Lifestyle Can Control New Hypertension
Hypertension affects millions of patients in primary care daily. Many cases start mild without prior diagnosis. Doctors wonder who responds best to lifestyle advice alone. This study identifies clear predictors for drug-free blood pressure control. Japanese researchers built on prior multivariable analysis to dig deeper. The results were published in the Journal of Cardiology.
Large Cohort from Routine Checkups
Researchers studied 5,428 residents aged 40-74 years with hypertension defined as BP ≥140/90 mmHg. All remained untreated at specific health checkups from May 2016 to March 2023. Of these, 2,468 patients started antihypertensive medications by their next checkup. Remaining 2,960 stayed off medications for analysis. Decision-tree analysis stratified groups by medication use to find success factors.
Over Half Succeed Without Pills
Among the non-medication group, 55.9% achieved BP <140/90 mmHg at follow-up. Decision-tree analysis pinpointed top predictors clearly. No history of hypertension at previous specific health checkup led first. Lower BP grade followed as second most important factor. Reduction in γ-glutamyl transpeptidase (γ-GTP) proved third strongest predictor in this group.
Liver Enzyme Tracks Lifestyle Success
γ-GTP drop showed strong association with BP control without drugs. This marker reflects alcohol reduction and metabolic improvements reliably. Patients with new grade I hypertension benefited most from this pattern. Younger age helped medication starters reach target BP more often.
Target Lifestyle Responders First
Primary care doctors can use these tree branches for patient selection. Focus intensive counseling on newly hypertensive grade I patients. Measure γ-GTP before and after interventions to track progress. Success rates over 55% justify this approach in low-risk cases.
Avoid Drugs When Possible Early
Delaying medications preserves long-term safety in responders. Regular specific health checkups catch new cases early for intervention. Monitor γ-GTP as objective lifestyle change marker alongside BP readings.
Simple Tests Guide Therapy Choices
No prior hypertension history plus grade I BP identifies best candidates. γ-GTP trends confirm counseling effectiveness objectively. These findings apply directly to daily hypertension management.
Build BP Control Without Medications
Lifestyle guidance works for over half of new mild cases. Decision-tree analysis makes responder identification practical. Japanese real-world data guides global primary care confidently.
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Key highlights
- Researchers analyzed 5,428 untreated hypertensive residents aged 40-74 years from Hiratsuka City specific health checkups between May 2016 and March 2023, with 2,468 starting medications by next checkup.
- Among 2,960 participants remaining off antihypertensive medications, 55.9% achieved BP <140/90 mmHg at follow-up using decision-tree analysis stratified by medication use.
- Decision-tree analysis identified no prior hypertension history at previous specific health checkup and lower BP grade as primary predictors of drug-free BP control success.
- Greater reduction in γ-glutamyl transpeptidase emerged as the third most influential factor for achieving BP <140/90 mmHg without medications, particularly in new grade I hypertension cases.
- Younger age associated with higher BP control rates among patients who started antihypertensive therapy, supporting targeted lifestyle interventions in newly diagnosed low-risk patients.
Source
Ohara R, Nakatsu F, Iekushi K, Tanaka-Mizuno S, Nakagami H, Yamamoto K. A greater reduction in γ-GTP was associated with achieving BP <140/90 mmHg without antihypertensive medication among individuals who newly developed Grade I hypertension. Journal of Cardiology. Published online January 2026. doi: https://doi.org/10.1016/j.jjcc.2026.01.002
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Japanese study of 5,428 untreated hypertensives finds 55.9% achieve BP <140/90 mmHg without meds; γ-GTP reduction key in grade I cases with no prior history.
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