Zhao Lin, Meng Xu, Zhang Qiong-Yu, Dong Xue-Qi, Zhou Xian-Liang
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Ann Transl Med. 2021 Jan;9(2):170. doi: 10.21037/atm-20-5482.
In 1939, Robinson and Brucer first proposed the concept of prehypertension (PHTN), which was defined as a systolic blood pressure of 120-139 mmHg and/or diastolic blood pressure of 80-89 mmHg. PHTN is a major global health risk that adversely affects human health, especially the cardiovascular system. People with PHTN have a higher risk of developing cardiovascular diseases, including stroke, coronary heart disease, myocardial infarction and total cardiovascular events. However, there are few systematic summaries of the relationship between PHTN and the cardiovascular system. Furthermore, because the definition of 'normal BP' and the advantages of more intensive BP control remain unclear, there is no consensus on optimal interventions. In an attempt to provide information for clinicians or professionals who are interested in reducing the risk associated with PHTN, we review the existing studies to provide references for them with the effects of PHTN on the cardiovascular system and the potential pathogenic mechanisms of PHTN, including inflammatory responses, insulin resistance, endothelial dysfunction, sympathovagal imbalance, activation of the renin-angiotensin system and others. PHTN is highly prevalent and has adverse effects on health. An effective public health strategy is important to prevent the progression of PHTN. We envisage that this information will increase the public attention of PHTN and help to provide more strategies to reduce the risk of cardiovascular events.
1939年，罗宾逊和布鲁瑟首次提出了高血压前期（PHTN）的概念，其定义为收缩压120 - 139 mmHg和/或舒张压80 - 89 mmHg。高血压前期是一种主要的全球健康风险，对人类健康，尤其是心血管系统产生不利影响。患有高血压前期的人患心血管疾病的风险更高，包括中风、冠心病、心肌梗死和总的心血管事件。然而，关于高血压前期与心血管系统之间关系的系统性总结较少。此外，由于“正常血压”的定义以及更严格血压控制的优势仍不明确，对于最佳干预措施尚无共识。为了给对降低与高血压前期相关风险感兴趣的临床医生或专业人员提供信息，我们回顾现有研究，为他们提供关于高血压前期对心血管系统的影响以及高血压前期潜在致病机制的参考，包括炎症反应、胰岛素抵抗、内皮功能障碍、交感迷走神经失衡、肾素 - 血管紧张素系统激活等。高血压前期非常普遍且对健康有不良影响。一项有效的公共卫生策略对于预防高血压前期的进展很重要。我们设想这些信息将提高公众对高血压前期的关注度，并有助于提供更多降低心血管事件风险的策略。
