Vetter W, Greminger P
Departement für Innere Medizin, Universitätsspital Zürich.
Praxis (Bern 1994). 1995 Oct 31;84(44):1277-81.
Today indications for treatment of hypertension in older age are no longer contested, even if only systolic pressure is raised. The choice of the antihypertensive drug for elderly patients, however, depends on concomitant diseases. The diversity of the latter demands a judicious, individualized use of the available substances (diuretics, beta-blockers, calcium antagonists and ACE-inhibitors). In elderly patients as well, a marked reduction of the cardiovascular risk is achievable by pharmacotherapy. So far, however, such results have only been reported for the use of diuretics and beta-blockers, in purely systolic hypertension by diuretics exclusively; however smaller studies, suggest that comparably favorable results may be obtained with calcium antagonists.
如今，即便仅收缩压升高，老年高血压的治疗指征也不再有争议。然而，老年患者抗高血压药物的选择取决于伴发疾病。伴发疾病的多样性要求明智、个体化地使用现有药物（利尿剂、β受体阻滞剂、钙拮抗剂和血管紧张素转换酶抑制剂）。在老年患者中，药物治疗也可显著降低心血管风险。然而，迄今为止，仅利尿剂和β受体阻滞剂的使用有此类结果报道，在单纯收缩期高血压中仅利尿剂有此结果；不过，小型研究表明，钙拮抗剂可能会取得类似的良好效果。
