nav emailalert searchbtn searchbox tablepage yinyongbenwen piczone journalimg journalInfo journalinfonormal searchdiv searchzone qikanlogo popupnotification paper paperNew
2026, 04, v.28 415-418
高血压防治及个体化管理的新进展
基金项目(Foundation):
邮箱(Email): caijun7879@126.com;
DOI:
发布时间: 2026-04-14
出版时间: 2026-04-14
移动端阅读
摘要:

<正>近年来,高血压领域的循证医学证据持续更新,一系列高质量随机对照试验和创新技术的应用正在重塑对血压管理的认识。从控制血压到改善心血管预后,从长期服药到长效干预,从被动管理到促进主动健康,再到远程监测及人工智能驱动的个体化决策,尤其是老年高血压的个体化管理,高血压领域将迎来防治模式的变革。现结合最新发布的多项重要研究,系统评述当前高血压诊疗的核心进展。

Abstract:

KeyWords:
参考文献

[1]SPRINT Research Group, Wright JT Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control[J].N Engl J Med, 2015, 373(22):2103-2116. DOI:10.1056/NEJMoa1511939.

[2]Zhang W, Zhang S, Deng Y, et al. Trial of intensive blood-pressure control in older patients with hypertension[J]. N Engl J Med, 2021,385(14):1268-1279. DOI:10.1056/NEJMoa2111437.

[3]Liu J, Li Y, Ge J, et al. Lowering systolic blood pressure to less than 120 mmHg versus less than 140 mmHg in patients with high cardiovascular risk with and without diabetes or previous stroke:an open-label, blinded-outcome, randomised trial[J]. Lancet, 2024,404(10449):245-255. DOI:10.1016/S0140-6736(24)01028-6.

[4]Song Q, Peng X, Bai J, et al. Intensive blood pressure control in older patients with hypertension:6-year results of the STEP trial[J]. J Am Coll Cardiol, 2025, 86(17):1421-1433. DOI:10.1016/j.jacc.2025. 06.045.

[5]Bi Y, Li M, Liu Y, et al. Intensive blood-pressure control in patients with type 2 diabetes[J]. N Engl J Med, 2025, 392(12):1155-1167. DOI:10.1056/NEJMoa2412006.

[6]Guo X, Sun G, Xu Y, et al. Benefit-harm trade-offs of intensive blood pressure control versus standard blood pressure control on cardiovascular and renal outcomes:an individual participant data analysis of randomised controlled trials[J]. Lancet, 2025, 406(10507):1009-1019. DOI:10.1016/S0140-6736(25)01391-1.

[7]McEvoy JW, McCarthy CP, Bruno RM, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension[J].Eur Heart J, 2024, 45(38):3912-4018. DOI:10.1093/eurheartj/ehae178.

[8]中华医学会老年医学分会,中国医疗保健国际交流促进会高血压病分会.老年高血压特点及临床诊治流程专家共识(2024)[J].中华老年医学杂志,2024,43(3):257-268. DOI:10.3760/cma.j.issn.0254-9026.2024.03.001.

[9]中华医学会心血管病学分会,海峡两岸医药卫生交流协会高血压专业委员会,中国康复医学会心血管疾病预防与康复专业委员会.中国高血压临床实践指南[J].中华心血管病杂志,2024,52(9):985-1032. DOI:10.3760/cma.j.cn112148-20240709-00377.

[10]Uchida HA, Wada J, Motoki H, et al. Efficacy and safety of esaxerenone in hypertensive patients with chronic kidney disease, with or without type 2 diabetes mellitus:a pooled analysis of five clinical studies[J]. Hypertens Res, 2025, 48(9):2413-2426. DOI:10.1038/s41440-025-02259-z.

[11]Laffin LJ, Rodman D, Luther JM, et al. Aldosterone synthase inhibition with lorundrostat for uncontrolled hypertension:the target-HTN randomized clinical trial[J]. JAMA, 2023, 330(12):1140-1150.DOI:10.1001/jama.2023.16029.

[12]Laffin LJ, Kopjar B, Melgaard C, et al. Lorundrostat efficacy and safety in patients with uncontrolled hypertension[J]. N Engl J Med,2025, 392(18):1813-1823. DOI:10.1056/NEJMoa2501440.

[13]Saxena M, Laffin L, Borghi C, et al. Lorundrostat in participants with uncontrolled hypertension and treatment-resistant hypertension:the launch-HTN randomized clinical trial[J]. JAMA, 2025, 334(5):409-418. DOI:10.1001/jama.2025.9413.

