1. BACKGROUND
Hypertension stands as the primary driver of cardiovascular (CV) mortality and morbidity on a global scale, affecting over a billion individuals worldwide.[1, 2] Its impact is particularly pronounced in Asia, where more than half of the world’s hypertensive population resides, a number projected to escalate with population aging and rising obesity rates in the region.[3, 4]
The efficacy of hypertension treatment in mitigating CV mortality and morbidity is well-established in contemporary clinical practice. However, significant disparities persist in awareness, treatment, and control rates between high-income and low- to middle-income countries, many of which are located in Asia.[5, 6] To address these challenges and standardize hypertension management, various professional bodies and institutions have formulated guidelines focusing on diagnosis, treatment, and control strategies. While initial guidelines emerged from the United States and Europe, numerous Asian nations have since developed their own national guidelines. This paper aims to compare these diverse guidelines, highlighting both the divergences and convergences in their recommendations.
2. CHRONOLOGY OF HYPERTENSION GUIDELINES
2.1. US Guidelines
The United States pioneered hypertension management guidelines in 1977 through the Joint National Committee (JNC), established in 1972 by the US National Institute of Health. Regular updates followed, with JNC VII in 2003 introducing the term “pre-hypertension” for systolic BP between 120-139 mmHg or diastolic BP between 80-89 mmHg, replacing previous “normal” and “borderline” classifications. This shift sparked considerable debate, and no further updates materialized for 14 years. In November 2017, professional societies led by the American College of Cardiology and American Heart Association took over guideline updates from the JNC. A significant and controversial change in the 2017 guidelines was the lowered threshold for hypertension diagnosis, defining hypertension as BP ≥130/80 mmHg. Consequently, the target BP control for most adults was also reduced to <130/80 mmHg.[7]
2.2. European Guidelines
The European Society of Hypertension (ESH) issued its first hypertension management guidelines in 2003, several years after the US. Subsequent updates were published in 2007, 2013, and most recently in August 2018. Unlike the US guidelines, the ESH maintained the hypertension diagnostic threshold at BP ≥140/90 mmHg in their latest update. However, they adopted a lower recommended target BP for control of <130/80 mmHg for most adults and associated clinical conditions like stroke and coronary artery disease, creating a disparity between their diagnostic threshold and treatment target.[8]
A notable departure from prior ESH guidelines was the ESH-ESC’s recommendation for combination drug therapy as initial treatment for hypertensive patients. This was partly motivated by the stricter BP target of <130/80 mmHg and substantial evidence indicating that most patients require multiple medications to achieve even the previous <140/90 mmHg target.
Monotherapy as initial therapy is still considered by the ESH-ESC for low-risk grade 1 hypertension (systolic BP <150 mmHg), very old (≥80 years), or frail patients.
The AHA-ACC guidelines advocate combination therapy initiation for stage 2 hypertension (BP ≥140/90 mmHg in US definition) and average BP >20/10 mmHg above target. This aligns with the ESC-ESH’s approach for many hypertensive patients. For stage 1 hypertension (BP 130–139/80–89 mmHg), monotherapy is recommended by AHA/ACC.
Conversely, most other guidelines continue to recommend monotherapy as the initial approach for hypertension, reserving dual therapy for cases with BP ≥160/100 mmHg.
2.3. International Guidelines
The International Society of Hypertension (ISH) published community hypertension management guidelines with the American Society of Hypertension in 2014. In 2020, the ISH issued its first worldwide practice guidelines.[9] Acknowledging resource disparities between high- and low- to middle-income countries, the ISH guidelines provide tailored essential and optimal care standards in an accessible format for clinicians, nurses, and community health workers, particularly in resource-limited settings.
The International Consortium on Health Outcome Measures (ICHOM) has also proposed care standards for low- and middle-income countries, suitable for Southeast and East Asian nations.[10]
2.4. Asian Guidelines
Lower- and middle-income regions often rely on guidelines from high-income regions due to resource limitations in developing and implementing local guidelines. However, several Asian countries, especially those with large populations, low treatment rates, and control rates, have recently formulated national guidelines. Most Southeast Asian countries, except for Cambodia, now have their own national hypertension guidelines. Table 1 indicates that most Asian guidelines were updated after the 2017 US guideline release, except for Singapore.[11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27]
TABLE 1. BP categories United States, European, International, and Asian hypertension guidelines
Alt Text: Comparison table of blood pressure categories across hypertension guidelines from AHA/ACC, ESC/ESH, ISH, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Pakistan, Philippines, Singapore, Taiwan, Thailand, and Vietnam, detailing systolic and diastolic BP ranges for normal, elevated, high normal, grade 1, grade 2, and grade 3 hypertension.
