Interpretation of the 2024 British and Irish Hypertension Society Position Statement: Investigation and Management of Hypertension in Young People

doi:10.12114/j.issn.1007-9572.2025.0457

Abstract

Abstract:

The prevalence of hypertension among young people is increasing year by year, but the awareness rate, treatment rate and control rate remain low. Moreover, young patients with hypertension face longer disease exposure time and higher potential cardiovascular risks. Comprehensive investigation and early precise management of this group are crucial for reducing the burden of cardiovascular-related diseases. However, both domestic and international research and guidelines have not paid sufficient attention to this group. For this reason, this article has organized relevant experts to interpret the latest 2024 Position Statement of the British and Irish Hypertension Society: Investigation and Management of Hypertension in Young People, based on the Expert Consensus on the Management of Hypertension in the Young and Middle-aged Chinese Poulation in 2020, aiming to provide practical methods for the investigation and management of hypertension in young people for Chinese clinicians.

Key words: Hypertension, Young people, Cardiovascular diseases, Interpretation of guidelines

摘要：

青年高血压患病率逐年升高，但知晓率、治疗率和控制率低，且青年高血压患者面临着更长的疾病暴露时间和更高的潜在心血管疾病风险，对其进行全面调查与早期精准管理，对于实现降低心血管相关疾病负担至关重要，但国内外研究、指南对这部分患者缺乏重视。基于上述原因，本文组织相关专家，结合我国2020年《中国中青年高血压管理专家共识》，解读最新《2024英国和爱尔兰高血压协会立场声明：青年高血压的调查与管理》，旨在为我国临床医生提供青年高血压调查和管理的实用方法。

关键词: 高血压, 青年, 心血管疾病, 指南解读

YANG Rui,LIAO Xiaoyang,HUANG Chuanying, et al. Interpretation of the 2024 British and Irish Hypertension Society Position Statement: Investigation and Management of Hypertension in Young People[J]. Chinese General Practice, 2026, 29(26): 3726-3732. DOI: 10.12114/j.issn.1007-9572.2025.0457.
杨芮,廖晓阳,黄传应等. 2024英国和爱尔兰高血压协会立场声明：青年高血压的调查与管理解读[J]. 中国全科医学, 2026, 29(26): 3726-3732. DOI: 10.12114/j.issn.1007-9572.2025.0457.

Figures/Tables 6

References 50

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病史	内容
高血压的病情陈述	·首次确诊高血压的时间 ·当前或既往降压药服用情况，包括不耐受药物情况 ·治疗依从性 ·高血压、心血管疾病、卒中、肾脏疾病家族史 ·勃起功能障碍病史 ·妊娠期高血压/子痫前期/胎儿生长受限病史
合并情况	·合并情况，注意心血管疾病的风险因素，如高胆固醇血症、多囊卵巢综合征 ·睡眠情况，打鼾、睡眠呼吸暂停（根据配偶观察情况）
合并用药	·注意口服避孕药或植入剂、激素替代剂、类固醇、非甾体抗炎药、血管内皮生长因子抑制剂、酪氨酸激酶抑制剂、三环类抗抑郁药、选择性5-羟色胺和去甲肾上腺素再摄取抑制剂、右苯丙胺和甲基苯丙胺等可能会使血压升高的药物 ·非处方药物/草药疗法和血管收缩剂 ·娱乐性药物/药物滥用，包括但不限于可卡因、苯丙胺、摇头丸和合成代谢类固醇
生活方式	·吸烟史：目前/曾经/从不 ·饮食史：水果和蔬菜、面包和早餐谷物、盐、酒精、甘草的摄入情况 ·每周身体活动 ·体质量增加或减轻情况

