Cushman W C
University of Tennessee College of Medicine, Memphis.
Curr Opin Cardiol. 1994 Sep;9(5):561-7. doi: 10.1097/00001573-199409000-00009.
Hypertension is the most important risk factor for cardiovascular events in the elderly, and it is present in more than 50% of the American population over 60 years of age. Both systolic and diastolic blood pressure are directly related to increasing cardiovascular risk and systolic pressure becomes even more important in the elderly. Borderline isolated systolic hypertension confers an 80% likelihood of developing definite hypertension over 20 years, as well as a higher risk for cardiovascular events. The morbidity trials in the elderly, especially the Systolic Hypertension in the Elderly Program, have clearly demonstrated the benefits of treating hypertension in the elderly in all subgroups examined. Although these benefits have been seen with diuretic (and to a lesser extent beta-blocker) regimens, physicians initiated therapy less often with these drugs during 1990 and 1991. All of the major classes of drugs are effective in lowering blood pressure in older whites, and calcium antagonists and diuretics are most effective in older black patients.
高血压是老年人发生心血管事件的最重要危险因素，在美国60岁以上人群中，超过50%的人患有高血压。收缩压和舒张压均与心血管风险增加直接相关，且收缩压在老年人中更为重要。临界单纯收缩期高血压患者在20年内发生明确高血压的可能性为80%，同时发生心血管事件的风险也更高。针对老年人的发病率试验，尤其是老年收缩期高血压计划，已清楚表明在所有研究的亚组中，治疗老年高血压均有益处。尽管利尿剂（以及程度较轻的β受体阻滞剂）治疗方案已显示出这些益处，但在1990年至1991年期间，医生较少使用这些药物启动治疗。所有主要类别的药物对降低老年白人的血压均有效，而钙拮抗剂和利尿剂对老年黑人患者最为有效。
