Heart failure (HF) is a common condition with an increasing prevalence. Despite a variety of evidence-based treatments for patients with HF with reduced ejection fraction, morbidity and mortality rates remain high. Furthermore, there are currently no treatments that have yet been shown to reduce complication and death rates in patients who have HF with preserved ejection fraction. Hypertension is a common comorbidity in patients with HF, contributing to disease development and prognosis. For example, hypertension is closely associated with the development of left ventricular hypertrophy, which an important precursor of HF. In particular, nighttime blood pressure (BP) appears to be an important, modifiable risk factor. Both nighttime BP and an abnormal circadian pattern of nighttime BP dipping have been shown to predict development of HF and the occurrence of cardiovascular events, independent of office BP. Key mechanisms for this association include sodium handling/salt sensitivity and increased sympathetic activation. These pathogenic mechanisms are targeted by several new treatment options, including sodium-glucose cotransporter 2 inhibitors, angiotensin receptor neprilysin inhibitors, mineralocorticoid receptor antagonists, and renal denervation. All of these could form part of antihypertensive strategies designed to control nighttime BP and contribute to the goal of achieving perfect 24-hour BP management. Nevertheless, additional research is needed to determine the effects of reducing nighttime BP and improving the circadian BP profile on the rate of HF, other cardiovascular events, and mortality.

中文翻译：

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夜间高血压和心力衰竭：机制、证据和新疗法

心力衰竭 (HF) 是一种常见疾病，患病率不断增加。尽管对射血分数降低的 HF 患者进行了各种循证治疗，但发病率和死亡率仍然很高。此外，目前还没有任何治疗方法可以降低射血分数保留的 HF 患者的并发症和死亡率。高血压是心衰患者的常见合并症，有助于疾病的发展和预后。例如，高血压与左心室肥大的发展密切相关，而左心室肥大是 HF 的重要前兆。特别是，夜间血压 (BP) 似乎是一个重要的、可改变的风险因素。夜间血压和夜间血压下降的异常昼夜节律模式已被证明可以预测心衰的发展和心血管事件的发生，与诊室血压无关。这种关联的关键机制包括钠处理/盐敏感性和交感神经激活增加。这些致病机制是几种新的治疗选择的目标，包括钠-葡萄糖协同转运蛋白 2 抑制剂、血管紧张素受体脑啡肽酶抑制剂、盐皮质激素受体拮抗剂和去肾神经支配。所有这些都可以构成旨在控制夜间血压的抗高血压策略的一部分，并有助于实现完美的 24 小时血压管理的目标。然而，需要进一步的研究来确定降低夜间血压和改善昼夜血压曲线对 HF 发生率的影响，