Kozaki Koichi
Department of Geriatric Medicine, Kyorin University School of Medicine.
Nihon Rinsho. 2005 Jun;63(6):1061-6.
Elderly people with hypertension and hyperlipidemia are regarded as high-risk patients and are supposed to be treated with appropriate drugs. From the evidence of clinical trials, renin-angiotensin system inhibitors and calcium channel blockers would be the first choices, and the combination therapy with diuretics or alpha-blockers would be the next choice. However, since the effect of anti-hypertensive drugs on plasma lipids is much less than that of the lipid-lowering drugs, anti-hypertensive drugs should be chosen in consideration of the patient's complicated diseases, because elderly people are often affected with other more serious complications such as ischemic heart disease, cerebrovascular disease, renal dysfunction, and chronic lung disease. If hyperlipidemia remains after anti-hypertensive drugs are used, the use of lipid-lowering drugs such as statins is recommended.
患有高血压和高脂血症的老年人被视为高危患者,应使用适当的药物进行治疗。从临床试验证据来看,肾素-血管紧张素系统抑制剂和钙通道阻滞剂是首选,利尿剂或α受体阻滞剂的联合治疗是次选。然而,由于降压药对血脂的影响远小于降脂药,应根据患者的复杂病情选择降压药,因为老年人常伴有其他更严重的并发症,如缺血性心脏病、脑血管疾病、肾功能不全和慢性肺病。如果使用降压药后仍存在高脂血症,建议使用他汀类等降脂药。