Individualized combination medication is an important measure to improve the rate of hypertension control, individualized combination medication is also an important method to protect organs, individualized combination medication is an important measure to reduce drug side effects and improve medication compliance, individualized combination medication is an important way to increase the rate of hypertension control and reduce the mortality and disability of cardiovascular disease. Therefore, it is considered that the emphasis on individualized combination medication for hypertension is an important strategy for prevention and treatment of hypertension.

The definition of hypertension has been the object of controversy for many years. The First Report of the Joint National Committee( JNC-1) on Detection, Evaluation, and Treatment of High Blood Pressure was issued in 1977 and the levels of blood pressure above 160/95 mmHg was considered as high blood pressure(BP). The early JNC series guidelines are relatively vague on the diagnostic criteria and treatment goals of hypertension, and put more emphasis on diastolic blood pressure(DBP) in hypertension diagnosis. Since the publication of JNC VI reports, hypertension is defined as office systolic blood pressure(SBP) values≥140 mmHg and/or DBP values≥90 mmHg. The 2017 ACC/AHA Hypertension Guidelines changed the diagnostic criteria for hypertension by 130/80 mmHg and has caused widespread controversy at home and abroad. The Chinese Medical Doctor Association issued a scientific statement on the diagnostic criteria for hypertension and treatment targets of high BP in China. Although the standards proposed by the new ACC/AHA hypertension guideline is not recognized by other national guidelines, its concept of earlier prevention of hypertension has been widely accepted.

Resistant hypertension(RH) is a type of hypertension that causes progression of cardiovascular and cerebrovascular diseases. Clear diagnosis and effective treatment are essential. The article provides a detailed summary of the definition, etiology, diagnosis and treatment of RH. The treatment of RH should emphasize individualization, and it is necessary to carefully discern the cause and distinguish from secondary hypertension. Ambulatory blood pressure monitoring and home blood pressure measurement are important diagnostic tools. A combination of multiple drugs(including diuretics) that are reasonable, optimal, and of tolerable doses is the key to controlling blood pressure.

In the 2017 AHA Hypertension Guidelines, BP≥130/80 mm Hg was used as the new diagnostic criterion for hypertension, and risk stratification was emphasized according to the 10-year CVD risk. Lifestyle intervention, without pharmacological treatment, was recommended for low-risk patients whose BP≥130/80 mmHg. However, high risk patients should receive antihypertensive pharmacological treatment as soon as their BP≥130/80 mmHg. In the 2018 European Guidelines for the management of hypertension, the definition and classification of office hypertension still followed the standard of the 2013's edition, but more aggressive therapeutic strategies were recommended.Hypertension can be divided into primary hypertension and secondary hypertension. To screen and diagnose secondary hypertension, it is necessary not only to construct a systematic and standardized method to avoid missed diagnosis and misdiagnosis but also to avoid screening blindly.

With the rapid aging of China's population, the incidence of hypertension has increased year by year. The lack of awareness, treatment and control is still one of the important public health problems of China. In-depth understanding of blood pressure measurement, so that residents understand their blood pressure level. It is an important part of improving residents' health literacy. Therefore, the article briefly discusses the key points of blood pressure measurement and its value for special types of hypertension.

Throughout the guidelines for hypertension published in China and abroad in recent years, the therapeutic principles of hypertension drug treatment mainly include: hypotensive treatment was given according to the overall risk level of patients with hypertension. Intensive antihypertensive therapy should be adopted to achieve maximum cardiovascular benefits, if conditions permit. Comprehensive intervention is needed for factors other than blood pressure,including treatable risk factors, subclinical target organ damage, and a variety of co-existing clinical diseases.The optimized principles of antihypertensive therapy include initiation of combined drug in most patients to raise the rate of blood pressure treatment targets, and the single-pill combination is preferred in combination therapy.

Hypertensive disorders in pregnancy(HDP)is a group of diseases including high blood pressure during pregnancy. Strengthening clinical monitoring, risk factors assessment and early intervention would promote outcomes of women and their children. Blood pressure and proteinuria are key monitoring during pregnancy. Antihypertensive drugs recommended for pregnancy include methyldopa, labellol, or nifedipine. Early screening and intervention of preeclampsia is one of the keys to the prevention of cardiovascular risk during pregnancy. In addition to medication, weight control, screening and treatment of obstructive sleep apnea(OSA), lifestyle intervention and so on can not be ignored.

Genetic as well as genomic study has advanced the development of precision medicine. We are marching on the road for right patients who are receiving more and more right treatment at right time. In hypertension field, precision medicine is available, actionable and affordable. First and the most practical advancement is monogenic hypertension, the disease-genes have been found for at least 17 types of monogenic hypertension. These patients can be precisely treated according to their carried gene mutation. Secondly, pharmacogenetic and pharmacogenomic guided anti-hypertensive drug selection, very promising but lack of clinic outcome data to support widely clinical application. Majority of hypertension are due to multiple genetic and environmental factors. GWAS fund some genetic variants related to primary hypertension, but these variants can only be responsible for 1-10% of blood pressure variation. We have a long way to go in exploring the real cause of primary hypertension.

According to the procedures for the development of evidence-based medicine guidelines, a multi-disciplinary guideline development working group was established, after three rounds of discussions by the consensus expert group, a new evidencebased guideline for diagnosis and treatment of senile osteoporosis in China(2018) was developed. The grading of recommendations assessment, development and evaluation(GRADE) system was used to rate the quality of evidence and the strength of recommendations. Recommendations were derived from evidence body, and at the same time considered the balance of benefits and harms as well as values and preferences of Chinese patients. The guideline development working group developed 15 recommendations for the diagnosis and treatment of senile osteoporosis. The guideline covered the screening for senile osteoporosis, risk assessment, diagnosis, basic treatment, multiple anti-osteoporosis drugs, therapeutic effect monitoring and evaluation of senile osteoporosis. This guideline aims to serve as a tool for clinicians and patients for best decisions-making in China.

OBJECTIVE: To compare the predictive value of Ees/Ea in patients with pulmonary arterial hypertension based on right cardiac catheterization and cardiac magnetic resonance examination. METHODS: A total of 50 pulmonary arterial hypertension patients confirmed by right heart catheterization were retrospectively reviewed and followed up 2 years. The relationship between the baseline clinical data and survival prognosis of patients with pulmonary arterial hypertension were analyzed. The predictive value of baseline Ees/Ea for prognosis in patients with pulmonary arterial hypertension were compared. RESULTS: The Ees/Ea calculated by volume method was significantly correlated with the prognosis of patients with pulmonary arterial hypertension(OR =0.082, 95%CI 0.009-0.814, P=0.032). The two-year survival rate of group Ees/Ea>0.67 was significantly higher than that of Ees/Ea≤0.67(86.7% vs. 50%, P=0.003). Conclution Ees/Ea calculated by volume method is an independent influence factor of the survival prognosis of patients with pulmonary arterial hypertension. When Ees/Ea≤0.67, the patients with pulmonary arterial hypertension is more likely to deteriorate.