Fletcher A, Bulpitt C
Division of Geriatric Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, Great Britain.
Aging (Milano). 1992 Jun;4(2):115-23.
Hypertension is common in the elderly with estimates of around 10-20% showing a sustained level of pressure, either systolic (greater than or equal to 160 mmHg), or diastolic (greater than or equal to 90 mmHg) or both. The benefits of treating subjects with raised diastolic pressure was shown by the trials of the European Working Party on High Blood Pressure in the Elderly (EWPHE), the Hypertension in Elderly Patients in Primary Care (HEP), and the Swedish Trial in Old patients with Hypertension (STOP-Hypertension). Evidence for the benefit of treating isolated systolic hypertension in the elderly was provided in one trial (SHEP: Systolic Hypertension in the Elderly Program), and the results of two others are awaited. However, it is important to provide data on all treatment effects, including adverse reactions as well as benefits. In addition to traditional measures of mortality, morbidity and side effects, the quality of life in patients on antihypertensive treatment should be considered. The methods of measuring quality of life in trials is discussed, and some results presented.
高血压在老年人中很常见，据估计约10%-20%的老年人存在持续的血压水平，无论是收缩压（大于或等于160 mmHg）、舒张压（大于或等于90 mmHg）或两者皆有。欧洲老年高血压工作组（EWPHE）试验、基层医疗中老年人高血压（HEP）试验以及瑞典老年高血压患者试验（STOP-高血压）表明了治疗舒张压升高患者的益处。一项试验（老年收缩期高血压计划：SHEP）提供了治疗老年人单纯收缩期高血压有益的证据，另外两项试验的结果有待公布。然而，提供包括不良反应以及益处在内的所有治疗效果的数据很重要。除了传统的死亡率、发病率和副作用指标外，还应考虑接受抗高血压治疗患者的生活质量。文中讨论了试验中测量生活质量的方法，并给出了一些结果。
