Highlights of the 2024 Chinese hypertension guidelines

The 2024 Chinese hypertension guidelines has been recently issued by Chinese Hypertension League (CHL), joint with partner societies. Since the 2018 guidelines was released, amount of evidence accumulated, in favor of intensive blood pressure (BP) control. New drugs and devices, innovative concepts and new insights have been introduced into hypertension management. The hypertension control rate improved gradually in past 30 years, while the constantly increased population of hypertension and high-normal BP still brought huge burden in China. More efficient, precise and individualized strategies for BP control are needed. The new guidelines integrated the latest evidence from epidemiological studies and clinical trials, particularly included recent data from Chinese populations, together with new concept and insights of hypertension management from the globe. In brief, the 2024 Chinese hypertension guidelines insists on 140/90 mmHg as the office BP thresholds for hypertension diagnosis. Ambulatory or home BP monitoring are recommended as alternatives for diagnosis. Validated smart wearable devices are introduced for hypertension screening and monitoring. A combined BP level and CV risk -based treatment strategy is still adopted. A more aggressive BP target ( < 130/80 mmHg) is recommended for most, including those at high CV risk, if tolerable. Low-sodium and potassium-rich salt substitute and Chinese heart-healthy diet are recommended and sleep and mental health are added in addition to traditional life style changes. New drugs and more flexible combination protocols, and concise treatment algorithm are introduced. Management of hypertension in special populations are updated and specific phenotype, for instance morning and nocturnal hypertension are addressed.