Ravindrarajah Rathi, Dregan Alex, Hazra Nisha C, Hamada Shota, Jackson Stephen H D, Gulliford Martin C
aDepartment of Primary Care and Public Health Sciences, Kings College LondonbNational Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' National Health Service Foundation TrustcDepartment of Clinical Gerontology, King's College London, London, UK.
J Hypertens. 2017 Jun;35(6):1276-1282. doi: 10.1097/HJH.0000000000001291.
Management of high blood pressure (BP) in people over 80 years is controversial, but there is limited information available concerning the uptake of hypertension treatment at this age.
To evaluate use of antihypertensive drugs and changes in SBP and DBP from 2001 to 2014 in men and women aged 80 years and over.
Cohort study using primary care electronic health records of 265 225 participants from the UK Clinical Practice Research Datalink. Records of BP and antihypertensive medications were analysed. Linear trends were estimated by frailty category in multiple regression models.
Data were analysed for 116 401 men and 148 824 women. The proportion with BP recorded increased from 51% in 2001 to 78% in 2014. The proportion of patients prescribed antihypertensive medications increased from 64 to 76%. Mean SBP declined from 150 (SD 20) mmHg in 2001 to 135 (16) mmHg in 2014. In 'fit' participants, the decline in SBP was 12.4 (95% confidence interval 11.9-13.0) mmHg/decade in those treated for hypertension and 8.5 (7.8-9.1) mmHg in those not treated. The decline in SBP was smaller as frailty increased. The proportion of all participants with BP less than 140/90 mmHg increased from 14 to 44% in the study period.
In octogenarians, BP treatment has intensified between 2001 and 2014. BP values have declined in both treated and untreated participants, with a substantial increase in the proportion achieving conventional BP targets.
80岁以上人群的高血压管理存在争议，但关于这个年龄段高血压治疗的接受情况，现有信息有限。
评估2001年至2014年80岁及以上男性和女性抗高血压药物的使用情况以及收缩压和舒张压的变化。
采用队列研究，利用来自英国临床实践研究数据链的265225名参与者的初级保健电子健康记录。分析血压和抗高血压药物记录。通过多回归模型按虚弱类别估计线性趋势。
对116401名男性和148824名女性的数据进行了分析。记录血压的比例从2001年的51%增至2014年的78%。开具抗高血压药物的患者比例从64%增至76%。收缩压均值从2001年的150（标准差20）mmHg降至2014年的135（16）mmHg。在“健康”参与者中，接受高血压治疗者收缩压的下降幅度为每十年12.4（95%置信区间11.9 - 13.0）mmHg，未治疗者为8.5（7.8 - 9.1）mmHg。随着虚弱程度增加，收缩压下降幅度变小。在研究期间，所有参与者血压低于140/90 mmHg的比例从14%增至44%。
在2001年至2014年期间，80多岁老人的血压治疗有所强化。接受治疗和未接受治疗的参与者血压值均有所下降，达到传统血压目标的比例大幅增加。
