Simon A, Levenson J
Int J Cardiol. 1987 Jul;16(1):1-18. doi: 10.1016/0167-5273(87)90265-8.
Hypertension in older atherosclerotic patients is characterised by a disproportionate elevation of systolic and pulse pressure contrasting with a subnormal diastolic level. Increased systolic pressure is strongly related to the excess of cerebrovascular complications and congestive heart failure observed in these patients. The physiopathological pattern is marked by a strong reduction in compliance of large arteries directly responsible for the predominant high systolic pressure because of the impairment of the buffering function of the arteries on the cardiac pulse wave. Clinical management is directed to the elevation of athero-arteriosclerotic changes of large arteries by means of appropriate non-invasive ultrasonic techniques and specific lowering in systolic pressure. Antihypertensive treatment must specifically decrease systolic pressure without superimposing adverse effects on the generalized and focalized atherosclerotic process. In this respect, new pharmacological agents capable of direct actions on large arteries might be suitable.
老年动脉粥样硬化患者的高血压特点是收缩压和脉压不成比例地升高，而舒张压水平低于正常。收缩压升高与这些患者中观察到的脑血管并发症和充血性心力衰竭的过量发生密切相关。生理病理模式的特点是大动脉顺应性显著降低，这直接导致了主要的高收缩压，原因是动脉对心脏脉搏波的缓冲功能受损。临床管理旨在通过适当的非侵入性超声技术提高大动脉的动脉粥样硬化改变，并特异性降低收缩压。抗高血压治疗必须特异性降低收缩压，同时不对全身性和局灶性动脉粥样硬化过程产生叠加的不利影响。在这方面，能够直接作用于大动脉的新型药物可能是合适的。
