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Objectives: To provide an occupational physician-pharmacist cooperative management for hypertension, we aimed to improve blood pressure (BP) control for workers with high-normal BP or hypertension., Method: Health checkups were performed from May 2005 to May 2008 for male professional grooms and exercise riders aged 20-69 years working at Miho Training Center, the largest racing-horse training facility in Japan. An occupational physician-pharmacist cooperative hypertension management was performed from Jan 2007 to Mar 2008, including the use of posters at the work site and letters to employers and the subjects who were diagnosed as having high-normal BP (office systolic/diastolic BPs 130-139 and/or 85-89 mmHg) or hypertension (≥ 140 and/or 90 mmHg) twice during 2005-2006 examinations. The observational study examined BP measurements before and after the hypertension management., Results: We analyzed 232 participants in the 2008 Nov examination with had high-normal BP or hypertension in both of 2005 and 2006 Nov examinations. Office systolic and diastolic BP decreased after the hypertension management by the use of educational letters and posters (-3.1 mmHg; p<0.001, -1.5 mmHg; p=0.02). The prevalence of workers with high-normal BP and hypertension also decreased after those activities (-15% and -7%; p<0.001). The subjects who started or continued the antihypertensive medication were more likely to show reductions in office BP and body mass index than those who received no treatment., Conclusions: An occupational physician-pharmacist cooperated hypertension management by the use of educational letters and posters may improve BP control for subjects with high-normal BP or hypertension.