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中华心脏与心律电子杂志 ›› 2025, Vol. 13 ›› Issue (01) : 29 -33. doi: 10.3877/cma.j.issn.2095-6568.2025.01.002

指南解读

《2024年ESC血压升高和高血压管理指南》更新要点解读
郑旭辉1, 姚文明1, 李新立1,()   
  1. 1. 210029 南京,南京医科大学第一附属医院(江苏省人民医院)心血管内科 络病理论创新转化全国重点实验室
  • 收稿日期:2024-12-05 出版日期:2025-03-25
  • 通信作者: 李新立

Interpretation of the updates on 2024 ESC guidelines for the management of elevated blood pressure and hypertension

Xuhui Zheng1, Wenming Yao1, Xinli Li1,()   

  1. 1. Department of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, State Key Laboratory for Innovation and Transformation of Luobing Theory, Nanjing 210029, China
  • Received:2024-12-05 Published:2025-03-25
  • Corresponding author: Xinli Li
引用本文:

郑旭辉, 姚文明, 李新立. 《2024年ESC血压升高和高血压管理指南》更新要点解读[J/OL]. 中华心脏与心律电子杂志, 2025, 13(01): 29-33.

Xuhui Zheng, Wenming Yao, Xinli Li. Interpretation of the updates on 2024 ESC guidelines for the management of elevated blood pressure and hypertension[J/OL]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2025, 13(01): 29-33.

欧洲心脏病学会(ESC)于2024年8月30日发布了《2024年ESC血压升高和高血压管理指南》,对2018年版指南进行了重要更新,吸纳了最新的循证医学证据。新指南继续沿用高血压的定义,但新增了“血压升高”这一分类,定义为诊室收缩压120~139 mmHg或舒张压70~89 mmHg。指南建议所有高血压患者的血压控制在140/90 mmHg以下,耐受性良好的患者应进一步将目标降至130/80 mmHg以下。对于高危患者和老年患者,分别建议将收缩压控制在120~129 mmHg和130~139 mmHg。新指南还强调高血压筛查的重要性并推荐诊室外血压测量,提出新的降压治疗方法,包括盐皮质激素受体拮抗剂、血管紧张素受体-脑啡肽酶抑制剂和钠-葡萄糖共转运蛋白2抑制剂等。本文对新指南的重要推荐进行解读,旨在帮助医务工作者更好地理解和遵循指南。

表1 基于确诊的血压类别和心血管疾病风险的降压治疗启动[1]
图1 降压治疗的药物治疗临床应用路径[1] ACEI为血管紧张素转化酶抑制剂,ARB为血管紧张素受体阻滞剂,CCB为钙通道阻滞剂,Y为是,N为否;1 mmHg=0.133 kPa
图2 运动及生活方式因素对血压和降低心血管风险的作用[1]
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