Pre-emptive medicine for hypertension and its prospects
Pre-emptive medicine for hypertension and its prospects
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DOI：
10.1038/s41440-018-0177-3
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发表时间：
2018-12
影响因子：
5.4
通讯作者：
H. Itoh;Kaori Hayashi;K. Miyashita
中科院分区：
文献类型：
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作者：
H. Itoh;Kaori Hayashi;K. Miyashita
先发制人医学是日本提出的一个新的医学概念，旨在精确预测疾病的发生和进展，并在症状出现之前的早期阶段提供治疗干预。预防医学的概念考虑了每个人疾病的时间进程，并寻求医疗干预措施以防止疾病进展。适合且有前景的先发制人医学目标是非传染性疾病，包括高血压。基因组分析、信息技术和人工智能的最新进展应该会使这一医学概念在不久的将来变得可行。在这篇综述中，我们重点关注高血压的预防医学，并提到了本研究未来方向的具体计划。预防医学的最终目标是通过精确预测血压升高并采取干预措施来避免高血压的发生和进展。从预防医学的角度来看，高血压的诊断过程应包括检测血压调节异常作为疾病的最早表现，描述个体高血压的现状（“即时预测”），以及预测疾病的未来轨迹（“预测”）。从预防医学的角度来看，高血压的新治疗策略应旨在通过早期治疗使高血压消退，并通过间歇性强化治疗缓解高血压。根据高血压的进展，需要有效地改变生活方式和治疗方法。如果高血压的预防医学得以建立，将极大地有助于延长健康寿命，但目前这一目标尚未令人满意。
Pre-emptive medicine is a novel medical concept proposed in Japan that aims to precisely predict the onset and progression of diseases and to provide therapeutic interventions during early stages, before symptoms appear. The concept of pre-emptive medicine considers the time-course of a disease in each individual and seeks medical interventions to prevent disease progression. Suitable and promising targets for pre-emptive medicine are non-communicable diseases, including hypertension. Recent advances in genomic analysis, information technology, and artificial intelligence should make this medical concept feasible in the near future. In this review, we focused on pre-emptive medicine for hypertension, referring to concrete plans for the future direction of this research. The ultimate goal of pre-emptive medicine is to completely prevent the onset and progression of hypertension by precisely predicting the elevation of blood pressure and performing interventions to avoid it. The diagnostic processes of hypertension, from the standpoint of pre-emptive medicine, should include the detection of abnormal blood pressure regulation as the earliest manifestation of the disease, the depiction of the present status of hypertension in an individual (“nowcasting”), and a prediction of the future trajectory of the disease (“forecasting”). Novel therapeutic strategies for hypertension, from the standpoint of pre-emptive medicine, should aim for the regression of hypertension through early treatments and the remission of hypertension through intermittent intensive therapies. An efficient modification of lifestyle and therapies, according to the progression of hypertension, should be required. If pre-emptive medicine for hypertension becomes established, it would greatly contribute to the extension of a healthy lifespan, which cannot yet be satisfactorily achieved.