New guidelines and health promotion: hypertension and chronic kidney disease

Abstract

 To catch up recent advance in medical practice and include recent clinical evidences for better cardiovascular prognosis of the patients, Japanese Society of Hypertension renews the guideline for the management of hypertension in 2014. Office blood pressure values to define hypertension remain unchanged. However, the importance of home blood pressure is strengthened in this revision. Indeed, to detect masked hypertension, new guideline clearly states that home blood pressure values should be used to diagnose hypertension, even if it differs from office blood pressure profile. Another important revision is that target of blood pressure is changed to 150/90 mmHg for patients over 75 y/o. In 2013, guideline for the treatment of chronic kidney disease (CKD) was revised by Japanese Society of Nephrology. CKD is defined as abnormality of urinalysis persisting for more than 3 months and/or estimated glomerular filtration rate (eGFR) less than 60 mL/min. Major changes in new guideline are that diabetic nephropathy is separated from the other nephropathy, and that diabetic nephropathy utilizes albuminuria instead of proteinuria for the classification of CKD. CKD stage is also revised by dividing stage 3 into 2 stages; stage 3a (eGFR 60-45 mL/min) and 3b (45-30 mL/min).