Nature Reviews Cardiology最新文献

Ageing of the cardiovascular system is associated with frailty and various life-threatening diseases. As global populations grow older, age-related conditions increasingly determine healthspan and lifespan. The circulatory system not only supplies nutrients and oxygen to all tissues of the human body and removes by-products but also builds the largest interorgan communication network, thereby serving as a gatekeeper for healthy ageing. Therefore, elucidating organ-specific and cell-specific ageing mechanisms that compromise circulatory system functions could have the potential to prevent or ameliorate age-related cardiovascular diseases. In support of this concept, emerging evidence suggests that targeting the circulatory system might restore organ function. In this Roadmap, we delve into the organ-specific and cell-specific mechanisms that underlie ageing-related changes in the cardiovascular system. We raise unanswered questions regarding the optimal design of clinical trials, in which markers of biological ageing in humans could be assessed. We provide guidance for the development of gerotherapeutics, which will rely on the technological progress of the diagnostic toolbox to measure residual risk in elderly individuals. A major challenge in the quest to discover interventions that delay age-related conditions in humans is to identify molecular switches that can delay the onset of ageing changes. To overcome this roadblock, future clinical trials need to provide evidence that gerotherapeutics directly affect one or several hallmarks of ageing in such a manner as to delay, prevent, alleviate or treat age-associated dysfunction and diseases.

With advances in materials science and medical technology, wearable sensors have become crucial tools for the early diagnosis and continuous monitoring of numerous cardiovascular diseases, including arrhythmias, hypertension and coronary artery disease. These devices employ various sensing mechanisms, such as mechanoelectric, optoelectronic, ultrasonic and electrophysiological methods, to measure vital biosignals, including pulse rate, blood pressure and changes in heart rhythm. In this Review, we provide a comprehensive overview of the current state of wearable cardiovascular sensors, focusing particularly on those that measure blood pressure. We explore biosignal sensing principles, discuss blood pressure estimation methods (including machine learning algorithms) and summarize the latest advances in cuffless wearable blood pressure sensors. Finally, we highlight the challenges of and offer insights into potential pathways for the practical application of cuffless wearable blood pressure sensors in the medical field from both technical and clinical perspectives.

Correction to: Nature Reviews Cardiology https://doi.org/10.1038/s41569-025-01123-4, published online 21 January 2025.

Hypertension is the leading cause of death globally, primarily due to its strong association with cardiovascular disease. The global prevalence of hypertension has surged over the past three decades, driven by rising rates of diabetes mellitus and obesity. Despite current antihypertensive therapies, only a small proportion of patients with hypertension achieve adequate blood pressure control, necessitating novel therapeutic strategies. In this Review we explore the challenges and emerging opportunities in hypertension management. Aprocitentan, a dual endothelin receptor antagonist, is the first agent from a novel class of antihypertensive drug to be licensed since 2007 and exemplifies innovative treatments on the horizon. Here we also address the complex factors contributing to poor hypertension control, including genetic influences, lifestyle factors, therapeutic inertia and poor patient adherence. We discuss the limitations of existing therapies and highlight promising new pharmacological approaches to hypertension management. Integrating these novel treatments alongside current pharmaceuticals combined with improved diagnostic and management strategies could substantially reduce the global burden of hypertension and associated cardiovascular disease.