老年高血压患者的治疗

O. Kovalyova
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摘要

本文以国际高血压学会、欧洲心脏病学会、欧美高血压学会、美国医师学会和美国家庭医师学会的指南为基础,探讨老年动脉高血压患者的治疗策略。根据流行病学和临床调查的结果显示,高血压对老年人心血管疾病结局和死亡率的影响。通过对随机对照试验的分析,指出了有说服力的数据,需要根据动脉高血压的水平和心血管危险因素来区分控制血压。对不同年龄组人群的初始降压治疗方法进行了比较。本文重点讨论了65 ~ 79岁及≥80岁患者降压治疗动态中与血压目标相关的主要问题。建议老年高血压患者的个体化医疗策略要求考虑到记忆、健康和精神状态、临床特征、合并症、并发症和高血压介导的器官损害。
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Treatment of hypertension in older patients
The article is dedicated to the strategy of management of arterial hypertension in older patients based on the Guidelines of the International Society of Hypertension, the European Society of Cardiology, the European and the American Society of Hypertension, the American College of Physicians and the American Academy of Family Physicians. According to the results of epidemiological and clinical investigations is shown the influence of high blood pressure on cardiovascular outcomes and mortality in the population of older persons. Due to the analyses of randomised controlled trials is pointed out the convicing data the need for differtntiated control of blood pressure according to the level of arterial hypertension and factors of cardiovascular risk. The methodology of initial antihypertensive therapy in persons of different age groups is taken in comparative aspects. The main discussed questions related to the blood pressure targets in the dynamics of antihypertensive treatment in patients 65–79 years and age ≥ 80 years are emphasized. The requirements for individual medical tactics of older hypertensive patients taken into account anamnesis, fit and mental state, clinical features, comorbidity, complications and hypertension-mediated organ damages are recommended.
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