Campbell N R, Hogan D B, McKay D W
Department of Medicine, University of Calgary.
Can J Public Health. 1994 Sep-Oct;85 Suppl 2:S26-8.
Accurate, reproducible blood pressure readings are more difficult to obtain in the elderly. Elderly patients have more variable blood pressure, show a reduction in blood pressure following meals, and can have postural hypotension, discrepancies in blood pressure between arms, auscultatory gaps and 'pseudohypertension', all of which can mislead clinicians regarding these patients' usual blood pressure. Arrhythmias, particularly atrial fibrillation, make accurate blood pressure determination difficult and are more common in the elderly. Prostatic hypertrophy causing high pressure urinary retention is suggested as a common and reversible cause of hypertension in older men. Proper measurement of blood pressure in elderly patients demands additional thought and action, all of which are necessary for accurate cardiovascular risk assessment and proper therapeutic decisions. Increasing the number of visits and the number of carefully taken blood pressure readings per visit will result in a more accurate assessment of blood pressure in older patients.
在老年人中获得准确、可重复的血压读数更加困难。老年患者的血压变化更大，饭后血压会降低，并且可能出现体位性低血压、双臂血压差异、听诊间隙和“假性高血压”，所有这些都可能使临床医生对这些患者的日常血压产生误解。心律失常，尤其是心房颤动，会使准确测定血压变得困难，且在老年人中更为常见。前列腺肥大导致高压性尿潴留被认为是老年男性高血压的常见且可逆的原因。对老年患者进行血压的正确测量需要更多的思考和行动，所有这些对于准确的心血管风险评估和正确的治疗决策都是必要的。增加就诊次数以及每次就诊时仔细测量血压的次数，将有助于更准确地评估老年患者的血压。