Abbreviations: AHA/ACC, American Heart Association/American College of Cardiology; BP, blood pressures; CHL, Chinese Hypertension League; DBP, diastolic BP; ESC/ESH, European Society of Cardiology/European Society of Hypertension; HK, Hong Kong; ISH, International Society of Hypertension; JSH, Japanese Society of Hypertension; KSH,Korean Society of Hypertension; SBP, systolic BP.
aTaiwan Focused update 2017.
bUse of Framingham general CV risk score recommended.
cThai Cardiovascular Risk Score.
3. DIFFERENCES AND SIMILARITIES
Despite being developed using the same evidence base, hypertension guidelines exhibit differences, particularly in diagnostic BP thresholds. Variations also exist in recommendations for out-of-office BP measurements, target BP for control, initiation of drug therapy, and combination therapy, especially single-pill combinations. Conversely, numerous similarities are also present. The following sections compare and discuss these differences and similarities focusing on diagnostic BP thresholds, BP categories, CV risk assessment, out-of-office BP measurements, antihypertensive therapy initiation (for all adults, high-risk adults, older adults, and specific indications), and BP control targets across various groups. Understanding What Website Can I Compare Countries Dbp On in relation to health metrics requires analyzing these guideline variations and their potential impact on global health outcomes.
4. DIAGNOSTIC BP THRESHOLD FOR HYPERTENSION AND HYPERTENSION CATEGORIES
The 2017 US guidelines lowering the hypertension diagnostic threshold to systolic BP (SBP) ≥130 mmHg and/or diastolic BP (DBP) ≥80 mmHg generated considerable controversy and discussion.[28] However, most other guidelines, including ESH, ISH, and many Asian guidelines, retained the ≥140/90 mmHg threshold (Table 1).[11]
Hypertension categories also underwent changes. US guidelines eliminated stage 3 hypertension, classifying 130/80–140/90 mmHg as stage 1 and BP above 140/90 mmHg as stage 2 hypertension.
ESH maintained three grades of hypertension, while most Asian guidelines, except Korean, also retained three categories (Table 1). Similar to US guidelines, ISH opted for two hypertension categories.
Definitions of “normal” BP varied significantly. US guidelines, due to the lower hypertension threshold, consider SBP <120 and DBP <80 mmHg as normal. Many Asian guidelines classify these levels as optimal and SBP 120–129 and/or DBP 80–85 as “normal.” ESH defines SBP 120–129 and/or DBP <80 mmHg as normal, while ISH uses SBP <130 and DBP <85 mmHg as “normal” BP (Table 1).
The US lower diagnostic threshold was justified by epidemiological evidence and meta-analyses showing a 1.5–2 times higher risk of coronary and stroke events at BP 130–139/80–90 mmHg compared to SBP below 120 mmHg. This increased CV risk at lower BP levels prompted the need for earlier identification and preventive measures, especially considering age-related BP increases. Concerns around the lower threshold include the increased number of individuals labeled “hypertensive,” with potential psychological, economic, and social implications.
However, the US guidelines do not recommend pharmacological treatment for all individuals with BP 130–139/80–89 mmHg. Lifestyle changes are prioritized, with medication recommended only for those with atherosclerotic events, target organ damage, or a CV risk exceeding 10%. While the hypertension prevalence increases from 31.9% to 45% (a 13.7% rise), the estimated increase in individuals needing medication is only 1.9% (from 34.3% to 36.2%).[29]
The Systolic Blood Pressure Intervention Trial (SPRINT) study also influenced the US guidelines, demonstrating greater CV mortality and morbidity reduction with intensive treatment targeting BP <120/80 mmHg compared to <140/90 mmHg.[30] Conversely, the HOPE-3 study showed no benefit from BP-lowering drugs in patients with SBP <143.5 mmHg at baseline, compared to those with higher SBP.[31] It’s important to note that HOPE-3 was a primary prevention trial in intermediate-risk individuals, while SPRINT involved high-risk patients, suggesting that treatment thresholds and BP goals may vary based on CV risk profiles.
