Kuramoto K, Matsushita S, Kuwajima I, Murakami M
Jpn Heart J. 1981 Jan;22(1):75-85. doi: 10.1536/ihj.22.75.
The 4 year prospective trial on the effectiveness of the antihypertensive treatment was performed in 100 mild hypertensive patients of the aged, the average age being 76.1 years. Dropouts during the drug-off control period were 9 cases. The matched pair group was selected by the age, sex, and blood pressure. Forty-four drug treated cases and 47 placebo treated cases were comparable in blood pressure as well as in laboratory data. Cerebrovascular and cardiac complications were observed in 4 cases or 10.5% in the drug group, and in 9 cases or 22.0% in the placebo group. When 8 cases of blood pressure elevation over 200/110 mmHg in the placebo group were added to the cardiovascular complications, dropouts in placebo group reached 41.5%, and this showed the significant difference. Other complications were observed in 12 cases or 31.6% in the drug group and in 17 cases or 41.5% in the placebo group. Major complications were cancers, infections, and bone or joint diseases. Blood pressure was decreased from 171/87 to 151/80 in the drug group, and the average decrease was 20/7 mmHg in 4 year period. No significant changes in hematocrit, serum protein, urea nitrogen, uric acid, sodium, and potassium were observed during the trial period. The present study suggested that antihypertensive treatment was effective in the aged with mild hypertension, and that careful follow up was needed not only for cardiovascular complications but also for general health condition.
对100例老年轻度高血压患者进行了为期4年的降压治疗效果前瞻性试验,平均年龄为76.1岁。药物停用对照期的失访者有9例。根据年龄、性别和血压选择配对组。44例药物治疗病例和47例安慰剂治疗病例在血压及实验室数据方面具有可比性。药物组有4例(10.5%)出现脑血管和心脏并发症,安慰剂组有9例(22.0%)出现。若将安慰剂组中8例血压升高超过200/110 mmHg的病例计入心血管并发症,则安慰剂组失访率达41.5%,差异有统计学意义。药物组有12例(31.6%)出现其他并发症,安慰剂组有17例(41.5%)出现。主要并发症为癌症、感染及骨或关节疾病。药物组血压从171/87降至151/80,4年期间平均下降20/7 mmHg。试验期间血细胞比容、血清蛋白、尿素氮、尿酸、钠和钾均无显著变化。本研究表明,降压治疗对老年轻度高血压患者有效,不仅需要密切关注心血管并发症,还需关注总体健康状况。