What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=623). Intervention: Home blood pressure monitoring (Observational). Primary outcome: Hypertension prevalence and JSH 2019-based blood pressure control rate.

What question did this study set out to answer?

The study aims to evaluate blood pressure status and control rates based on the JSH 2019 guidelines in a community population.

April 8, 2026Open Access

Blood pressure status, JSH 2019-based control rate, and associated factors among community-dwelling adults: The NOSE study

PCPhouvanh ChanthavongOsaka University of Economics KKKeigo KobayashiOsaka University of Economics YAYuya AkagiOsaka University of Economics

Key Result

In a community-dwelling Japanese population, hypertension prevalence was 66.8%, with guideline-based blood pressure control achieved in only 22.9% (office) and 7.3% (morning home) of treated patients.

Key Points

The study aims to evaluate blood pressure status and control rates based on the JSH 2019 guidelines in a community population.
Analyzed baseline data from 623 community-dwelling adults (2020–2021)
Assessed blood pressure using office and home monitoring methods
Employed multivariable regression analysis to identify factors affecting hypertension prevalence and control
Hypertension prevalence was 66.8%, associated with older age and higher body mass index
Only 22.9% of treated participants achieved control based on office BP
Poor control rates were found at 7.3% for morning home BP, with 24.8% having masked hypertension

Study Design

Type

Cross-Sectional (n=623)

Multicenter

Structured PICO

Population

623 community-dwelling adults (mean age 67.6 years; 37.4% men) from the NOSE Study (baseline data 2020-2021).

Outcome

Blood pressure status (hypertension prevalence and treatment) and guideline-based blood pressure control rates defined by JSH 2019 criteria.surrogate

Community-dwelling adults have high hypertension prevalence and very low control rates under the stricter JSH 2019 guidelines, highlighting the critical need for home blood pressure monitoring and intensified pharmacological therapy.

Limitations

Cross-sectional design precludes causal inference
Home BP values manually recorded and lifestyle variables self-reported, introducing potential measurement error and reporting bias
Voluntary participation may have resulted in a healthy participant bias
Morning home BP was measured before medication intake, partially reflecting the pharmacodynamic trough
Lacked detailed information on medication adherence, dietary salt intake, and other lifestyle factors
Limited data on atrial fibrillation and antithrombotic subtypes may have resulted in residual confounding
Physician specialty information at the individual level was unavailable

Abstract

Abstract The Japanese Society of Hypertension Guidelines (JSH 2019) introduce stricter blood pressure (BP) targets, but BP status (hypertension prevalence and treatment) and control rates under these criteria, particularly by home BP monitoring, remain limited. This study investigated BP status, guideline-based BP control rates, and associated factors in a community-dwelling population. We analyzed baseline data (2020–2021) from 623 participants (mean age 67.6 years; 37.4% men) in the NOSE Study. BP status and control were defined using JSH 2019 criteria, with thresholds modified by age and comorbidities and 5 mmHg lower for home BP. Office BP and 30-day mean morning and evening home BP values (≥14 days) were assessed. Multivariable regression analysis was used to identify factors associated with hypertension prevalence, treatment status, and poor BP control. Hypertension prevalence was 66.8% and was associated with older age and higher body mass index. Approximately half of adults with hypertension were untreated, despite having higher BP levels, and tended to be younger with fewer comorbidities. Among treated participants, BP control rates were 22.9% based on office BP and 7.3% based on morning home BP. Masked hypertension was frequent (24.8%). Monotherapy was common (59.2%), while diuretics (10.1%) and beta-blockers (4.1%) were underutilized. A higher number of anti-hypertensive medications was associated with better BP control. Community-dwelling adults showed high hypertension prevalence, substantial untreated BP, and very low control rates under guideline targets. Home BP monitoring is essential for detecting uncontrolled morning and masked hypertension, and current treatment patterns appear insufficient to meet JSH recommendations.

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