Greminger P, Vetter W
Departement für Innere Medizin, Medizinische Poliklinik, Universitätsspital Zürich.
Praxis (Bern 1994). 1995 Oct 31;84(44):1252-5.
Hypertension is the single most potent common and remediable risk factor for cardiovascular morbidity and mortality in the population over age 65. Data from newer intervention studies show that it is clearly beneficial to treat elderly patients with either both systolic and diastolic hypertension or with isolated systolic hypertension. The indication to start treatment in a given patient depends on blood pressure values, age and eventual concomitant disease. In the evaluation of the elderly hypertensive patient, multiple blood pressure measurements in the standing and lying patient should be taken. In the case of suspected carotid artery stenosis, a Doppler ultrasound is indicated before starting antihypertensive therapy. Finally, if refractory hypertension or kidney failure develop in an elderly patient, renal artery stenosis should be considered.
高血压是65岁以上人群心血管发病和死亡的最常见且可纠正的单一危险因素。最新干预研究的数据表明，治疗收缩压和舒张压均高或单纯收缩期高血压的老年患者显然有益。特定患者开始治疗的指征取决于血压值、年龄以及最终的伴随疾病。在评估老年高血压患者时，应在患者站立和卧位时进行多次血压测量。对于疑似颈动脉狭窄的情况，在开始抗高血压治疗前需进行多普勒超声检查。最后，如果老年患者出现难治性高血压或肾衰竭，应考虑肾动脉狭窄。
