收稿日期: 2026-05-09
修回日期: 2026-06-10
录用日期: 2026-06-15
网络出版日期: 2026-08-13
基金资助
国家重点研发计划项目(2023YFC2705501);上海市公共卫生研究专项项目(2025GKM25);上海交通大学内蒙古研究院科技创新发展专项项目(2025XYJG0001-01-19)
Postpartum blood pressure management of hypertensive disorders in pregnancy ： An integrated perspective from guideline discrepancies to digital proactive interventions
Received date: 2026-05-09
Revised date: 2026-06-10
Accepted date: 2026-06-15
Online published: 2026-08-13
妊娠是评估女性心血管疾病（CVD）风险的理想切入点。妊娠期高血压疾病（hypertensive disorders in pregnancy， HDP）作为妊娠期常见并发症，使产妇远期罹患CVD的风险显著升高，因此产后血压管理成为衔接女性长期心血管健康的关键环节。然而HDP患者产后血压的管理与随访面临核心挑战：一是指南缺乏共识，国内外启动降压治疗的阈值差异显著；二是传统随访模式低效，导致风险筛查错失良机。近年来研究显示，更严格的产后血压控制可能带来更多心血管收益，相关随机对照试验正在探索最优控制目标。管理模式也向主动化、数字化转型，以家庭血压监测（home BP monitoring， HBPM）+远程药物调整为核心的干预，可显著改善血压控制效果。未来需通过高质量长期临床试验明确不同亚型HDP的适宜控制目标，探索HBPM整合模式的可行性与成本效益。HDP产后血压管理应纳入女性终身心血管预防体系，减少短期妊娠并发症风险与远期心血管负担。
杨绪辰 , 梅天茹 , 邵一菲 , 马珏 , 郑黎强 . 妊娠期高血压疾病产后血压管理：从指南分歧到数字化主动干预的整合视角[J]. 实用医学杂志, 2026 , 42(15) : 2675 -2683 . DOI: 10.3969/j.issn.1006-5725.2026.15.001
Pregnancy serves as an ideal entry-point for assessing women's risk of cardiovascular disease. Hypertensive disorders in pregnancy （HDP）， which are common complications during pregnancy， substantially elevate the risk of long-term cardiovascular disease in puerperae. As a result， postpartum blood pressure management has emerged as a crucial link for ensuring women's long-term cardiovascular health. Nevertheless， the management and follow-up of postpartum blood pressure in HDP patients encounter core challenges. Firstly， there is a lack of consensus among guidelines， with notable disparities in the thresholds for initiating antihypertensive treatment both at home and abroad. Secondly， the traditional follow-up model is inefficient， causing missed opportunities for risk screening. Recent research has indicated that more stringent postpartum blood pressure control may yield greater cardiovascular benefits， and relevant randomized controlled trials are currently exploring the optimal control target. The management model is also undergoing an active and digital transformation. Interventions centered on home BP monitoring （HBPM） combined with remote medication adjustment can significantly enhance blood pressure control outcomes. In the future， high-quality long-term clinical trials are required to determine the appropriate control targets for different HDP subtypes and to explore the feasibility and cost-effectiveness of integrated HBPM models. Postpartum blood pressure management for HDP should be integrated into the long-term cardiovascular prevention system for women to mitigate the risk of short-term pregnancy complications and long-term cardiovascular burden.
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