The Japanese Society of Hypertension Practical Consensus Guidelines for Seasonal Blood Pressure Management.

Blood pressure (BP) and cardiovascular disease risk show clear seasonal variations. In addition to increases in BP and cardiovascular events associated with cold exposure during winter, attention should also be paid to high temperatures, dehydration, excessive BP lowering, and increases in nighttime BP during summer. In recent years, it has become increasingly clear that not only outdoor temperature but also indoor temperature, temperature differences within the home, living environments, and socioeconomic factors are associated with BP fluctuations, increasing the importance of year-round BP management that takes seasonal and thermal environmental factors into consideration. This practical guidance document complements existing guidelines for the management and treatment of hypertension and provides practical direction for BP assessment, lifestyle guidance, interventions targeting the residential environment, and adjustment of antihypertensive therapy according to seasonal changes based on current evidence and expert consensus. Specifically, ten key questions relating to seasonal variations in BP, cardiovascular risk factors and events, and hypertension management are covered. This includes the consideration of appropriate indoor temperatures and temperature differences, attention to BP variability, and use/modification of lifestyle interventions and antihypertensive pharmacotherapy. This guidance positions seasonal BP management not only as part of the clinical management of individual patients but also as an area of "Implementation Hypertension" that connects the home, housing, local communities, and government. Going forward, standardization of temperature exposure indices, accumulation of year-round home BP data, development of intervention models for vulnerable populations, and promotion of multidisciplinary and cross-sectoral collaboration, including improvement of residential environments, will be required.