Lindholm L H, Johannesson M
Health Sciences Centre, Lund University, Sweden.
Blood Press Suppl. 1995;3:11-4.
Treatment of elderly hypertensives with beta-receptor blockers and/or diuretics is cost-effective according to the analyses of the results of the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). The cost-effectiveness ratios are low and of the same magnitude for both men and women. The results with respect to reduced risk of cardiovascular disease in STOP Hypertension are also supported by several other studies using the same groups of drugs. The more modern drugs (calcium antagonists, alpha 1 blockers, and ACE inhibitors) have not proven their efficacy in the reduction of cardiovascular events in prospective studies of primary hypertension. It has, however, been shown that they lower blood pressure well also in the elderly and that they are cost-effective among the elderly if treatment with beta-receptor blockers and/or diuretics is contraindicated, provided that they lower the incidence of cardiovascular disease to the same extent as do beta-receptor blockers and diuretics. Studies tackling this latter question are under way, also in the elderly.
根据瑞典老年高血压患者试验（STOP - 高血压）结果分析，使用β受体阻滞剂和/或利尿剂治疗老年高血压患者具有成本效益。成本效益比很低，男性和女性的情况相当。使用相同药物组的其他几项研究也支持了STOP高血压试验中降低心血管疾病风险的结果。在原发性高血压的前瞻性研究中，更现代的药物（钙拮抗剂、α1受体阻滞剂和血管紧张素转换酶抑制剂）尚未证明其在降低心血管事件方面的疗效。然而，已表明它们在老年人中也能很好地降低血压，并且如果禁忌使用β受体阻滞剂和/或利尿剂进行治疗，只要它们能将心血管疾病的发生率降低到与β受体阻滞剂和利尿剂相同的程度，那么在老年人中它们也是具有成本效益的。针对后一个问题的研究也正在老年人中进行。
