We examined blood pressure (BP) and medication over 5 years in 80 hypertensive patients who participated in the Hypertension Control Based on home systolic pressure (HOSP) study that compares effects of strict and mild control of morning home systolic blood pressure (SBP) as well as amlodipine- and losartan-based regimens. Average morning home SBP after 5 years was 126 mmHg in the strict control group and 135 mmHg in the mild control group. The strict control group and the losartan group required more combination therapy than the other groups. These results show that long-term strict control of morning BP is feasible. Amlodipine appears to be more effective in controlling morning BP than losartan when the medication is administered alone in the morning.