Hasegawa Eri, Tsuchihashi Takuya, Ohta Yuko
Division of Hypertension, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan.
Intern Med. 2012;51(12):1473-8. doi: 10.2169/internalmedicine.51.7285. Epub 2012 Jun 15.
Hypertension guidelines recommend strict blood pressure (BP) control to less than 130/80 mmHg in patients complicated with chronic kidney disease (CKD). However, it is unclear whether this target BP level is applicable to the elderly hypertensive patients. The aim of this study was to assess the prevalence of CKD and BP control status in elderly hypertensive patients.
Subjects were 675 hypertensive patients (65.5 ± 11.7 years, 290 males and 385 females). Prevalence of CKD and BP control status were compared between elderly and young/middle-age patients.
Average BP of elderly and young/middle-age patients were 134 ± 10/71 ± 9 mmHg and 131 ± 11/78 ± 9 mmHg, respectively. CKD was more prevalent in the elderly than in the young/middle-age patients (35.5% and 24.5%, respectively). The elderly patients with CKD were more likely to be males and older. They also required a greater number of antihypertensive drugs than those without CKD (2.4 ± 1.2 vs. 2.0 ± 1.1, p<0.01). Elderly patients without CKD who achieved a target BP of <140/90 mmHg were 73.2%. Similarly, 78.5% of the patients with CKD achieved BP of <140/90 mmHg, while those who achieved <130/80 mmHg were only 29.6%.
Our results suggest that CKD is frequently complicated in elderly hypertensive patients, and many of them failed to achieve strict BP goal in spite of the average use of 2.4 antihypertensive drugs.
高血压指南建议，对于合并慢性肾脏病（CKD）的患者，应将血压严格控制在130/80 mmHg以下。然而，尚不清楚这一目标血压水平是否适用于老年高血压患者。本研究旨在评估老年高血压患者中CKD的患病率及血压控制情况。
研究对象为675例高血压患者（年龄65.5±11.7岁，男性290例，女性385例）。比较老年患者与青年/中年患者之间CKD的患病率及血压控制情况。
老年患者与青年/中年患者的平均血压分别为134±10/71±9 mmHg和131±11/78±9 mmHg。CKD在老年患者中的患病率高于青年/中年患者（分别为35.5%和24.5%）。老年CKD患者更可能为男性且年龄更大。与无CKD的患者相比，他们需要更多种类的降压药物（2.4±1.2种 vs. 2.0±1.1种，p<0.01）。血压达到<140/90 mmHg目标值的老年非CKD患者比例为73.2%。同样，78.5%的CKD患者血压<140/90 mmHg，而血压<130/80 mmHg的患者仅为29.6%。
我们的结果表明，老年高血压患者常合并CKD，尽管平均使用了2.4种降压药物，但许多患者仍未达到严格的血压目标。
