构建女性全生命周期血压管理的“一体化防线”

Establishing an integrated, life-course-oriented framework for blood pressure management in women

摘要

高血压是女性心血管疾病（CVD）防控中最重要且可干预的危险因素之一，其发生发展及相关不良结局在女性不同生命阶段呈现出显著的性别特异性和阶段性特征。女性血压管理亟需由阶段性干预转向连续、整合的“一体化防线”建设。生命早期不良宫内环境可通过发育编程机制影响个体远期血压水平及 CVD 风险；儿童青少年期规范筛查与早期干预有助于降低成年期高血压及靶器官损害的发生；育龄期及妊娠期是女性血压管理的关键窗口，妊娠期高血压疾病不仅影响围产结局，更是女性未来 CVD 的重要预警信号；产后及哺乳期长期随访有助于早期识别并管理 CVD 危险因素；围绝经期雌激素撤退与代谢异常叠加，推动血压水平和 CVD 风险显著上升；老年期女性则需在多重共病和脆弱性背景下实施以安全性和个体化为核心的综合管理策略。构建女性全生命周期血压管理的“一体化防线”，应强化风险识别关口前移，促进多学科协作与连续管理，实现由疾病治疗向健康促进转型，为提升女性整体心血管健康水平提供系统化路径。

Abstract

Hypertension is one of the most important and modifiable risk factors in the prevention and control of cardiovascular disease (CVD) in women. Its development, progression, and associated adverse outcomes demonstrate pronounced sex-specific and stage-dependent patterns across the female life course. Blood pressure management in women should move beyond fragmented, stage-based care toward the establishment of an integrated, life-course-oriented framework. Growing evidence suggests that adverse intrauterine environments influence long-term blood pressure trajectories and cardiovascular risk through developmental programming. During childhood and adolescence, standardized screening and early intervention are essential to mitigate the future burden of hypertension and target-organ damage. The reproductive and pregnancy periods constitute critical windows for CVD risk stratification and blood pressure management. Hypertensive disorders of pregnancy not only affect perinatal outcomes but also function as early indicators of a woman's long-term CVD risk profile. Sustained follow-up in the postpartum and lactation stages supports the timely detection and management of emerging CVD risk factors. The perimenopausal transition, characterized by estrogen decline and concurrent metabolic disturbances, marks a pivotal stage of accelerated blood pressure elevation and CVD risk amplification. In older women, management strategies must emphasize safety, individualization, and comprehensive care in the setting of multimorbidity and frailty. Collectively, establishing an integrated, life-course-oriented framework for blood pressure management in women requires a forward shift in risk identification, strengthened multidisciplinary collaboration, and continuity of care across life stages. This framework promotes a transition from reactive disease treatment to proactive health promotion, providing a structured pathway to improve cardiovascular health outcomes in women.

关键词

女性 / 高血压 / 心血管疾病 / 全生命周期

Key words

women / hypertension / cardiovascular disease / life-course approach

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