病史	内容
高血压的病情陈述	·首次确诊高血压的时间 ·当前或既往降压药服用情况，包括不耐受药物情况 ·治疗依从性 ·高血压、心血管疾病、卒中、肾脏疾病家族史 ·勃起功能障碍病史 ·妊娠期高血压/子痫前期/胎儿生长受限病史
合并情况	·合并情况，注意心血管疾病的风险因素，如高胆固醇血症、多囊卵巢综合征 ·睡眠情况，打鼾、睡眠呼吸暂停（根据配偶观察情况）
合并用药	·注意口服避孕药或植入剂、激素替代剂、类固醇、非甾体抗炎药、血管内皮生长因子抑制剂、酪氨酸激酶抑制剂、三环类抗抑郁药、选择性5-羟色胺和去甲肾上腺素再摄取抑制剂、右苯丙胺和甲基苯丙胺等可能会使血压升高的药物 ·非处方药物/草药疗法和血管收缩剂 ·娱乐性药物/药物滥用，包括但不限于可卡因、苯丙胺、摇头丸和合成代谢类固醇
生活方式	·吸烟史：目前/曾经/从不 ·饮食史：水果和蔬菜、面包和早餐谷物、盐、酒精、甘草的摄入情况 ·每周身体活动 ·体质量增加或减轻情况

病症	表现
嗜铬细胞瘤	反复出现心悸发作（通常伴有轻度头痛）、面色苍白、焦虑、濒死感
原发性醛固酮增多症	有自发性或利尿剂诱发的低钾血症，有肌肉无力和手足抽搐
甲状腺功能减退症	舒张压升高、疲劳、体质量增加、皮肤干燥、脱发、便秘和肌肉无力
甲状腺功能亢进症	收缩压升高、震颤、焦虑、多汗、体质量减轻、腹泻和怕热
皮质醇增多症	躯干肥胖伴四肢纤细、水牛背、皮肤条纹、满月脸、皮肤薄脆易瘀伤、痤疮
神经纤维瘤病	咖啡牛奶斑、纤维瘤、腋窝雀斑
肢端肥大症	面部改变、手足增大、多汗
慢性肾病	体质量增加、血尿、瘙痒、脚踝肿胀、呼吸急促
子痫前期	既往或本次妊娠时有血压升高
肾脏瘢痕	反复肾/尿路疾病/尿路感染/结石病史

病症	表现
嗜铬细胞瘤	反复出现心悸发作（通常伴有轻度头痛）、面色苍白、焦虑、濒死感
原发性醛固酮增多症	有自发性或利尿剂诱发的低钾血症，有肌肉无力和手足抽搐
甲状腺功能减退症	舒张压升高、疲劳、体质量增加、皮肤干燥、脱发、便秘和肌肉无力
甲状腺功能亢进症	收缩压升高、震颤、焦虑、多汗、体质量减轻、腹泻和怕热
皮质醇增多症	躯干肥胖伴四肢纤细、水牛背、皮肤条纹、满月脸、皮肤薄脆易瘀伤、痤疮
神经纤维瘤病	咖啡牛奶斑、纤维瘤、腋窝雀斑
肢端肥大症	面部改变、手足增大、多汗
慢性肾病	体质量增加、血尿、瘙痒、脚踝肿胀、呼吸急促
子痫前期	既往或本次妊娠时有血压升高
肾脏瘢痕	反复肾/尿路疾病/尿路感染/结石病史

器官	相关的临床诊断	终末器官损害的亚临床表现
心脏	·心力衰竭（包括射血分数保留/射血分数降低的心力衰竭） ·冠状动脉疾病 ·心律失常（特别是心房颤动）	·左心室肥厚 ·左心室收缩或舒张功能障碍、心房扩张 ·脑钠肽或N末端脑钠肽前体升高
肾脏	·慢性肾脏疾病	·微量白蛋白尿/蛋白尿 ·肾小球滤过率下降 ·肾皮质厚度减少或其他肾脏疾病特征
眼	·视力损害	·高血压性视网膜病变：出血、微动脉瘤、硬性渗出、棉绒斑
脑	·脑血管意外/短暂性脑缺血发作	·颅脑MRI结果显示腔隙性梗死、脑微出血或大面积白质高信号 ·颈动脉粥样硬化
血管	·外周血管疾病、主动脉瘤	·轻度胸主动脉扩张 ·主动脉僵硬 ·踝臂指数降低 ·动脉粥样硬化斑块