Luño J, García de Vinuesa S
Servicio de Nefrología Hospital General Universitario Gregorio Marañón Dr. Esquerdo, 46 28007 Madrid.
Nefrologia. 2002;22 Suppl 1:30-5.
The incidence of arterial hypertension increases with age in such a way that by the age of 60 the incidence is greater than 50% in men and women. This increase is particularly relevant if we consider the changes in systolic blood pressure (increase) and diastolic blood pressure (decrease) in relation to age and as a consequence in the reduction of vascular compliance which is common in men and women over the age of 60. These disorders are associated to artheriosclerosis and the corresponding increase in pulse pressure. It is for these reasons that the most common form of hypertension is isolated systolic hypertension (SBP > 140 mmHg and SBP < 90 mmHg), which represents 50% of hypertensive patients in the elderly population. Isolated systolic hypertension is also associated to an increase in cardiovascular disease (MI, stroke), increasing the risk of mortality four times. In elderly people, hypertension and isolated systolic hypertension are risk factors that can be managed. Today there is sufficient evidence from clinical trials that show a clear benefit in the reduction of the cardiovascular and renal risk associated to the antihypertensive treatment in the elderly, at least when the blood pressure is greater than 160/90 mmHg. The target blood pressure figures to control in the elderly person, probably below 160/90 mmHg, still need to be determined.
动脉高血压的发病率随年龄增长而上升，到60岁时，男性和女性的发病率均超过50%。如果考虑到收缩压（升高）和舒张压（降低）随年龄的变化，以及由此导致的血管顺应性降低（这在60岁以上的男性和女性中很常见），这种上升就尤为显著。这些病症与动脉粥样硬化及脉压相应增加有关。正是由于这些原因，最常见的高血压形式是单纯收缩期高血压（收缩压>140 mmHg且舒张压<90 mmHg），在老年人群中占高血压患者的50%。单纯收缩期高血压还与心血管疾病（心肌梗死、中风）增加有关，使死亡风险增加四倍。在老年人中，高血压和单纯收缩期高血压是可以控制的风险因素。如今，临床试验有充分证据表明，至少当血压高于160/90 mmHg时，降压治疗对降低老年人心血管和肾脏风险有明显益处。老年人需要控制的目标血压数值可能低于160/90 mmHg，仍有待确定。
