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In recent years, the treatment landscape for heart failure patients (HF) has undergone a dramatic transformation with the emergence of angiotensin receptor–neprilysin inhibitors (ARNI) and sodium–glucose cotransporter 2 inhibitors (SGLT2is). During this period, multiple major international and regional hypertension guidelines have also been updated. Recently, the Japanese Society of Hypertension published Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025 (JSH2025), with updated recommendations for blood pressure (BP) management in HF (Japanese Society of Hypertension. Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025. in press). This commentary aims to compare the updated BP management recommendations for HF patients in JSH2025 with those from other major hypertension guidelines, including ESH2023 (https://doi.org/10.1097/HJH.0000000000003480), ESC2024 (https://academic.oup.com/eurheartj/article/45/38/3912/7741010?login=true), and AHA2025 (https://doi.org/10.1016/j.jacc.2025.05.007https://doi.org/10.1016/j.jacc.2025.05.007).