5. GLOBAL CV RISK ASSESSMENT
Early JNC guidelines acknowledged the increased CV risk in hypertensive individuals with factors like smoking, diabetes, and hyperlipidemia, but formal global CV risk assessment recommendations were absent until JNC VI in 1997. JNC VI introduced risk stratification into three groups based on CV risk factors, target organ damage, and clinical CVD. These risk groups guided antihypertensive therapy initiation based on overall risk, not solely BP readings.
Latest US guidelines advocate formal CV risk assessment and assigning absolute risk values, particularly for those without existing atherosclerotic CVD or diabetes. Pharmacological treatment is recommended for this group with BP 130–139/80–89 mmHg and a CV risk ≥10% using the Pooled Cohort Risk Calculator.
The 2018 ESH guidelines categorize CV risk into low, moderate, high, and very high risk, considering hypertension stages, CV risk factors, hypertension-mediated organ damage (HMOD), and comorbidities.
ISH, similar to ESH, stratifies CV risk by BP levels, additional risk factors, HMOD, and prior CVD, but uses three categories: low, medium, and high.
Most Asian guidelines also recommend overall CV risk assessment (Table 1). Many Asian countries, except Thailand, lack validated local risk prediction charts and often adopt ESH risk categories. Malaysian guidelines have a slightly different risk stratification table and recommend using the validated Framingham General CVD prediction tool, reflecting Malaysia’s CV risk profile mirroring the US during its CV epidemic peak in the 1950s.[32]
Despite variations in risk categories, most guidelines clinically recommend drug therapy for high CV risk and some, like Malaysia, even at medium risk.
6. USE OF OUT-OF-OFFICE BP MEASUREMENTS
Out-of-office BP measurements offer well-established benefits, including better prediction of CV mortality and morbidity and identification of white coat hypertension (WCH), masked hypertension, and resistant hypertension. They are also crucial for monitoring BP control. Home BP monitoring (HBPM) has been linked to lower BP, improved adherence, and greater patient satisfaction.
The National Institute for Health and Clinical Excellence (NICE) in the UK first recommended using out-of-office BP measurements (preferably ambulatory BP monitoring – ABPM, or HBPM) to confirm hypertension diagnosis in 2011, and this was reaffirmed in their 2019 update. This recommendation raised concerns, particularly in low- to middle-income Asian countries with limited ABPM access and HBPM usage.[5] The rationale is to identify WCH, reducing unnecessary drug treatment, costs, and adverse effects.
Not all recent guidelines mandate out-of-office BP measurements for diagnosis, with office/clinic measurements still forming the basis of diagnosis. However, out-of-office measurements are encouraged for diagnostic confirmation. Most Asian countries lack HBPM consensus guidelines, but recent Asian consensus and insights on HBPM and ABPM are available to guide practitioners.[33, 34, 35, 36]
While the US lowered their office BP diagnostic threshold to ≥130/80 mmHg, their home BP and daytime ABPM threshold remains ≥130/80 mmHg, which is somewhat inconsistent as home BP is typically lower than office readings. However, the US did lower their ABPM thresholds for 24-hour and nighttime averages by 5 mmHg. ESH, ISH, and Asian countries maintained their previous out-of-office BP thresholds (Table 2).
TABLE 2. Thresholds for diagnosing hypertension based on clinic and out-of-office (home and ambulatory) blood pressures for United States, Europe, and Asia
Alt Text: Comparative table illustrating blood pressure thresholds used for diagnosing hypertension in clinic, home, and ambulatory settings across ACC/AHA, ESC/ESH, ISH, and Asian guidelines, highlighting variances in systolic and diastolic readings.
Abbreviations: ABPM, ambulatory blood pressure measurements; ACC/AHA, American College of Cardiology/American Heart Association; ESC/ESH, European Society of Cardiology/European Society of Hypertension; ISH, International Society of Hypertension.
NICE recommends out-of-office BP measurements for diagnosis confirmation but not for treatment titration, citing limited evidence of improved CV outcomes compared to clinic BP-based titration, which is supported by numerous clinical trials.
Latest US guidelines advocate broader out-of-office BP measurement use, including for treatment titration, similar to NICE. ESH recommends out-of-office measurements for diagnosis confirmation when feasible. ISH considers them optimal, not essential, recognizing limitations in resource-constrained settings. Most Asian guidelines recommend wider out-of-office BP measurement use and diagnostic confirmation when possible.
