Ferrer Soler C, Ehret G, Pechère-Bertschi A
Rev Med Suisse. 2015 Sep 9;11(485):1638, 1640-4.
The prevalence of hypertension in elderly is extremely high. Because of the burden of ageing of population, this condition considered as the most important risk factor for mortality is supposed to increase. There are some specific pitfalls in the diagnosis and management of hypertension in elderly. The definition of hypertension is the same in all age groups, however the phenotype is different in the elderly: white coat effect, non-dipping pattern, orthostatic hypotension, dysautonomia and pseudohypertension. The hallmark of hypertension in the elderly is pure systolic hypertension and an increased variability of blood pressure. The diagnosis is often difficult to establish. The elderly can be overtreated with undesirable effects of falls or hypoperfusion, particularly when there is frailty, or polymedication.
老年人高血压的患病率极高。由于人口老龄化负担，这种被视为最重要死亡风险因素的疾病预计会增加。老年人高血压的诊断和管理存在一些特定的陷阱。高血压的定义在所有年龄组中都是相同的，然而老年人的表型有所不同：白大衣效应、非勺型血压模式、体位性低血压、自主神经功能障碍和假性高血压。老年人高血压的标志是单纯收缩期高血压和血压变异性增加。诊断往往难以确立。老年人可能会接受过度治疗，从而出现跌倒或灌注不足等不良影响，尤其是在存在身体虚弱或多重用药的情况下。
