Belmin J
Service de médicine interne-gériatrique, hôpital Charles-Foix, Ivry-sur-Seine.
Rev Prat. 1990 May 21;40(15):1379-84.
Arterial hypertension is common in elderly people, and the risk of cardiovascular complications due to that disease is reduced by antihypertensive treatments in these as in younger hypertensive patients. However, some points must be borne in mind when treating and following up elderly subjects with hypertension. Old age alters the metabolism and effects of antihypertensive agents. Concomitant pathologies are frequent and may preclude the use of some of these agents, while other medicines taken by the patient interreact with them. Several complications of antihypertensive therapy particularly threaten elderly hypertensive drugs patients. The complications depend on the antihypertensive drugs used and include malaise, excessive fall in blood pressure, postural hypotension, water and electrolyte disorders, renal impairment and neuropsychological disturbances. Because of these iatrogenic effects, which may have more serious consequences in elderly therapy must be handled with care. Close supervision enables these undesirable effects to be detected early on and corrected before more serious complications develop.
动脉动脉高血压在老年人中很常见，与年轻高血压患者一样，针对这种疾病进行的抗高血压治疗可降低因该疾病导致心血管并发症的风险。然而，在治疗和随访老年高血压患者时必须牢记一些要点。衰老会改变抗高血压药物的代谢和作用。伴随疾病很常见，可能会妨碍某些药物的使用，而患者服用的其他药物会与它们相互作用。抗高血压治疗的几种并发症尤其威胁老年高血压患者。并发症取决于所使用的抗高血压药物，包括不适、血压过度下降、体位性低血压、水和电解质紊乱、肾功能损害以及神经心理障碍。由于这些医源性效应在老年人中可能产生更严重的后果，因此治疗必须谨慎处理。密切监测能够在更严重的并发症发生之前尽早发现并纠正这些不良影响。
