Birkenhäger W H, de Leeuw P W
Drugs. 1986;31 Suppl 4:1-7. doi: 10.2165/00003495-198600314-00002.
The main demographic transition during the next decade will be a worldwide increase in older and elderly people, both in proportional and absolute terms. Although age itself is the main risk factor for morbidity and disability, additional cardiovascular risk may be brought about by inherent rises of blood pressure in these older age groups. This additional risk factor appears to be a suitable target for corrective measures. Recent therapeutic trials in mild or moderate hypertension all shared the common use of thiazides as one of the basic drugs of treatment. Subgroups of older hypertensives who were randomised to active treatment tended to fare better than those on placebo. This was mainly due to a reduction in cerebrovascular complications, but in the one trial where a potassium-sparing component was added to the thiazide, cardiac events were also reduced.
未来十年主要的人口结构转变将是全球老年人数量在比例和绝对数量上都有所增加。虽然年龄本身是发病和残疾的主要风险因素，但这些老年人群中血压的内在升高可能会带来额外的心血管风险。这一额外的风险因素似乎是采取纠正措施的合适目标。近期针对轻度或中度高血压的治疗试验都普遍将噻嗪类药物作为基本治疗药物之一。被随机分配接受积极治疗的老年高血压亚组患者的情况往往比接受安慰剂治疗的患者更好。这主要是由于脑血管并发症的减少，但在一项将保钾成分添加到噻嗪类药物中的试验中，心脏事件也有所减少。
