Asian Guidelines on Hypertension

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The prevalence of hypertension in most Asian countries has been increasing in the last 30 years and more dramatically in the last 10 years. Various factors are thought to have contributed to such drastic changes in Asia, but social and lifestyle changes due to rapid urbanization can be considered major contributing factors. Given that Asian countries comprise a large portion of the world's population, these changes will be a big burden on healthcare systems in Asia and around the world. As expected, the characteristics of Asians and Asian hypertension are different from those of Eastern and other South and Western Asian countries. First, Asian countries are experiencing rapid aging of their societies, particularly in Far Eastern Asia. Second, the prevalence of diseases that constitute what we call a ‘metabolic pandemic’, for example, hypertension, obesity, poor lipid profile etc., is increasing due to the adoption of Western lifestyles. Third, despite various efforts made by the governments, salt intake levels are still high. Fourth, Asian countries have a relatively higher risk of stroke than Western countries even though the overall risk of coronary artery disease is lower. In addition, the relationship between blood pressure level and stroke incidence is stronger in Asia. We now have evidence-based, highly qualified guidelines for hypertension management from Europe [1] and North America [2]. However, different characteristics of Asian hypertension necessitate the need for hypertension guidelines for Asian populations. In Asia, hypertension guidelines have recently been released from the Korean Society of Hypertension in 2013 [3], the Japanese Society of Hypertension in 2014 [4], and from the Taiwan Society of Cardiology and the Taiwan Hypertension Society in 2015 [5]. Also, hypertension guidelines from China [6] are expected to be updated this year. This summarizes the essentials and key elements of the guidelines for hypertension management from China, Japan, Korea and Taiwan, focusing on the similarities and differences from the guidelines from Europe and North America. These efforts will hopefully serve as the groundwork for the concrete establishment of Asian hypertension guidelines.