Filipovský Jan
Vnitr Lek. 2018 Winter;64(11):987-992.
Hypertension is one of the most common problems at higher age and belongs to the most important cardiovascular risk factors. Subjects aged 65 years and more have typically isolated systolic hypertension with increased pulse pressure as a consequence of decreased elasticity of central arteries. With increasing age, the prevalence of cardiovascular/ renal diseases and diabetes is higher. Therefore, we use drugs that have cardiprotective effect and do not affect negatively concomitant diseases. Diuretics have the largest data from prospective studies, calcium channels blockers are suitable especially in isolated systolic hypertension, and ACE inhibitors tested in high-risk hypertensive patients, especially after stroke. The HYVET study showed that the risk of cardiovascular events and of heart failure is decreased with antihypertensive troroeatment also in subjects aged 80 years and more. Key words: hypertension in the elderly - isolated systolic hypertension - pulse pressure - treatment of hypertension.
高血压是老年人群中最常见的问题之一，也是最重要的心血管危险因素之一。65岁及以上的人群通常患有单纯收缩期高血压，由于中心动脉弹性降低，脉压升高。随着年龄的增长，心血管/肾脏疾病和糖尿病的患病率更高。因此，我们使用具有心脏保护作用且不会对伴发疾病产生负面影响的药物。利尿剂在前瞻性研究中有最多的数据，钙通道阻滞剂尤其适用于单纯收缩期高血压，而ACE抑制剂在高危高血压患者中进行了测试，尤其是在中风后。HYVET研究表明，80岁及以上的受试者进行抗高血压治疗后，心血管事件和心力衰竭的风险也会降低。关键词：老年高血压 - 单纯收缩期高血压 - 脉压 - 高血压治疗
