Department of Primary Care and Mental Health, University of Liverpool.
Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.
J Hypertens. 2023 Oct 1;41(10):1502-1510. doi: 10.1097/HJH.0000000000003495. Epub 2023 Jul 5.
The optimal management of hypertension in individuals aged 80 years or older with frailty remains uncertain due to multiple gaps in evidence. Complex health issues, polypharmacy, and limited physiological reserve make responding to antihypertensive treatments unpredictable. Patients in this age group may have limited life expectancy, so their quality of life should be prioritized when making treatment decisions. Further research is needed to identify which patients would benefit from more relaxed blood pressure targets and which antihypertensive medications are preferable or should be avoided. A paradigm shift is required in attitudes towards treatment, placing equal emphasis on deprescribing and prescribing when optimizing care. This review discusses the current evidence on managing hypertension in individuals aged 80 years or older with frailty, but further research is essential to address the gaps in knowledge and improve the care of this population.
由于证据不足，80 岁或以上体弱老年人的高血压最佳管理仍不确定。复杂的健康问题、多种药物治疗和有限的生理储备使得对降压治疗的反应难以预测。该年龄组的患者预期寿命有限，因此在做出治疗决策时应优先考虑他们的生活质量。需要进一步研究以确定哪些患者从更宽松的血压目标中受益，以及哪些降压药物更可取或应避免。需要在治疗态度上进行范式转变，在优化护理时平等重视减少药物和开具药物。本文讨论了目前关于治疗 80 岁或以上体弱老年人高血压的证据，但需要进一步研究来解决知识空白并改善这一人群的护理。
