Managing hypertension in the aging dragon: bridging the 2026 Taiwan (THS) and 2025 Japanese (JSH) perspectives on blood pressure control in older adults

Older adults (defined as age ≥65 years, with specific strata for ≥75 and ≥80 years) with hypertension in East Asia (Taiwan and Japan), including subgroups stratified by frailty, chronic kidney disease (CKD), diabetes mellitus (DM), heart failure with reduced ejection fraction (HFrEF), atrial fibrillation (AF), and prior stroke.

Guideline-directed blood pressure management strategies as outlined in the 2026 Taiwan Hypertension Society (THS2026) and 2025 Japanese Society of Hypertension (JSH2025) guidelines, including intensive systolic blood pressure (SBP) targets (<130 mmHg for robust older adults, <120 mmHg for high-risk groups in THS2026), home blood pressure monitoring (7-2-2 protocol in THS2026), frailty-guided individualized targets, structured lifestyle modification (SP-ABCDE mnemonic), and first-line antihypertensive pharmacotherapy (renin-angiotensin-aldosterone system inhibitors, calcium channel blockers, diuretics).

Comparison between THS2026 and JSH2025 guideline perspectives, or standard/more liberal blood pressure targets in frail or functionally impaired patients (e.g., SBP <140 mmHg, <150 mmHg, or 140-160 mmHg depending on functional category in JSH2025).