Leonetti G, Chianca R
Centro Fisiologia Clinica e Ipertensione, Ospedale Maggiore di Milano, Italy.
J Cardiovasc Pharmacol. 1990;16 Suppl 2:S5-8.
Hypertension becomes more prevalent with advancing age, and the hemodynamic pattern differs from that in younger patients. In the elderly, elevated blood pressure is primarily due to reduced compliance of large vessels, resulting in an increase in total peripheral resistance, but in younger subjects it mainly reflects an increase in cardiac output. Vasodilator drugs, such as calcium antagonists, might therefore be expected to be particularly effective in lowering blood pressure in the elderly. Clinical experience has confirmed the safety and antihypertensive efficacy of these drugs, with some workers suggesting that calcium antagonists are particularly effective in the elderly. A 6-month multicenter study involving 2,184 patients has shown a direct correlation between pretreatment blood pressure and the degree of blood pressure reduction observed during nicardipine treatment with or without other antihypertensive drugs. Isolated systolic hypertension was significantly reduced but diastolic blood pressure was not affected. The incidence of side effects among elderly hypertensive patients, both with and without concomitant disease, was slightly lower than in younger patients.
高血压随着年龄增长愈发普遍，其血流动力学模式与年轻患者不同。在老年人中，血压升高主要是由于大血管顺应性降低，导致总外周阻力增加，但在年轻受试者中，血压升高主要反映心输出量增加。因此，钙拮抗剂等血管扩张剂可能在降低老年人血压方面特别有效。临床经验证实了这些药物的安全性和降压效果，一些研究人员认为钙拮抗剂对老年人特别有效。一项涉及2184名患者的为期6个月的多中心研究表明，无论是否使用其他降压药物，尼卡地平治疗期间的预处理血压与观察到的血压降低程度之间存在直接相关性。单纯收缩期高血压显著降低，但舒张压未受影响。老年高血压患者（无论有无伴发疾病）的副作用发生率略低于年轻患者。
