诊断学理论与实践 ›› 2024, Vol. 23 ›› Issue (03): 297-304.doi: 10.16150/j.1671-2870.2024.03.007

• 国内外学术动态 • 上一篇    下一篇

世界卫生组织《全球高血压报告》(2023年)概要及解读

张冬燕, 李燕()   

  1. 上海市高血压研究所 上海交通大学医学院附属瑞金医院,上海 200025
  • 收稿日期:2024-04-15 接受日期:2024-05-08 出版日期:2024-06-25 发布日期:2024-06-25
  • 通讯作者: 李燕,E-mail: liyanshcn@163.com
  • 基金资助:
    国家自然科学基金委员会(82100445);国家自然科学基金委员会(82270469);上海市科学技术委员会“扬帆计划”人才项目(21YF1438700)

Summary and interpretation of the World Health Organization “Global Report on Hypertension”

ZHANG Dongyan, LI Yan()   

  1. Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, Chhina
  • Received:2024-04-15 Accepted:2024-05-08 Published:2024-06-25 Online:2024-06-25

摘要:

2023年,世界卫生组织(World Health Organization ,WHO)发布了首个《全球高血压报告—与无声杀手的赛跑》,报告涵盖了全球高血压的流行情况和管理方法,分析了高血压导致的死亡及疾病负担,探讨了高血压的危险因素,评价了降压治疗的成本效益,并介绍了多国高血压管理的成功案例,尤其是HEARTS高血压防控计划的全球推广情况。高血压是一个全球性公共卫生挑战,严重危害健康。过去30多年间,全球高血压(收缩压≥140 mmHg,或舒张压≥90 mmHg,或服用降压药物)患者的数量翻了一倍,从1990年的6.5亿增长至2019年的13亿,在30~79岁的全球高血压患者中,大约54%诊断为高血压,其中42%正在接受降压治疗,而仅有21%得到控制。2019年,全球范围内超过一半的心血管疾病死亡可归因于收缩压升高,如果全球范围内将高血压控制率提高到50%,从2023年至2050年间可以避免7 600万人死亡。人群水平的高血压相关危险因素包括高盐和低钾摄入、饮酒、缺乏运动、空气污染等。WHO支持通过减少膳食钠摄入,增加钾摄入、限制饮酒、戒烟、增加运动和改善空气污染等方式预防和控制高血压。治疗方面,WHO指南建议对收缩压≥140 mmHg或舒张压≥90 mmHg的个体使用降压药物治疗。对于特定人群,收缩压在130~139 mmHg之间时也建议开始使用降压药物治疗,同时推荐使用单片复方制剂进行联合治疗,以提高治疗的依从性和持久性。我国高血压的流行趋势和管理情况同样令人关注。高血压是我国人群中重要的死亡和疾病负担因素,通过学习和借鉴全球高血压管理的成功经验,可以加强我国高血压的预防、控制和监测工作,特别是推动HEARTS技术包在我国的应用,以提升高血压管理效果。该报告旨在提醒人们重点关注非传染性疾病,特别是高血压这一公共卫生挑战,通过详细的数据分析和成功案例明确了高血压防治的重要性,并为各国制定相关政策提供了科学依据,为实现2025年将未控制高血压比例较2010年相对下降25%的全球目标而共同努力。本文结合中国高血压病的流行趋势与管理情况对该报告进行简要解读。

关键词: 高血压, 患病率, 死亡, 疾病负担

Abstract:

In 2023, the World Health Organization (WHO) released the first document of “Global report on hypertension—The race against a silent killer”. which covers the global prevalence and management of hypertension, analyzes the mortality and disease burden caused by hypertension, explores the risk factors for hypertension, evaluates the cost-effectiveness of blood pressure treatment, and presents successful examples of hypertension management in many countries, especially the global implementation of the WHO-launched HEARTS project for hypertension control. Hypertension is a significant global public health challenge with severe health implications. Over the past 30 years, the number of people with hypertension (defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, or taking antihypertensive medication) has doubled, rising from 650 million in 1990 to 1.3 billion in 2019. Among the global hypertensive population aged 30-79, approximately 54% have been diagnosed, of which 42% are receiving antihypertensive treatment, and only 21% have controlled blood pressure. In 2019, elevated systolic pressure was responsible for over half of cardiovascular disease deaths globally. Increasing the global hypertension control rate to 50% could prevent 76 million deaths from 2023 to 2050. Population-level risk factors for hypertension include high salt and low potassium intake, alcohol consumption, physical inactivity, and air pollution. WHO advocates for the prevention and control of hypertension through measures such as reducing dietary sodium intake, increasing potassium intake, limiting alcohol consumption, quitting smoking, increasing physical activity, and improving air quality. In terms of treatment, WHO guidelines recommend antihypertensive medication for individuals with systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg. For specific populations, it is also recommended to start antihypertensive treatment when systolic blood pressure is between 130-139 mmHg. The use of single-pill combination therapy is also advised to improve adherence and persistence in treatment. The prevalence and management of hypertension in China are also noteworthy. Hypertension is a major cause of mortality and disease burden in the Chinese population. By learning from global successes in hypertension management, China can enhance its efforts in the prevention, control, and monitoring of hypertension, particularly by promoting the application of the HEARTS technical package to improve hypertension management. This report aims to draw attention to major non-communicable diseases, particularly hypertension, as a public health challenge. Through detailed data analysis and successful case studies, the report underscores the importance of hypertension prevention and control, providing scientific evidence for policy-making across countries. This collective effort aims to achieve the global goal of a 25% relative reduction in uncontrolled hypertension prevalence by 2025 compared to 2010. This article will interpret briefly the reports based on the prevalence and management of hypertension in China.

Key words: Hypertension, Prevalence, Mortality, Disease burden

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