Davidov E L, Yaskevich R A
Voyno-Yasenetsky Krasnoyarsk State Medical University.
Research Institute of Medical Problems of the North - a separate division of Federal Research Center "Krasnoyarsk Scientific Center" Siberian Branch of the Russian Academy of Sciences.
Ter Arkh. 2023 Jan 16;94(12):1381-1386. doi: 10.26442/00403660.2022.12.201982.
To conduct a pharmacoepidemiological study to determine the characteristics of antihypertensive therapy in older patients with senile asthenia syndrome (SSA) and compliance of this therapy with modern clinical recommendations.
The study included 146 patients diagnosed with stage I-III hypertension who underwent inpatient treatment in the therapeutic department of the Krasnoyarsk Regional Hospital for War Veterans, the subjects were divided into two groups. The first group included 55 elderly patients (WHO, 2012) with hypertension and SSA. The second group included 35 elderly patients (WHO, 2012) with hypertension and SSA. The comparison group consisted of 56 patients aged 60 to 84 years with hypertension without SSA. Evaluation of the pharmacotherapy was carried out based on extracts from the medical histories of inpatient patients.
The most commonly taken groups of antihypertensive drugs in patients of older age groups with hypertension and SSA according to the study are diuretics and β-blockers. Diuretics were taken by 88.6% of elderly patients and 83.6% of senile patients. The main combinations of antihypertensive drugs in patients with hypertension and SSA were: a two-component scheme of combination of an ACE inhibitor and a diuretic, a three-component scheme of combination of an ACE inhibitor, a β-blocker and a diuretic, four-component schemes of combination of an ACE inhibitor, a β-blocker, a calcium channel blocker and a diuretic, as well as a combination of an angiotensin II receptor blocker, a β-blocker, calcium channel blocker and diuretic with combined medications.
The prescribed antihypertensive therapy in patients of older age groups with hypertension and SSA in most cases is represented by a combination of several drugs. Many patients take three-component antihypertensive therapy regimens. There were no statistically significant differences between patients of older age groups with hypertension and SSA, as well as patients of older age groups with hypertension without SSA. Therefore, it can be concluded that the presence of senile asthenia syndrome does not affect the tactics of treatment of hypertension and regardless of the presence or presence of SSA, patients receive the same hypotensive therapy, which contradicts existing clinical guidelines.
开展一项药物流行病学研究，以确定老年衰弱综合征（SSA）患者的降压治疗特点以及该治疗与现代临床建议的依从性。
该研究纳入了146例诊断为I - III期高血压且在克拉斯诺亚尔斯克地区退伍军人医院治疗科接受住院治疗的患者，将受试者分为两组。第一组包括55例（世界卫生组织，2012年标准）患有高血压和SSA的老年患者。第二组包括35例（世界卫生组织，2012年标准）患有高血压和SSA的老年患者。对照组由56例年龄在60至84岁之间患有高血压但无SSA的患者组成。基于住院患者病历摘要对药物治疗进行评估。
根据研究，高血压合并SSA的老年患者中最常服用的降压药类别是利尿剂和β受体阻滞剂。88.6%的老年患者和83.6%的高龄患者服用利尿剂。高血压合并SSA患者降压药的主要组合有：ACE抑制剂与利尿剂的二联方案、ACE抑制剂、β受体阻滞剂和利尿剂的三联方案、ACE抑制剂、β受体阻滞剂、钙通道阻滞剂和利尿剂的四联方案，以及血管紧张素II受体阻滞剂、β受体阻滞剂、钙通道阻滞剂和利尿剂与联合用药的组合。
高血压合并SSA的老年患者所开具的降压治疗在大多数情况下是几种药物的联合使用。许多患者采用三联降压治疗方案。高血压合并SSA的老年患者与无SSA的高血压老年患者之间无统计学显著差异。因此，可以得出结论，老年衰弱综合征的存在并不影响高血压的治疗策略，无论是否存在SSA，患者接受相同的降压治疗，这与现有临床指南相矛盾。
