(i) Routine clinical activities: We are trying to prevent cardiovascular diseases such as stroke, heart failure, coronary heart disease, renal impairment, aortic aneurysm, and peripheral arterial disease, which are mainly caused or promoted by persistence of hypertension. The Division of Hypertension is composed of a director, a head, two staffs and several residents, who contribute to close inspection of etiology of hypertension, pathophysiology, hypertensive organ damages and other risk factors of cardiovascular diseases such as glucose intolerance, dyslipidemia and so on. Referring to these results, we decide the most preferable treatment for individual hypertensives. 

(ii) Home blood pressure and ambulatory blood pressure monitoring: We are engaging in assessment of home blood pressure and diurnal blood pressure changes in order to find an appropriate antihypertensive treatment. In our out-patient clinic about a half of patients are recording home blood pressure by themselves continually.

(iii) Clinical studies: Clinical studies are carried out with patient's consent in order to elucidate etiology and pathophysiology of hypertension and to develop measures of its prevention and therapy. Ongoing studies are as follows; the effects of life-style modification or non-pharmacological treatment such as reduction of weight, moderation of salt intake and alcohol, and physical exercise on blood pressure, metabolic parameters and autonomic nervous function; neural mechanisms of essential hypertension; the relation between newly found vasoactive substances (atrial natriuretic peptide, brain natriuretic peptide, adrenomedullin and so on) and blood pressure regulation, and hypertensive organ damages. As to questions from the clinical findings, we are doing cooperative research study with staffs of Section of Hypertension of Research Institute of National Cerebral and Cardiovascular Center.

(iv) Short-term education program: It is very important for each patient to understand the feature of hypertension and its therapeutic policy. For this purpose, hypertension educational activity and hospital care for one week started this February. Lectures given by doctors, nurses, pharmaceutists and dietitians, and discussions deepen the patients' understanding. Patients are encouraged to measure and control their blood pressure by themselves.

(v) Clinical intervention trials: We need the results of clinical trials on a large scale to evaluate antihypertensive treatment. However, so many of our therapeutic policies for hypertension are based on the results from Europe and USA. We are charged with great responsibility in taking the leadership in this field, because features of cardiovascular diseases in Japan are not the same as those in Western countries. We are taking an important role in the studies;"Japanese Trial on the Efficacy of Antihypertensive Treatment in the Elderly" (JATE) and"Study Group on Long-term Antihypertensive Therapy" (GLANT), both of which were designated by Japan Cardiovascular Research Foundation. We are planning to make a start of JATE-II, in which follow-up survey of aged patients with hypertension focuses on the optimal blood pressure reduction by doing brain computerized tomography examination before and after antihypertensive treatment.