Shimamoto Kazuaki
Second Department of Internal Medicine, Sapporo Medical University.
Nihon Rinsho. 2005 Jun;63(6):1000-4.
Hypertension in the elderly consists mostly of essential hypertension, and its pathophysiology differs in many ways from that of essential hypertension in the young or middle-aged. No special diagnostic criteria for hypertension in the elderly were stated in ESH/ESC JNC 7 guidelines, that is, the criteria is systolic pressure of 140 mmHg and greater or diastolic pressure of 90mmHg and greater as in general adults. As the diagnostic considerations for hypertension in the elderly, we should pay much attention to medical history taking, measurement of blood pressure, discrepancy on auscultation, pseudohypertension, fluctuation of blood pressure, and diagnosis of secondary hypertension.
老年人高血压大多为原发性高血压，其病理生理学在许多方面与年轻人或中年人的原发性高血压不同。欧洲高血压学会/欧洲心脏病学会《美国国家联合委员会第七次报告》指南中未提及老年人高血压的特殊诊断标准，即诊断标准与普通成年人一样，收缩压≥140mmHg和（或）舒张压≥90mmHg。作为老年人高血压的诊断考量因素，我们应高度重视病史采集、血压测量、听诊差异、假性高血压、血压波动以及继发性高血压的诊断。