However, except for Japan, guidelines generally recommend using office/clinic BPs for medication titration, with HBPM as a complementary tool. Japan strongly recommends antihypertensive treatment based on home BP (Recommendation Grade 1 Evidence Level B).[17]
7. INITIATION AND CHOICE OF ANTI-HYPERTENSIVE MEDICATIONS
Universal consensus exists across guidelines for initiating antihypertensive drugs at BP ≥160/90 mmHg, regardless of CV risk. Combination therapy can be initiated, except in individuals ≥75 years. Agreement is also widespread, excluding US and Hong Kong guidelines, that pharmacological treatment for BP 140–159/90–99 mmHg should be based on overall CV risk (Table 3). These guidelines recommend antihypertensive agents for medium or higher risk individuals at this BP range. AHA/ACC guidelines, in contrast, recommend medication for BP ≥140/90 mmHg without considering CV risk. Hong Kong guidelines initiate treatment at BP ≥160/100 mmHg and only consider treatment for BP 140–159/90–99 mmHg if lifestyle modifications fail after 6 months.
TABLE 3. Initiation and choice of anti-hypertension drugs
Alt Text: Table comparing recommendations for initiating antihypertensive drug therapy and preferred drug classes across AHA/ACC, ESC/ESH, ISH, and various Asian guidelines, categorized by income level and specific regions like Hong Kong, Japan, Korea, Singapore, and Taiwan.
Abbreviations: AHA/ACC, American Heart Association/American College of Cardiology; BP, blood pressures; ESC/ESH, European Society of Cardiology/European Society of Hypertension; HMOD, hypertension-mediated organ damage; ISH, International Society of Hypertension.
aChina, Indonesia, Malaysia, Thailand.
bIndia, Pakistan, Philippines, Vietnam.
US guidelines recommend medication for all BP ≥140/90 mmHg (stage 2) and for stage 1 hypertension (BP 130–139/80–89 mmHg) if atherosclerotic CVD is present or CV risk is ≥10%.[28] European and Asian guidelines recommend pharmacological agents for BP 130–139/80–89 mmHg only if CV risk is high or very high.
ESH guidelines uniquely recommend initial combination therapy, except for low-risk stage 1 hypertension (BP 140–159/90–99 mmHg) or very old/frail patients.[8]
For first-line antihypertensive drugs, US guidelines recommend calcium channel blockers (CCB), diuretics (DU), angiotensin-converting enzyme inhibitors (ACE-I), and angiotensin receptor blockers (ARB), omitting β-blockers (BB). ESC/ESH recommend all five classes, including BB, as potential first-line options. ISH, considering resource limitations in low- to middle-income countries, recommends any evidence-based class effective in morbidity/mortality prevention for the treated population. Similar to the US, Asian countries generally recommend DU, CCB, ACE-I, and ARB as first-line monotherapy, with China, Indonesia, India, Korea, Singapore, and Thailand also including BB (Table 3).
For specific hypertensive patient groups (e.g., hypertension with coronary artery disease or stroke), guidelines largely agree on antihypertensive classes. Most patients require multiple drugs to reach lower BP targets, typically including ACE-I or ARB combined with CCB or DU. Japan recommends a lower clinic BP target of <130/80 mmHg and home BP <125/75 mmHg for adults <75 years and special groups, with a higher target for those ≥75 years (clinic BP <140/90 and home BP <135/85 mmHg) (Table 3).
8. BP TARGET FOR CONTROL
US guidelines recommend a lower BP target of <130/80 mmHg, consistent with their hypertension definition. This target applies universally to all hypertensive patient groups, regardless of CV risk (Table 4).
TABLE 4. Target for blood pressure control and recommended anti-hypertensive drugs in special groups
Alt Text: Comprehensive table outlining target blood pressure levels and recommended antihypertensive drug classes for various special patient groups (e.g., HTN+CAD, HTN+CVA, HTN+DM) across AHA/ACC, ESC/ESH, ISH, and numerous Asian guidelines, also detailing targets for elderly hypertensive patients and timeframes for BP control.
