Okaishi Kohya, Morimoto Shigeto, Matsumoto Masayuki
Department of Geriatric Medicine, Kanazawa Medical University.
Nihon Rinsho. 2005 Jun;63(6):1016-27.
Hypertension is one of the most significant risk factors for cerebrovascular and heart diseases, which rank as the second and third most frequent causes of death in Japan, respectively. The prevalence of hypertension rises as the population grows older, affecting approximately 60% of the Japanese aged 65 yr or older, and there are currently more patients receiving treatment for hypertension than for any other disease in Japan. As the size of the elderly populations in our country continuously increases rapidly, hypertension has become one of the most important diseases to be treated. Based on the results of numerous clinical intervention trials, treatment of hypertension in the elderly, including treatment of systolic hypertension, has generally been of great benefit. However, the efficacy of treatment of so-called very old hypertensive patients aged 85 yr or older is still controversial. Recently, Guidelines for the Management of Hypertension of Japanese Society of Hypertension (JSH 2004) has been reported, which are based on evidence-based medicine(EBM), adopting the results of mega-trials in Japan and in Western countries, but also considering the lifestyle of Japanese. This paper explaines the part of "Antihypertensive Treatment of Elderly Hypertensive Patients without Complications" in the Guidelines.
高血压是脑血管疾病和心脏病最重要的危险因素之一,在日本,这两种疾病分别是第二和第三大常见死因。高血压的患病率随着人口老龄化而上升,约60%的65岁及以上日本老年人受其影响,目前日本接受高血压治疗的患者比其他任何疾病的患者都多。随着我国老年人口规模持续快速增长,高血压已成为最重要的待治疗疾病之一。基于众多临床干预试验的结果,老年高血压的治疗,包括收缩期高血压的治疗,总体上大有裨益。然而,对于85岁及以上所谓高龄高血压患者的治疗效果仍存在争议。最近,日本高血压学会发布了《高血压管理指南(2004)》,该指南基于循证医学(EBM),采用了日本和西方国家大型试验的结果,同时也考虑了日本人的生活方式。本文解释该指南中“老年无并发症高血压患者的降压治疗”部分。