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《2024年中国高血压防治指南》要点

Highlights of the 2024 Chinese hypertension guidelines.

作者信息

Liu Jing

机构信息

Department of Hypertension, Peking University People's Hospital, Beijing, China.

Department of Cardiovascular Medicine, Peking University People's Hospital, Qingdao, Qingdao, China.

出版信息

Hypertens Res. 2025 Mar;48(3):1048-1053. doi: 10.1038/s41440-024-02070-2. Epub 2025 Jan 6.

Abstract

The 2024 Chinese hypertension guidelines has been recently issued by Chinese Hypertension League (CHL), joint with partner societies. Since the 2018 guidelines was released, amount of evidence accumulated, in favor of intensive blood pressure (BP) control. New drugs and devices, innovative concepts and new insights have been introduced into hypertension management. The hypertension control rate improved gradually in past 30 years, while the constantly increased population of hypertension and high-normal BP still brought huge burden in China. More efficient, precise and individualized strategies for BP control are needed. The new guidelines integrated the latest evidence from epidemiological studies and clinical trials, particularly included recent data from Chinese populations, together with new concept and insights of hypertension management from the globe. In brief, the 2024 Chinese hypertension guidelines insists on 140/90 mmHg as the office BP thresholds for hypertension diagnosis. Ambulatory or home BP monitoring are recommended as alternatives for diagnosis. Validated smart wearable devices are introduced for hypertension screening and monitoring. A combined BP level and CV risk -based treatment strategy is still adopted. A more aggressive BP target ( < 130/80 mmHg) is recommended for most, including those at high CV risk, if tolerable. Low-sodium and potassium-rich salt substitute and Chinese heart-healthy diet are recommended and sleep and mental health are added in addition to traditional life style changes. New drugs and more flexible combination protocols, and concise treatment algorithm are introduced. Management of hypertension in special populations are updated and specific phenotype, for instance morning and nocturnal hypertension are addressed.

摘要

中国高血压联盟(CHL)联合相关学会最近发布了《2024年中国高血压防治指南》。自2018年指南发布以来,积累了大量支持强化血压控制的证据。高血压管理引入了新药物、新器械、创新理念和新见解。过去30年高血压控制率逐步提高,但不断增加的高血压和血压正常高值人群仍给中国带来巨大负担。需要更高效、精准和个体化的血压控制策略。新指南整合了流行病学研究和临床试验的最新证据,特别是纳入了中国人群的近期数据,以及全球高血压管理的新理念和新见解。简而言之,《2024年中国高血压防治指南》坚持将140/90 mmHg作为高血压诊断的诊室血压阈值。推荐采用动态血压监测或家庭血压监测作为替代诊断方法。引入经过验证的智能可穿戴设备用于高血压筛查和监测。仍然采用基于血压水平和心血管风险的联合治疗策略。对于大多数人,包括心血管风险高的人群,如果耐受,推荐更积极的血压目标(<130/80 mmHg)。推荐低钠富钾盐替代品和中国心脏健康饮食,除了传统的生活方式改变外,还增加了睡眠和心理健康方面的内容。引入了新药物、更灵活的联合用药方案和简洁的治疗算法。更新了特殊人群的高血压管理内容,并针对特定表型,如清晨高血压和夜间高血压进行了阐述。

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