Pathological Mechanisms and Therapeutic Advances in Hypertensive Myocardial Fibrosis

高血压是全球心血管疾病预后不良的首要危险因素，长期血压控制不佳最终可演变为高血压心脏病。以成纤维细胞过度增殖，并伴有胶原异常沉积分布为特征的心肌纤维化是高血压心脏病的重要病理基础，可导致心源性猝死等严重心血管并发症。现对高血压心肌纤维化病理生理机制及治疗进展进行梳理，以期为延缓甚至逆转高血压心脏病的不良结局提供可能。Hypertension stands as the primary risk factor for poor prognosis in global cardiovascular diseases, with long-term uncontrolled blood pressure ultimately progressing to hypertensive heart disease. Myocardial fibrosis, characterized by excessive proliferation of fibroblasts accompanied by abnormal collagen deposition and distribution, constitutes a critical pathological basis for hypertensive heart disease, predisposing to severe cardiovascular complications including sudden cardiac death. This review synthesizes current knowledge on the pathophysiological mechanisms underlying hypertensive myocardial fibrosis and recent therapeutic advancements, aiming to provide insights for potential strategies to delay or even reverse the adverse outcomes of hypertensive heart disease.