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80岁以上人群的动脉高血压:该问题可成功解决

[Arterial hypertension in persons older than 80 years: the problem can be successfully solved].

作者信息

Preobrazhenskiĭ D V, Sidorenko B A, Batyraliev T A, Fettser D V, Ishlek M

出版信息

Kardiologiia. 2008;48(11):69-73.

Abstract

It has been noted in recommendations of the European Society of Hypertension (ESH) and of the European Society of Cardiology (2007) that there are no data on effects of antihypertensive therapy on risk of development of cardiovascular complications in patients older than 80 years. In the recently completed study HYVET on 3845 patients aged>80 years (mean age 83 years) with arterial pressure (AP)>160 mm Hg as criterion of inclusion, and target AP below 150/80 mm Hg at the background of 1.5 mg of indapamide retard with or without addition of 2-4 mg of perindopril, 30% lowering of risk of development of fatal and nonfatal stroke (95% confidence interval [CI] -1 to 51, p=0.06), 21% lowering of risk of all-cause death (95%CI 4 to 35, p=0.02), 23% lowering o f risk of cardiovascular death (95%CI -1 to 40, p=0.06), and 64% lowering of risk of development of heart failure (95%CI 42 to 78, p<0.001) were observed. Thus lowering of elevated AP in persons older than 80 years leads to substantial decrease of total mortality, rate of development of fatal stroke and heart failure, improvement of prognosis of life.

摘要

欧洲高血压学会(ESH)和欧洲心脏病学会(2007年)的建议中指出,尚无关于降压治疗对80岁以上患者发生心血管并发症风险影响的数据。在最近完成的HYVET研究中,纳入了3845名年龄>80岁(平均年龄83岁)、动脉压(AP)>160 mmHg的患者,以1.5 mg缓释吲达帕胺为基础,加用或不加用2 - 4 mg培哚普利,将目标AP降至150/80 mmHg以下,结果显示致命性和非致命性卒中发生风险降低30%(95%置信区间[CI] -1至51,p = 0.06),全因死亡风险降低21%(95%CI 4至35,p = 0.02),心血管死亡风险降低【此处原文有误,根据前文推测应为23%】(95%CI -1至40,p = 0.06),心力衰竭发生风险降低64%(95%CI 42至78,p<0.001)。因此,降低80岁以上人群升高的血压可显著降低总死亡率、致命性卒中和心力衰竭的发生率,改善生活预后。 【注:原文中“23% lowering o f risk of cardiovascular death”多了个字母“o”,译文已修正】

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