Hansson L, Zanchetti A
Department of Geriatrics, University of Uppsala, Sweden.
Blood Press Suppl. 1995;3:68-72.
Treatment of hypertension in the elderly has become not only accepted but also a highly ethical, effective and compelling procedure following the many clearly positive reports on the benefits of lowering elevated arterial pressure in elderly patients. So far most intervention studies in elderly hypertensive patients have used diuretics or beta-blockers or the two in combination as the moiety by which blood pressure has been lowered. However, from a theoretical point of view, more novel therapies could offer advantages that would translate into an even better reduction of cardiovascular morbidity and mortality than has been obtained with the traditional antihypertensive therapies used so far. Some of the studies in elderly hypertensives that are in progress using angiotensin converting enzyme inhibitors or calcium antagonists as the main therapies, e.g. the STOP-Hypertension-2 Study and the Syst-Eur Study, will be briefly reviewed here as will the large data base on urapidil, a dual action antihypertensive drug used in the treatment of elderly hypertensives. By careful evaluation of the effects of novel antihypertensive drugs, and the already existing data base on urapidil in elderly hypertensive patients, it is likely that still better reduction of risk can be obtained in the elderly hypertensives by the use of more novel therapies than diuretics and beta-blockers.
随着众多关于降低老年患者动脉血压升高所带来益处的明确积极报告问世，老年高血压的治疗不仅已被接受，而且成为一项极具伦理道德、行之有效且势在必行的举措。到目前为止，大多数针对老年高血压患者的干预研究都使用利尿剂或β受体阻滞剂，或者二者联合作为降低血压的药物。然而，从理论角度来看，更新颖的疗法可能具有诸多优势，相比目前使用的传统抗高血压疗法，能够更有效地降低心血管疾病的发病率和死亡率。本文将简要回顾一些正在进行的以血管紧张素转换酶抑制剂或钙拮抗剂作为主要治疗方法的老年高血压研究，例如“老年高血压治疗研究-2（STOP-Hypertension-2）”和“欧洲收缩期高血压研究（Syst-Eur）”，同时还将回顾关于乌拉地尔的大量数据库情况，乌拉地尔是一种用于治疗老年高血压的具有双重作用的抗高血压药物。通过仔细评估新型抗高血压药物的效果以及老年高血压患者中已有的乌拉地尔数据库，使用比利尿剂和β受体阻滞剂更新颖的疗法，很可能在老年高血压患者中进一步降低风险。
