Gifford R W
Geriatrics. 1987 May;42(5):45-50.
Of the more than 25,000,000 people in the United States older than 65 years, more than 60% have hypertension. Approximately 10% of the elderly people have isolated systolic hypertension (systolic blood pressure greater than or equal to 160 mm Hg, diastolic less than 90 mm Hg). Hypertension in the elderly, either systolic or diastolic, increases the risk of cardiovascular morbidity and mortality as much as it does for younger patients. Three large, controlled clinical trials have shown that diuretic-based stepped care therapy will reduce the risk of cardiovascular mortality for patients 60 years of age and older who have diastolic hypertension. In general, elderly patients tolerate antihypertensive drugs as well as younger patients do, and they are as compliant as younger patients. As yet, there is no evidence from controlled trials that drug treatment reduces the risk for patients with isolated systolic hypertension.
在美国超过2500万65岁以上的人群中，超过60%患有高血压。约10%的老年人患有单纯收缩期高血压（收缩压大于或等于160毫米汞柱，舒张压小于90毫米汞柱）。老年人的高血压，无论是收缩期还是舒张期，与年轻患者一样会增加心血管发病和死亡风险。三项大型对照临床试验表明，基于利尿剂的阶梯式护理疗法可降低60岁及以上舒张期高血压患者的心血管死亡风险。一般来说，老年患者对抗高血压药物的耐受性与年轻患者一样好，并且他们的依从性也与年轻患者相同。目前，尚无对照试验的证据表明药物治疗能降低单纯收缩期高血压患者的风险。
