Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
Department of Cardiology, Traditional Chinese Medicine Hospital of Shuangliu District, Chengdu, China.
PeerJ. 2024 Jul 11;12:e17760. doi: 10.7717/peerj.17760. eCollection 2024.
Hypertension is one of the most common chronic diseases in older people, and the prevalence is on the rise as the global population ages. Hypertension is closely associated with many adverse health outcomes, including cardiovascular disease, chronic kidney disease and mortality, which poses a substantial threat to global public health. Reasonable blood pressure (BP) management is very important for reducing the occurrence of adverse events. Frailty is an age-related geriatric syndrome, characterized by decreased physiological reserves of multiple organs and systems and increased sensitivity to stressors, which increases the risk of falls, hospitalization, fractures, and mortality in older people. With the aging of the global population and the important impact of frailty on clinical practice, frailty has attracted increasing attention in recent years. In older people, frailty and hypertension often coexist. Frailty has a negative impact on BP management and the prognosis of older hypertensive patients, while hypertension may increase the risk of frailty in older people. However, the causal relationship between frailty and hypertension remains unclear, and there is a paucity of research regarding the efficacious management of hypertension in frail elderly patients. The management of hypertension in frail elderly patients still faces significant challenges. The benefits of treatment, the optimal BP target, and the choice of antihypertensive drugs for older hypertensive patients with frailty remain subjects of ongoing debate. This review provides a brief overview of hypertension in frail older adults, especially for the management of BP in this population, which may help in offering valuable ideas for future research in this field.
高血压是老年人中最常见的慢性病之一，随着全球人口老龄化，其患病率呈上升趋势。高血压与许多不良健康结局密切相关，包括心血管疾病、慢性肾脏病和死亡，这对全球公共卫生构成了重大威胁。合理的血压（BP）管理对于减少不良事件的发生非常重要。衰弱是一种与年龄相关的老年综合征，其特征是多个器官和系统的生理储备减少，对压力源的敏感性增加，这会增加老年人跌倒、住院、骨折和死亡的风险。随着全球人口老龄化以及衰弱对临床实践的重要影响，近年来衰弱越来越受到关注。在老年人中，衰弱和高血压常常并存。衰弱对老年高血压患者的 BP 管理和预后产生负面影响，而高血压可能会增加老年人衰弱的风险。然而，衰弱和高血压之间的因果关系尚不清楚，对于衰弱的老年患者有效管理高血压的研究也很少。衰弱的老年患者的高血压管理仍然面临着重大挑战。治疗的获益、最佳的 BP 目标以及衰弱的老年高血压患者的降压药物选择仍存在争议。本综述简要概述了衰弱老年人的高血压，特别是该人群的 BP 管理，这可能为该领域的未来研究提供有价值的思路。
