Seto Shinji
Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University.
Nihon Rinsho. 2005 Jun;63(6):1041-6.
Incidence and prevalence of heart failure, in the form of systolic or diastolic ventricular dysfunction, are particularly common in elderly patients with hypertension. The importance of treating hypertension in the elderly as a means of preventing chronic heart failure was emphasized by recent trials including meta-analysis. Fastidious blood pressure control by angiotensin-converting enzyme inhibitors and angiotensin-II receptor antagonists along with low-doses diuretics as first-line therapy is recommended. However, many elderly patients with hypertension have other risk factors, target organ damages and associated cardiovascular conditions, to which the choice of the first drug should be tailored. In such cases, beta blockers, aldosterone blockers and long-acting Ca antagonists are also recommended.
以收缩性或舒张性心室功能障碍形式出现的心力衰竭的发病率和患病率，在老年高血压患者中尤为常见。包括荟萃分析在内的近期试验强调了治疗老年高血压作为预防慢性心力衰竭手段的重要性。建议将血管紧张素转换酶抑制剂和血管紧张素II受体拮抗剂与低剂量利尿剂一起作为一线治疗，严格控制血压。然而，许多老年高血压患者还有其他危险因素、靶器官损害和相关心血管疾病，首选用药应根据这些情况进行调整。在这种情况下，也推荐使用β受体阻滞剂、醛固酮阻滞剂和长效钙拮抗剂。