[14]Flack JM, Azizi M, Brown JM, et al. Efficacy and safety of Baxdrostat in uncontrolled and resistant hypertension[J]. N Engl J Med,2025, 393(14):1363-1374. DOI:10.1056/NEJMoa2507109.

[15]Schlaich MP, Bellet M, Weber MA, et al. Dual endothelin antagonist aprocitentan for resistant hypertension(PRECISION):a multicentre,blinded, randomised, parallel-group, phase 3 trial[J]. Lancet, 2022,400(10367):1927-1937. DOI:10.1016/S0140-6736(22)02034-7.

[16]Desai AS, Webb DJ, Taubel J, et al. Zilebesiran, an RNA interference therapeutic agent for hypertension[J]. N Engl J Med, 2023, 389(3):228-238. DOI:10.1056/NEJMoa2208391.

[17]Bakris GL, Saxena M, Gupta A, et al. RNA interference with zilebesiran for mild to moderate hypertension:the KARDIA-1 randomized clinical trial[J]. JAMA, 2024, 331(9):740-749. DOI:10.1001/jama.2024.0728.

[18]Malhotra A, Grunstein RR, Fietze I, et al. Tirzepatide for the treatment of obstructive sleep apnea and obesity[J]. N Engl J Med, 2024,391(13):1193-1205. DOI:10.1056/NEJMoa2404881.

[19]Rajagopalan S, Brook RD, Münzel T. Environmental hypertensionology and the mosaic theory of hypertension[J]. Hypertension, 2025,82(4):561-572. DOI:10.1161/HYPERTENSIONAHA.124.18733.

[20]Prabhakaran D, Roy A, Chandrasekaran AM, et al. Comparison of dual therapies for hypertension treatment in India:a randomized clinical trial[J]. Nat Med, 2025, 31(9):3169-3175. DOI:10.1038/s41591-025-03854-w.

[21]Rodgers A, Salam A, Schutte AE, et al. Efficacy and safety of a novel low-dose triple single-pill combination of telmisartan, amlodipine and indapamide, compared with dual combinations for treatment of hypertension:a randomised, double-blind, active-controlled,international clinical trial[J]. Lancet, 2024, 404(10462):1536-1546. DOI:10.1016/S0140-6736(24)01744-6.

[22]Ojji DB, Salam A, Sani MU, et al. Low-dose triple-pill vs standard-care protocols for hypertension treatment in Nigeria:a randomized clinical trial[J]. JAMA, 2024, 332(13):1070-1079. DOI:10.1001/jama.2024.18080.

[23]Jones DW, Ferdinand KC, Taler SJ, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults:a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. Circulation, 2025,152(11):e114-e218. DOI:10.1161/CIR.0000000000001356.

[24]Zhang X, Yuan Y, Li C, et al. Effect of a salt substitute on incidence of hypertension and hypotension among normotensive adults[J]. J Am Coll Cardiol, 2024, 83(7):711-722. DOI:10.1016/j.jacc.2023.12.013.

[25]Argentesi G, Wu X, Ney A, et al. Endoscopic, ultrasound-guided,radiofrequency ablation of aldosterone-producing adenomas(FABULAS):a UK, multicentre, prospective, proof-of-concept trial[J].Lancet, 2025, 405(10479):637-647. DOI:10.1016/S0140-6736(24)02755-7.

[26]Benetos A, Gautier S, Freminet A, et al. Reduction of antihypertensive treatment in nursing home residents[J]. N Engl J Med, 2025,393(20):1990-2000. DOI:10.1056/NEJMoa2508157.

[27]Li S, Peng Y, Li Y, et al. Effects of intensive blood pressure control in patients with frailty:a post hoc analysis from ESPRIT[J]. J Am Coll Cardiol, 2026, 87(1):4-16. DOI:10.1016/j.jacc.2025.08.092.

[28]Song J, Wang X, Wang B, et al. Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China:pragmatic cluster randomised controlled trial[J]. BMJ, 2024, 386:e079143. DOI:10.1136/bmj-2023-079143.

[29]Siedner MJ, Magula N, Mazibuko L, et al. Home-based care for hypertension in Rural South Africa[J]. N Engl J Med, 2025, 393(13):1304-1314. DOI:10.1056/NEJMoa2509958.

基本信息:

中图分类号:R544.1

引用信息:

[1]王运红,蔡军.高血压防治及个体化管理的新进展[J].中华老年心脑血管病杂志,2026,28(04):415-418.

发布时间:

2026-04-14

出版时间:

2026-04-14

检 索 高级检索

引用

GB/T 7714-2015 格式引文
MLA格式引文
APA格式引文