Tsai Hao-Yuan, Chuang Hung-Jui, Liao Wei-Hsiang, Wang Yi-Jie, Li Pei-Hsuan, Wang Wen-Ting, Liao Shih-Cheng, Yeh Chih-Fan, Chen Pey-Rong, Lai Tai-Hsuan, Lin Hung-Ju, Cheng Shao-Yi, Chen Wen-Jone, Lin Yen-Hung, Chang Yi-Yao
Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College Medicine, Taipei, Taiwan.
J Formos Med Assoc. 2024 Nov 5. doi: 10.1016/j.jfma.2024.10.022.
Many studies have examined the effectiveness of lifestyle modifications such as exercise, diet, weight loss, and stress reduction in controlling hypertension in elderly individuals, and several meta-analyses have reported that both aerobic and resistance exercise can reduce blood pressure in this population. In addition, the higher sensitivity to sodium in elderly individuals highlights the importance of restricting salt intake for blood pressure control. Low-sodium salt or potassium supplementation can help with blood pressure control in elderly individuals with hypertension. Several clinical trials have shown that both the Dietary Approaches to Stop Hypertension (DASH) and a Mediterranean diet pattern are effective in reducing blood pressure in older hypertensive patients. Although moderate alcohol consumption does not appear to negatively impact blood pressure control in older adults, blood pressure increases along with heavy alcohol intake. Some studies have indicated that coffee intake increases blood pressure in elderly hypertensive subjects, especially for those who consume more than 3 cups a day. Clinical studies have shown that weight loss through exercise and diet control is beneficial for controlling hypertension in elderly individuals. Anxiety, depression and insomnia also appear to have an impact on elderly hypertension. In this review, we discuss the effectiveness of lifestyle modifications and non-pharmacological management of these factors and their impact on hypertension in elderly individuals, and how to effectively implement them in real-world settings.
许多研究探讨了运动、饮食、减肥和减压等生活方式改变在控制老年个体高血压方面的有效性，多项荟萃分析报告称，有氧运动和抗阻运动均可降低该人群的血压。此外，老年个体对钠的敏感性较高，这凸显了限制盐摄入对控制血压的重要性。低钠盐或补钾有助于控制老年高血压患者的血压。多项临床试验表明，终止高血压膳食疗法（DASH）和地中海饮食模式均可有效降低老年高血压患者的血压。虽然适度饮酒似乎不会对老年人的血压控制产生负面影响，但大量饮酒会导致血压升高。一些研究表明，老年高血压患者摄入咖啡会使血压升高，尤其是对于那些每天饮用超过三杯咖啡的人。临床研究表明，通过运动和饮食控制来减肥有利于控制老年个体的高血压。焦虑、抑郁和失眠似乎也会对老年高血压产生影响。在本综述中，我们讨论了生活方式改变和对这些因素的非药物管理的有效性及其对老年个体高血压的影响，以及如何在现实环境中有效实施这些措施。
