Leibovitch Eric R
Internal Medicine, Ventura County (CA) Medical Center, and UCLA School of Medicine, Los Angeles, USA.
Geriatrics. 2008 Oct;63(10):14-5, 17-20.
Clinical studies continue to modify our approach to the older hypertensive patient. The pathophysiology of hypertension is now better understood from data derived from ambulatory blood pressure monitoring, the assessment of central arterial pressure and of vascular stiffness. This is altering both the ways we assess, monitor, and treat our older hypertensive patients as well as our choice of pharmacological agents. New data have confirmed the importance of treating the very elderly patient's blood pressure and of modifying the increasing incidence of atrial fibrillation. Resistant hypertension is frequently the result of excessive aldosterone production, a situation easily treated. Several investigators have raised the question of the prehypertensive state and of possible therapy.
临床研究不断改变我们对老年高血压患者的治疗方法。通过动态血压监测、中心动脉压评估和血管僵硬度评估所获得的数据，我们现在对高血压的病理生理学有了更深入的了解。这正在改变我们评估、监测和治疗老年高血压患者的方式，以及我们对药物制剂的选择。新数据证实了治疗高龄患者血压以及改善心房颤动发病率上升情况的重要性。顽固性高血压常常是醛固酮分泌过多所致，这种情况很容易治疗。几位研究人员提出了高血压前期状态及可能的治疗问题。
