Abstract: There is significant regional and population heterogeneity in the prevention and control of hypertension. The guidelines from Europe and America are difficult to adapt to the disease and treatment characteristics of the East Asian population. To improve the standardized diagnosis and treatment system for hypertension in East Asia, this paper systematically compares the core update points and treatment frameworks of the new hypertension guidelines for China in 2024, Japan in 2025, and South Korea in 2026. All three guidelines are based on local evidence-based medicine and epidemiological characteristics, and have reached consensus on diagnostic criteria, target blood pressure values for high-risk populations, digital monitoring, and individualized stratified intervention. This reflects the trend of precise and comprehensive diagnosis and treatment of hypertension. At the same time, each country has formed differentiated innovations: China has established a comprehensive management model of classification, staging, and typing to adapt to the local high-salt diet and aging situation; Japan has implemented an individualized blood pressure reduction plan based on the physical function of the elderly; South Korea has innovatively introduced an intelligent monitoring technology without a cuff, focusing on the prevention of diastolic hypertension in young people, which can provide evidence-based references for the clinical diagnosis, treatment and prevention of hypertension in East Asia.