Franklin S S
Med Clin North Am. 1983 Mar;67(2):395-417. doi: 10.1016/s0025-7125(16)31211-1.
Hypertension in the elderly is a frequent occurrence and is associated with an increase in cardiovascular complications. Therapeutic drug intervention in diastolic-systolic hypertension is both safe and effective in decreasing cardiovascular morbidity and mortality. Convincing evidence supporting the value of therapeutic intervention in isolated systolic hypertension is not yet available. At present, selection of specific antihypertensive drugs remains empirical because of insufficient controlled trials in elderly hypertensives. Antihypertensive agents should be initiated in smaller dosages and titrated upward slowly with particular care in avoiding orthostatic hypotension. Above all, lifestyle modification should be kept to a minimum and special attention should be given to the patient's quality of life while on drug treatment.
老年人高血压很常见，且与心血管并发症的增加有关。治疗药物干预舒张期-收缩期高血压在降低心血管发病率和死亡率方面既安全又有效。目前尚无令人信服的证据支持对单纯收缩期高血压进行治疗性干预的价值。目前，由于针对老年高血压患者的对照试验不足，特定抗高血压药物的选择仍基于经验。抗高血压药物应以较小剂量开始，并缓慢向上滴定，尤其要注意避免直立性低血压。最重要的是，应尽量减少生活方式的改变，在药物治疗期间应特别关注患者的生活质量。