Abbreviations: ACC/AHA, American College of Cardiology/American Heart Association; Alb+ve, albuminuria present; Alb−ve, no albuminuria−; CCB, calcium channel blocker; DU, diuretic; DU^, thiazide-like diuretic; ESC/ESH, European Society of Cardiology/European Society of Hypertension; Hong K, Hong Kong; ISH, International Society of Hypertension; MRA, mineralocorticoid receptor antagonist; Msia, Malaysia; Non-DHP, non-dihydropyridine calcium channel blocker; NR, no recommendation; Protein+ve, proteinuria positive, Protein−ve proteinuria negative; RAS, renin-angiotensin system inhibitors [includes ACE (angiotensin-converting enzyme) and ARB (angiotensin receptor blocker).
*Taiwan Focused update 2017.
aRecommends SBP 130 or lower if tolerated, but SBP not <120 and DBP 70–79.
b<130/80 if tolerated.
cUAE-ve Albuminuria <30 mg/24 h, UAE+ve Albuminuria >30 mg/24 h.
dPro Proteinuria <1Gm/24 h, Proteinuria >1Gm/24 h.
eFor non-institutionalized ambulant community dwelling adults.
While ESH guidelines maintain a ≥140/90 mmHg diagnostic threshold, their target BP for hypertensives <65 years is <130/80 mmHg (but not SBP <120 mmHg, except in chronic kidney disease). For those ≥65 years, the target is 130–139/70–79 mmHg if tolerated. ISH’s target is similar to ESH.
Guidelines offer clear drug choice recommendations for special groups (Table 4). Drug choices for each group are largely consistent, typically recommending RAS blockers as a foundation, often combined with CCBs or diuretics. For example, in coronary artery disease, BBs are universally recommended alongside RAS blockers.
Most guidelines lack specific recommendations for hypertension with metabolic syndrome, except Taiwan (ACE-I or ARB preferred over diuretics or β-blockers unless indicated for comorbidities) and India (ACE-I or ARB recommended). Given the high and increasing prevalence of metabolic syndrome in Asia, future guidelines should address this specifically.
For Asian countries, excluding Japan, the BP target is generally <140/90 mmHg, with lower targets of <130/80 mmHg considered if tolerated. Japan, like the US, targets <130/80 mmHg for all hypertensive patients, including special groups. Most Asian countries recommend lower targets of <130/80 mmHg for special groups, with some (e.g., China) opting for an interim target of <140/90 mmHg, aiming for <130/80 mmHg if tolerated. Elderly classifications vary across Asian guidelines, but generally, target control is <140/90 mm for those under 75 and <150/90 mmHg for those 75 or older.
Japan recommends a lower clinic BP target of <130/80 mmHg and home BP <125/75 mmHg for adults <75 years, and a higher target for those ≥75 years (clinic BP <140/90 and home BP <135/85 mmHg), still 10 mmHg lower than other Asian countries (Table 4).
The timeframe to reach BP control is also important. Studies demonstrate early treatment can significantly reduce left ventricular hypertrophy within 6 months, and stroke incidence reduction can be observed within 6 months of improved BP control in clinical trials. However, most guidelines, except for China, Indonesia, Japan, Malaysia, and Pakistan, do not explicitly specify a timeframe to reach control (Table 4), highlighting a potential area for future guideline enhancement.
9. TARGET BP IN ELDERLY
While the diagnostic BP threshold for elderly individuals remains the same as for younger adults (≥140/90 mmHg by most guidelines, ≥130/80 mmHg by US guidelines), target BP control in the elderly varies considerably across guidelines and age categories (Table 4).
This variability stems partly from differing definitions of “elderly.” Recommendations for elderly hypertension treatment are further complicated by varied “elderly” or “older” definitions in randomized control trials (initially >60 years, then 65, 70, and finally 75 or 80 years). Many trials also excluded patients over 75, or included only those already on antihypertensive medication.
ESH guidelines categorize elderly patients into “old” (≥65 years) and “very old” (≥80 years). Drug therapy is recommended for BP ≥140/90 mmHg in the “old” and ≥160/90 mmHg in the “very old.” However, despite the higher treatment threshold for the “very old,” the target BP remains the same for both groups at 130–139/70–79 mmHg, if tolerated (Table 4).
US guidelines do not differentiate between “old” and “very old,” recommending a target of <130/80 mmHg, if tolerated, for all individuals ≥65 years.
ISH, like the US, does not separate elderly age groups but defines “elderly” as ≥65 years. ISH is more “conservative” than European and American guidelines, with a higher BP target of <140/80 mmHg for individuals ≥65 years.
