Hypertension with Bronchial Asthma: Interaction Mechanism and Management

doi:10.12114/j.issn.1007-9572.2022.0587

Chinese General Practice ›› 2023, Vol. 26 ›› Issue (03): 274-279.DOI: 10.12114/j.issn.1007-9572.2022.0587

Special Issue: 述评栏目最新文章合辑；高血压最新文章合辑

• Editorial • Previous Articles Next Articles

Hypertension with Bronchial Asthma: Interaction Mechanism and Management

1.Cardiovascular Department, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
2.Postdoctoral Mobile Station, Beijing University of Chinese Medicine, Beijing 100029, China
3.Huanggang Hospital of TCM, Hubei University of Chinese Medicine, Huanggang 438000, China
4.Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China

Received:2022-05-17 Revised:2022-10-07 Published:2023-01-20 Online:2022-10-20
Contact: ZHANG Lijing
About author:
SUN R, PAN Y, TAN A H, et al. Hypertension with bronchial asthma: interaction mechanism and management [J] . Chinese General Practice, 2023, 26 (3) : 274-279. SUN Rui and PAN Yi are co-first authors

高血压合并支气管哮喘：机制与管理

1．100700　北京市，北京中医药大学东直门医院心内科
2．100029　北京市，北京中医药大学博士后流动站
3．438000　湖北省黄冈市，湖北中医药大学附属黄冈中医医院
4．100091　北京市，中国中医科学院西苑医院

通讯作者: 张立晶
作者简介:
孙瑞，潘熠，谭爱华，等.高血压合并支气管哮喘：机制与管理[J].中国全科医学，2023，26（3）：274-279. [www.chinagp.net] 作者贡献：孙瑞、潘熠、张立晶提出综述撰写思路；孙瑞、潘熠、王建新负责文献搜索、文献阅读，论文起草、撰写；谭爱华、王璇负责文章修改；张立晶负责最终版本修订，对论文负责。孙瑞和潘熠为共同第一作者
基金资助:
国家中医药管理局慢性病治未病干预方案制定项目(ZYZB-2020-196); 国家中医药管理局标准化项目(SATCM-2015-BZ402)

Abstract

Abstract:

Genetic susceptibility, inflammatory mechanism and unhealthy lifestyle are associated with increased risk of hypertension, a common chronic cardiovascular disease, and asthma, a common chronic respiratory disease. The research on the pathogenesis and management of hypertension with bronchial asthma has become a hotspot recently. We did a review of the latest relevant studies on hypertension and bronchial asthma. It was concluded that the co-morbidity of hypertension and asthma was related to common genetic disorders, systemic inflammation and poor lifestyle. Then gave a summary of the interaction mechanism between the two diseases and related management methods. Calcium channel blockers and angiotensin receptor antagonists were recommended as the first choice for drug treatment. This study aims at offering insights into clinical research on the pathogenesis and scientific management of hypertension with asthma.

Key words: Hypertension, Bronchial asthma, Disease management, Antihypertensive agents, Review

摘要：

高血压和支气管哮喘分别是心血管系统和呼吸系统常见的慢性病。基因易感性、炎症机制以及不良生活方式等均可增加高血压和哮喘的发病风险。近年来高血压合并哮喘在发病机制、疾病管理方面的研究已成为热点。本文分析了高血压和哮喘相互作用的机制，认为高血压和哮喘共病与共同的遗传失调、系统性炎症、不良生活方式有关；总结了高血压合并哮喘时患者的管理方法，推荐药物治疗时首选钙离子通道阻滞剂和血管紧张素受体拮抗剂。通过分析和总结旨在为高血压合并哮喘的发病机制及科学管理提供研究方向。

关键词: 高血压, 支气管哮喘, 疾病管理, 抗高血压药, 综述

SUN Rui,PAN Yi,TAN Aihua, et al. Hypertension with Bronchial Asthma: Interaction Mechanism and Management[J]. Chinese General Practice, 2023, 26(03): 274-279. DOI: 10.12114/j.issn.1007-9572.2022.0587.
孙瑞,潘熠,谭爱华等. 高血压合并支气管哮喘：机制与管理[J]. 中国全科医学, 2023, 26(03): 274-279. DOI: 10.12114/j.issn.1007-9572.2022.0587.

Figures/Tables 1

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药物类型	适应证	不良反应和注意事项	针对哮喘的考虑因素
噻嗪类利尿剂	一线或附加药物	引起低血钾或低血钠	短效β-受体激动剂、茶碱和糖皮质激素用量增多的情况下，可降低血钾，需慎用
ACEI	慢性肾脏病、充血性心力衰竭和心肌梗死的一线或附加药物	可升高血钾和肌酐水平；血管神经性水肿；妊娠妇女禁用	诱发咳嗽；诱发或加重哮喘，需慎用
ARB	慢性肾脏病、充血性心力衰竭和心肌梗死的一线或附加药物	可升高血钾和肌酐水平；血管神经性水肿；妊娠妇女禁用	可降低支气管反应性；有望成为哮喘合并高血压一线选择
CCB	一线或附加药物	水肿；与β-受体阻滞剂联用时，可能出现便秘和心脏传导阻滞	可能对平滑肌收缩和触发因素产生有益作用，因此建议哮喘合并高血压时首选
β-受体阻滞剂	不建议单药治疗；适用于充血性心力衰竭、心肌梗死和心律失常	可能出现心动过缓、疲劳、失眠；外周循环、糖脂代谢受损	可诱发支气管痉挛；哮喘病情不稳定患者和重度气流阻塞患者禁用

药物类型	适应证	不良反应和注意事项	针对哮喘的考虑因素
噻嗪类利尿剂	一线或附加药物	引起低血钾或低血钠	短效β-受体激动剂、茶碱和糖皮质激素用量增多的情况下，可降低血钾，需慎用
ACEI	慢性肾脏病、充血性心力衰竭和心肌梗死的一线或附加药物	可升高血钾和肌酐水平；血管神经性水肿；妊娠妇女禁用	诱发咳嗽；诱发或加重哮喘，需慎用
ARB	慢性肾脏病、充血性心力衰竭和心肌梗死的一线或附加药物	可升高血钾和肌酐水平；血管神经性水肿；妊娠妇女禁用	可降低支气管反应性；有望成为哮喘合并高血压一线选择
CCB	一线或附加药物	水肿；与β-受体阻滞剂联用时，可能出现便秘和心脏传导阻滞	可能对平滑肌收缩和触发因素产生有益作用，因此建议哮喘合并高血压时首选
β-受体阻滞剂	不建议单药治疗；适用于充血性心力衰竭、心肌梗死和心律失常	可能出现心动过缓、疲劳、失眠；外周循环、糖脂代谢受损	可诱发支气管痉挛；哮喘病情不稳定患者和重度气流阻塞患者禁用

Hypertension with Bronchial Asthma: Interaction Mechanism and Management

高血压合并支气管哮喘：机制与管理

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