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老年高血压 Syst-Eur、Syst-China临床试验证明, 降压治疗可降低患者心血管并发症,尤其是脑 卒中的发生率和病死率。STOP-2研究表明, 70-84岁高血压患者中利尿剂、β-阻滞剂、 ACEI、CCBs(二氢吡啶类)组间心血管病死 率和主要终点事件没有差异。ALLHAT试验 结果表明,利尿剂、ACEI、CCBs对65岁以 上的高血压患者心血管事件的影响没有差异。 LIFE研究表明,55-80岁并存左室肥厚的高 血压患者,使用ARB氯沙坦能更有效降低心 血管事件,尤其对脑卒中疗效优于β-阻滞剂 阿替洛尔。SCOPE研究提示,70岁或70岁以 上高血压患者使用坎地沙坦后非致命性脑卒中 发生率降低。老年高血压患者抗高血压治疗多 数需要2种或2种以上的抗高血压药物。应注 意对于老年患者应逐步降压,应测量直立位血 压,以排除体位性低血压。
Syst-Eur, Syst-China Clinical Trial of Geriatric Hypertension Demonstrates that antihypertensive therapy can reduce cardiovascular complications, especially stroke, and mortality. The STOP-2 study showed no difference in cardiovascular mortality and primary endpoints among diuretics, beta-blockers, ACEIs, and CCBs (dihydropyridines) among 70-84-year-old hypertensive patients. ALLHAT test results show that diuretics, ACEI, CCBs on hypertension in patients over the age of 65 no difference in cardiovascular events. LIFE study showed that 55-80 years of hypertension in patients with left ventricular hypertrophy, the use of ARB losartan can be more effective in reducing cardiovascular events, especially for stroke better than β-blocker atenolol. The SCOPE study suggests that the incidence of non-fatal stroke may be reduced after candesartan is used in hypertensive patients 70 and older. Antihypertensive treatment in elderly patients with hypertension mostly require two or more antihypertensive drugs. Should pay attention to the elderly patients should be gradually reduced pressure, blood pressure should be measured upright position to rule out orthostatic hypotension.