Dallmeier Dhayana, Denkinger Michael D
Geriatrie der Universität Ulm, AGAPLESION Bethesda Klinik, Zollernring 26, 89073, Ulm, Deutschland.
Geriatrisches Zentrum Ulm/Alb-Donau, Ulm, Deutschland.
Z Gerontol Geriatr. 2018 Nov;51(7):825-838. doi: 10.1007/s00391-018-1454-0. Epub 2018 Nov 6.
Untreated high blood pressure in old age increases the risk of secondary diseases, especially stroke, coronary heart disease, myocardial infarction and heart failure and should be treated according to the guidelines. For slightly frail people up to the age of 80 years, a systolic blood pressure of 130-139 mm Hg (measured in the doctors surgery) should be the aim. According to the current European guidelines the same values are recommended for those over the age of 80 years but treatment should start at a systolic blood pressure of ≥160 mm Hg. In physically disabled and very frail older people an individually tailored approach is recommended, regardless of age. The authors recommend a target systolic value <150 mm Hg but not below 130/70 mm Hg. In the event of poor tolerance the treatment should be adapted further as necessary. Antihypertensive medication should be selected under the aspects of polypharmacy. In many cases arterial hypertension in old age can be treated in accordance with the guidelines, taking multimorbidity and the interaction of medications into consideration.
老年人未经治疗的高血压会增加患继发性疾病的风险,尤其是中风、冠心病、心肌梗死和心力衰竭,应按照指南进行治疗。对于80岁及以下轻度体弱的人,收缩压目标应为130 - 139毫米汞柱(在医生诊所测量)。根据当前欧洲指南,80岁以上人群推荐相同的值,但治疗应在收缩压≥160毫米汞柱时开始。对于身体残疾和非常体弱的老年人,无论年龄大小,都建议采用个体化的治疗方法。作者推荐收缩压目标值<150毫米汞柱,但不低于130/70毫米汞柱。如果耐受性差,应根据需要进一步调整治疗。应从多重用药的角度选择抗高血压药物。在许多情况下,考虑到多重疾病和药物相互作用,老年人的动脉高血压可以按照指南进行治疗。