Highlights of the 2024 Chinese hypertension guidelines

Area of Science:

• Cardiology
• Public Health
• Clinical Practice Guidelines

Background:

• Hypertension remains a significant health burden in China, despite gradual improvements in control rates.
• Recent evidence supports more intensive blood pressure (BP) control and highlights new management approaches.
• There is a need for efficient, precise, and individualized strategies to manage hypertension effectively.

Purpose of the Study:

• To present the updated 2024 Chinese hypertension guidelines.
• To integrate the latest global and Chinese-specific evidence, concepts, and insights into hypertension management.
• To provide updated recommendations for diagnosis, treatment, and lifestyle modifications.

Main Methods:

• Integration of recent epidemiological studies and clinical trial data, with a focus on Chinese populations.
• Inclusion of new concepts and insights in global hypertension management.
• Review and synthesis of evidence for diagnostic thresholds, treatment targets, and lifestyle interventions.

Main Results:

• Maintains 140/90 mmHg as the office BP threshold for hypertension diagnosis, recommending ambulatory or home BP monitoring as alternatives.
• Introduces validated smart wearable devices for hypertension screening and monitoring.
• Adopts a combined BP level and cardiovascular (CV) risk-based treatment strategy, recommending a more aggressive BP target (<130/80 mmHg) if tolerable for most patients.

Conclusions:

• The 2024 guidelines emphasize a more aggressive BP target and personalized treatment strategies.
• Recommendations include lifestyle modifications like low-sodium, potassium-rich diets, and attention to sleep and mental health.
• Updates cover new drugs, flexible combination protocols, concise treatment algorithms, and management in special populations, including specific phenotypes like morning and nocturnal hypertension.