Offers Elmar, Kolloch Rainer E
Klinik für Kardiologie und Internistische Intensivmedizin, Städtische Kliniken Bielefeld Mitte, Akademisches Lehrkrankenhaus der Westfälischen Wilhelms-Universität Münster, Bielefeld, Germany.
Herz. 2003 Dec;28(8):702-6. doi: 10.1007/s00059-003-2505-9.
HEMODYNAMICS: Elevated diastolic as well as elevated systolic blood pressure substantially contribute to the increase of cardiovascular risk. Conclusive results have proven that lowering diastolic and/or systolic blood pressure can reduce cardiovascular risk. There is evidence that not only the absolute values for diastolic and systolic blood pressure alone but also the pulse pressure as an additional indicator of cardiovascular risk have to be considered. The prevalence of isolated systolic hypertension increases with age. Remodeling of the arterial wall with increase of collagen and decrease of elastic fibers are leading to an impaired arterial compliance. Decreased compliance and acceleration of the pulse wave velocity can elevate systolic and lower diastolic blood pressure. In consequence cardiac stress and pulse pressure will rise.
There is a strong correlation in elderly patients between cardiovascular mortality and morbidity and systolic blood pressure. Antihypertensive therapy is able to lower cardiovascular event rate in elderly patients with isolated systolic hypertension with a predominant risk reduction for stroke.
血流动力学：舒张压升高以及收缩压升高均显著增加心血管风险。确凿的结果证明，降低舒张压和/或收缩压可降低心血管风险。有证据表明，不仅要考虑舒张压和收缩压的绝对值，还必须将脉压作为心血管风险的附加指标加以考虑。单纯收缩期高血压的患病率随年龄增长而增加。动脉壁重塑，胶原蛋白增加而弹性纤维减少，导致动脉顺应性受损。顺应性降低和脉搏波速度加快可使收缩压升高，舒张压降低。结果，心脏压力和脉压将会升高。
老年患者心血管死亡率和发病率与收缩压之间存在密切关联。抗高血压治疗能够降低单纯收缩期高血压老年患者的心血管事件发生率，对中风的风险降低作用尤为显著。
