Even though Japan has the longest life expectancy in the world, blood
pressure has not been adequately controlled, irrespective of age. More than half of
Japanese individuals of ≥70 years of age had blood pressure levels of
≥140/≥90 mmHg. Though the impact of blood pressure on cardiovascular complications
differs according to the age, blood pressure lowering treatment reduces cardiovascular
risk across various baseline blood pressure levels and comorbidities.
Meanwhile, antihypertensive treatment itself is a sort of marker of the chronicity
and severity of blood pressure elevation as well as the subclinical disease burden.
Clinicians who initiate antihypertensive drug therapy should therefore recognize
that patients have an increased risk in general, e.g., they fail to make lifestyle modifications,
not just only related to their blood pressure level. Furthermore, self-measured
home blood pressure is more reliable prognostic factors than the
conventional office blood pressure, and affordable and validated automated devices
for the self-measurement of home blood pressure are readily available. The careful
and intensive follow-up of elderly individuals with hypertension is essential, and
active utilization of the self-measured home blood pressure is desirable.