Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, U.S.A..
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, U.S.A.
Curr Cardiol Rep. 2024 Aug;26(8):783-787. doi: 10.1007/s11886-024-02080-z. Epub 2024 Jun 25.
This review aims to evaluate intensive blood pressure control in older adults, assessing its necessity, effectiveness, benefits and risks including cardiovascular outcomes, adverse events, quality of life, and overall mortality.
Recent studies have supported that intensive antihypertensive treatment lowers the rates of cardiovascular events compared to standard treatment in older patients with hypertension, and it may also reduce the risk of cognitive decline. Intensive blood pressure lowering strategies are associated with reduced risk of cardiovascular morbidity and mortality as well as all-cause mortality, without compromising quality of life or functional status, and are relatively well tolerated in this patient population. Evidence suggests that maintaining systolic blood pressure below 130 mm Hg can yield cardiovascular and cognitive benefits in older patients with hypertension, particularly among those at risk of myocardial infarction or stroke. However, clinicians should vigilantly monitor for adverse events and engage in shared decision-making when pursuing intensive blood pressure goals tailored to individual risks and benefits.
本文旨在评估老年人群强化血压控制的效果，评估其必要性、有效性、获益和风险，包括心血管结局、不良事件、生活质量和总体死亡率。
最近的研究表明，与高血压老年患者的标准治疗相比，强化降压治疗可降低心血管事件的发生率，并且可能降低认知能力下降的风险。强化降压策略与降低心血管发病率和死亡率以及全因死亡率相关，同时不影响生活质量或功能状态，在该患者人群中相对耐受良好。有证据表明，对于高血压老年患者，将收缩压维持在 130mmHg 以下可带来心血管和认知获益，特别是对于那些有心肌梗死或中风风险的患者。然而，当追求针对个体风险和获益的强化血压目标时，临床医生应警惕不良事件并进行共同决策。