Several Asian guidelines differentiate between “old” and “very old” elderly, but their recommended BP targets of <140/90 mmHg for the “old” and <150/90 mmHg for the “very old” are higher than American and European recommendations (<130/80 mmHg and 130–139/70–79 mmHg, respectively).
While some Asian guidelines recommend BP targets for those ≥80 years, specific recommendations for those aged 65–79 are often absent, implying the target is the same as for younger adults. Conversely, other Asian guidelines recommending targets for ≥65 years may not specify targets for ≥80 years, possibly implying the target remains consistent for those 65 and older (Table 4).
10. CONCLUSION
In conclusion, key differences among hypertension guidelines lie in the definition of hypertension, with the US uniquely recommending a lower diagnostic BP threshold of ≥130/80 mmHg. This difference impacts treatment initiation and BP control targets. The US guideline aims to reduce hypertension-related disease burden by earlier identification of at-risk individuals using lower BP thresholds. Conversely, ESH and Asian guidelines adopt a more conservative approach, focusing on individual patient management rather than broad epidemiological considerations. The long-term impact of these differing strategies on CV mortality and morbidity reduction, in a safe and cost-effective manner, remains to be observed.
CONFLICT OF INTEREST
S Hoshide has received research grants from Sanofi Co., Astellas Pharma Inc and Novartis Pharma KK. KK has received independent principal investigator‐initiated research grants from Omron Healthcare Inc, Fukuda Denshi Inc, A&D Inc, Taisho Pharmaceutical Co. Inc, and Sanwa Kagaku Kenkyusho Co. Inc. YC Chia has received honorarium and sponsorship at attend conferences and seminars from Boeringher‐Ingelheim, Pfizer, Omron, Servier and Xepa‐Sol and an investigator‐initiated research grant from Pfizer. CH Chen reports personal fees from Novartis, Sanofi, Daiichi Sankyo, SERVIER, Bayer, and Boehringer Ingelheim Pharmaceuticals, Inc. HM Cheng received speaker honorarium and sponsorship to attend conferences and CME seminars from Eli Lilly and AstraZeneca; Pfizer Inc; Bayer AG; Boehringer Ingelheim Pharmaceuticals, Inc; Daiichi Sankyo, Novartis Pharmaceuticals, Inc; SERVIER; Co., Pharmaceuticals Corporation; Sanofi; TAKEDA Pharmaceuticals International and served as an advisor or consultant for ApoDx Technology, Inc. S Park reports research grant from Sankyo; lecture fee from Sankyo, Servier, Daewoong, Donga, Takeda, Boryung, Hanmi, Pfizer and Servier. All other authors report no potential conflicts of interest in relation to this review paper.
AUTHOR CONTRIBUTIONS
Yook‐Chin Chia takes primary responsibility for this paper. Yook‐Chin Chia wrote the manuscript. Yook‐Chin Chia, Yuda Tura, Apichard Sukonthasarn, Yuqing Zhang, Jinho Shin, Hao‐Min Cheng, Jam Chin Tay, Kelvin Tsoi, Saulat Siddique, Narsingh Verma, Peera Buranakitjaroen, Guru Prasad Sogunuru, Jennifer Nailes, Huynh Van Minh, Sungha Park, Boon Wee Teo, Chen‐Huan Chen, Tzung‐Dau Wang, Arieska Ann Soenarta, Satoshi Hoshide, Ji‐Guang Wang and Kazoumi Kario contributed to the data about their own country. Yook‐Chin Chia, Yuda Tura, Apichard Sukonthasarn, Yuqing Zhang, Jinho Shin, Hao‐Min Cheng, Jam Chin Tay, Kelvin Tsoi, Saulat Siddique, Narsingh Verma, Peera Buranakitjaroen, Guru Prasad Sogunuru, Jennifer Nailes, Huynh Van Minh, Sungha Park, Boon Wee Teo, Chen‐Huan Chen, Tzung‐Dau Wang, Arieska Ann Soenarta, Satoshi Hoshide, Ji‐Guang Wang and Kazoumi Kario read and approved the manuscript.
Chia Y‐C, Turana Y, Sukonthasarn A, et al; Comparison of guidelines for the management of hypertension: Similarities and differences between international and Asian countries; perspectives from HOPE‐Asia Network. J Clin Hypertens. 2021;23:422–434. 10.1111/jch.14226
