Vetter W
Schweiz Rundsch Med Prax. 1989 Nov 7;78(45):1247-54.
Pharmacotherapy of hypertension in the aged does not differ qualitatively but only quantitatively from that in use for younger patients. Adjusted, usually lower doses of diuretics, beta-blocking agents, ACE-inhibitors and calcium-channel blockers are the basic drugs. Individual aging processes and concomitant diseases determine the choice of drugs in the elderly (individualized therapy). All substances are initially prescribed at very low dose. The increasing infirmity of the aged often associated with tiredness, dyspnea and dizziness even without treatment requires careful instruction of the patient about effects and side effects of the prescribed medication. The old WHO-guidelines (systolic BP greater than or equal to 160, diastolic BP greater than or equal to 95 mm mercury) should be maintained for diagnosis and treatment of hypertension. However antihypertensive therapy in patients over 80 years of age and in those with marginally elevated diastolic or solely elevated systolic pressure is controversial today.
老年人高血压的药物治疗在性质上与年轻患者所用治疗并无不同，只是在剂量上有所差异。调整后的、通常较低剂量的利尿剂、β受体阻滞剂、血管紧张素转换酶抑制剂和钙通道阻滞剂是基本药物。个体衰老过程和伴随疾病决定了老年人的药物选择（个体化治疗）。所有药物最初都以非常低的剂量开具。老年人日益衰弱，即使未经治疗也常伴有疲劳、呼吸困难和头晕，这就需要仔细告知患者所开药物的作用和副作用。世界卫生组织的旧指南（收缩压大于或等于160，舒张压大于或等于95毫米汞柱）仍应作为高血压诊断和治疗的依据。然而，如今80岁以上患者以及舒张压轻度升高或仅收缩压升高患者的降压治疗存在争议。
