Wang Xiao-Ya, Wang Peng-Qian, Xiong Xing-Jiang
Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China.
Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2023 Sep;48(17):4819-4824. doi: 10.19540/j.cnki.cjcmm.20230603.501.
Hypertension is the most important risk factor for cardiovascular disease-related deaths among urban and rural residents, and it has become a significant global public health issue. In October 2022, the Clinical Practice Guidelines for the Management of Hypertension in China(hereinafter referred to as the Practice Guidelines) were jointly released by the National Cardiovascular Center and other academic organizations. The Practice Guidelines sparked extensive discussions as they clearly lowered the diagnostic criteria for hypertension, raised the blood pressure targets for elderly patients, and proposed changes in the timing of early medication intervention. While these adjustments have some international evidence-based support, there is still debate regarding the cardiovascular benefits of intensified blood pressure control based on the existing level of evidence. Furthermore, whether the series of new standards proposed in the Practice Guidelines are suitable for the Chinese population and whether the hypertension control level in primary care in China can adapt to the new diagnostic and treatment standards require further in-depth research. In contrast to the strict blood pressure control concept emphasized in the Practice Guidelines, traditional Chinese medicine(TCM) emphasizes the concept of comprehensive prevention and treatment and holistic therapy in the treatment of hypertension, including prehypertension, hypertension, and target organ damage. In recent years, based on abundant clinical trial research and high-quality evidence-based support, the advantages of TCM in treating hypertension have gradually emerged. Previous studies by this research team have found that the pathogenesis of hypertension includes three major types: fire syndrome, fluid retention syndrome, and deficiency syndrome. TCM treatment of hypertension features stable blood pressure reduction, gentle blood pressure lowering, and long-lasting effects. In addition to blood pressure reduction, it also has effects such as reversing risk factors and protecting target organ damage. It demonstrates the characteristics of multiple targets, multiple components, and comprehensive regulation, and can be applied throughout the entire process of prevention and treatment, including prehypertension, hypertension, and target organ damage in the early, middle, and late stages of hypertension. Therefore, it has certain clinical application prospects.
高血压是城乡居民心血管疾病相关死亡的最重要危险因素，已成为一个重大的全球公共卫生问题。2022年10月，国家心血管病中心等学术组织联合发布了《中国高血压防治临床指南》（以下简称《指南》）。《指南》因明确降低高血压诊断标准、提高老年患者血压控制目标以及提出早期药物干预时机的变化而引发了广泛讨论。虽然这些调整有一些国际循证支持，但基于现有证据水平，强化血压控制对心血管的益处仍存在争议。此外，《指南》中提出的一系列新标准是否适用于中国人群，以及我国基层医疗中的高血压控制水平能否适应新的诊疗标准，还需要进一步深入研究。与《指南》强调的严格血压控制理念不同，中医在高血压治疗中强调综合防治和整体调理的理念，包括对高血压前期、高血压以及靶器官损害的治疗。近年来，基于丰富的临床试验研究和高质量的循证支持，中医治疗高血压的优势逐渐显现。该研究团队之前的研究发现，高血压的发病机制包括火证、水饮证和虚证三大类型。中医治疗高血压具有降压平稳、缓降且作用持久的特点。除了降低血压外，还具有逆转危险因素和保护靶器官损害等作用。它体现了多靶点、多成分、综合调控的特点，可应用于高血压前期、高血压以及高血压早、中、晚期靶器官损害的防治全过程。因此，具有一定的临床应用前景。
