In Japan, the 2019 Japanese Society of Hypertension Guidelines for the Management of Hypertension and the 2023 Japanese Society of Nephrology (JSN) Evidence-based Clinical Practice Guidelines for CKD recommend the use of angiotensin receptor blockers (ARBs)/angiotensin converting enzyme inhibitors (ACEis) as first-line treatment for hypertension in patients with CKD and proteinuria [6, 7]. Here, ACE is linked to chronic kidney disease.