazaki O, Noshiro T, et al. Dose Timing of an Angiotensin II Receptor Blocker/Calcium Channel Blocker Combination in Hypertensive Patients With Paroxysmal Atrial Fibrillation. J Clin Hypertens (Greenwich). 2016;18:1036–44.

    CAS  Article  Google Scholar 

  61. 61.

    Bowles NP, Thosar SS, Herzig MX, Shea SA. Chronotherapy for hypertension. Curr Hypertens Rep. 2018;20:97.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  62. 62.

    Pickering TG. The clinical significance of diurnal blood pressure variations. Dippers Nondippers Circul. 1990;81:700–2.

    CAS  Article  Google Scholar 

  63. 63.

    de la Sierra A, Redon J, Banegas JR, Segura J, Parati G, Gorostidi M, et al. Prevalence and factors associated with circadian blood pressure patterns in hypertensive patients. Hypertension. 2009;53:466–72.

    PubMed  Article  CAS  PubMed Central  Google Scholar 

  64. 64.

    Kario K, Pickering TG, Hoshide S, Eguchi K, Ishikawa J, Morinari M, et al. Morning blood pressure surge and hypertensive cerebrovascular disease: role of the alpha adrenergic sympathetic nervous system. Am J Hypertens. 2004;17:668–75.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  65. 65.

    Fujiwara T, Tomitani N, Kanegae H, Kario K. Comparative effects of valsartan plus either cilnidipine or hydrochlorothiazide on home morning blood pressure surge evaluated by information and communication technology-based nocturnal home blood pressure monitoring. J Clin Hypertens (Greenwich). 2018;20:159–67.

    CAS  Article  Google Scholar 

  66. 66.

    Rakugi H, Kario K, Enya K, Sugiura K, Ikeda Y. Effect of azilsartan versus candesartan on morning blood pressure surges in Japanese patients with essential hypertension. Blood Press Monit. 2014;19:164–9.

    PubMed  PubMed Central  Article  Google Scholar 

  67. 67.

    Kario K, Hoshide S. Age-related difference in the sleep pressure-lowering effect between an angiotensin II receptor blocker and a calcium channel blocker in Asian hypertensives: the ACS1 Study. Hypertension. 2015;65:729–35.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  68. 68.

    Mizuno H, Hoshide S, Tomitani N, Kario K. Comparison of ambulatory blood pressure-lowering effects of higher doses of different calcium antagonists in uncontrolled hypertension: the Calcium Antagonist Controlled-Release High-Dose Therapy in Uncontrolled Refractory Hypertensive Patients (CARILLON) Study. Blood Press. 2017;26:284–93.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  69. 69.

    Kario K, Hoshide S, Okawara Y, Tomitani N, Yamauchi K, Ohbayashi H, et al. Effect of canagliflozin on nocturnal home blood pressure in Japanese patients with type 2 diabetes mellitus: The SHIFT-J study. J Clin Hypertens (Greenwich). 2018;20:1527–35.

    CAS  Article  Google Scholar 

  70. 70.

    Kario K, Okada K, Kato M, Nishizawa M, Yoshida T, Asano T, et al. 24-hour blood pressure-lowering effect of an SGLT-2 inhibitor in patients with diabetes and uncontrolled nocturnal hypertension: results from the randomized, placebo-controlled SACRA study. Circulation. 2018;139:2089–97.

    PubMed Central  Article  CAS  Google Scholar 

  71. 71.

    Kario K, Ferdinand KC, O’Keefe JH. Control of 24-hour blood pressure with SGLT2 inhibitors to prevent cardiovascular disease. Prog Cardiovasc Dis. 2020;63:249–62.

    PubMed  Article  PubMed Central  Google Scholar 

  72. 72.

    Kario K, Okada K, Murata M, Suzuki D, Yamagiwa K, Abe Y, et al. Effects of luseogliflozin on arterial properties in patients with type 2 diabetes mellitus: The multicenter, exploratory LUSCAR study. J Clin Hypertens (Greenwich). 2020;22:1585–93.

  73. 73.

    Kinguchi S, Wakui H, Ito Y, Kondo Y, Azushima K, Osada U, et al. Improved home BP profile with dapagliflozin is associated with amelioration of albuminuria in Japanese patients with diabetic nephropathy: the Yokohama add-on inhibitory efficacy of dapagliflozin on albuminuria in Japanese patients with type 2 diabetes study (Y-AIDA study). Cardiovasc Diabetol. 2019;18:110.

    PubMed  PubMed Central  Article  CAS  Google Scholar 

  74. 74.

    American Diabetes Association. 9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes—2020. Diabetes Care. 2020;43:S98–110.

    Article  Google Scholar 

  75. 75.

    American Diabetes Association. 10. Cardiovascular disease and risk management: standards of medical care in diabetes—2020. Diabetes Care. 2020;43:S111–34.

    Article  Google Scholar 

  76. 76.

    Kario K, Yamasaki K, Yagi K, Tsukamoto M, Yamazaki S, Okawara Y, et al. Effect of suvorexant on nighttime blood pressure in hypertensive patients with insomnia: The SUPER-1 study. J Clin Hypertens (Greenwich). 2019;21:896–903.

    CAS  Article  Google Scholar 

  77. 77.

    Ishida T, Oh A, Hiroi S, Shimasaki Y, Tsuchihashi T. Current prescription status of antihypertensive drugs in Japanese patients with hypertension: analysis by type of comorbidities. Clin Exp Hypertens. 2019;41:203–10.

    PubMed  Article  PubMed Central  Google Scholar 

Download references

Acknowledgements

Medical writing assistance was provided by Nicola Ryan, independent medical writer, funded by Jichi Medical University.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Kazuomi Kario.

Ethics declarations

Conflict of interest

KK has received independent principal investigator-initiated research grants from Omron Healthcare Inc., Fukuda Denshi Inc., A&D Inc., Taisho Pharmaceutical Co. Inc., and Sanwa Kagaku Kenkyusho Co. Inc. HR and KY have received independent principal investigator-initiated research grants from Astellas Pharma Inc., Daiichi Sankyo Co., Kyowa Hakko Kirin Co., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Takeda Pharmaceutical Company and Teijin Pharma. HR has received lecture fees from Daiichi Sankyo Co. and Takeda Pharmaceutical Company. SH has received research grants from Sanofi Co., Astellas Pharma Inc. and Novartis Pharma K.K. AO has no conflicts of interest to declare.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kario, K., Hoshide, S., Yamamoto, K. et al. Clinical studies on pharmacological treatment of hypertension in Japan. J Hum Hypertens (2021). https://doi.org/10.1038/s41371-021-00533-4

Download citation

Search

Quick links