作者：陈珂，于俊民，李大鹤，陈洪叶，张小波，赵园园

单位：

150001黑龙江省哈尔滨市，哈尔滨医科大学附属第四医院老年病科

Units：

Department of Geriatrics, the Fourth Hospital Affiliated to Harbin Medical University, Harbin 150001, China

关键词：

高血压；老年人；机制；综述

Keywords：

Hypertension; Aged; Pathogenesis; Review

CLC：

R 544.1

DOI：

10.12114/j.issn.1008-5971.2023.00.291

Funds：

黑龙江省自然科学基金资助项目（H201389）； 黑龙江省哈尔滨市应用技术研究与开发项目（科技创新人才） （2015RAXYJO64）

摘要：

高血压是一种高度异质性疾病，其患病率、发病率及致残率均随着年龄增长而明显升高。老年高血 压发病机制复杂，其发病受环境和遗传因素影响，且交感神经及肾素-血管紧张素-醛固酮系统活性亢进、胰岛素抵抗 等也参与了其发病，此外，随着年龄增长，免疫系统慢性低度炎症状态持续存在、非编码基因调控异常和脑-肠轴变 化均可加剧血管内皮功能障碍及靶器官损伤，最终导致高血压的发生发展。本文主要从免疫机制、非编码基因调控、 脑-肠轴调控机制角度综述了老年高血压的发病机制。

Abstract：

Hypertension is a highly heterogeneous disease, the prevalence rate, morbidity and disability rate of hypertension are increased significantly with age. The pathogenesis of elderly hypertension is complex, and its onset is influenced by environmental and genetic factors. Besides, the hyperactivity of sympathetic nervous system and renin-angiotensin-aldosterone system and insulin are also involved in its onset. In addition, as age increases, persistence of chronic low-grade inflammation of the immune system, abnormal regulation of non-coding genes and changes in the brain-gut axis can aggravate vascular endothelial dysfunction and target organ damage, which eventually lead to the occurrence and development of hypertension. This article mainly reviews the pathogenesis of elderly hypertension from the perspectives of immune mechanism, non-coding gene regulation, and brain-gut axis regulation.

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