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高齢者におけるシストリック高血圧
Sarwat I Chaudhry1, Harlan M Krumholz, JoAnne Micale Foody
1Department of Veterans Affairs, West Haven Veterans Affairs Medical Center, West Haven, Conn 06520-8088, USA.
JAMA
|September 2, 2004
まとめ
高齢者のシストリック高血圧 (SH) の治療は,SBP ≥160 mm Hgで強く支持されています. SHを<160mmHgまで治療するための証拠は,患者の要因を考慮する必要があり,より堅固ではありません.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- 心臓病学 心臓病学
- 薬理学 薬理学とは
背景:
- 収縮性高血圧 (SH) は,60歳以上の人々の重要な懸念事項です.
- 合同国家委員会の第7次報告書では,SHをシストリック血圧 (SBP) ≥140mmHgとダイアストリック血圧 <90mmHgと定義しています.
研究 の 目的:
- 高齢者のシストリック高血圧の臨床管理に関する体系的な文献レビューを実施する.
- 高齢者のSHに対する抗高血圧療法を支持する証拠を評価する.
主な方法:
- 1966年から2004年の間に出版された英語の文献について,包括的なMEDLINE検索が行われました.
- 検索は,高齢者のSHの研究に焦点を当て,ランダム化臨床試験を優先しました.
- 1064件の研究が,高血圧,心筋収縮 (または心筋収縮),および老化といったキーワードを用いて選択されました.
主要な成果:
- 強力な臨床試験の証拠は,SBP ≥160 mm Hgの高齢者のSH治療をサポートしています.
- 140~159mmHgのSBPについては,限定的な大規模試験が実施されているが,勧告は,心血管リスクの度合いを示す観察データに基づいている.
- シアジド性尿剤と長作用カルシウムチャネルブロッカーは,SHの好ましい第一線療法として特定されています.
結論:
- SBP ≥160 mm Hgの高齢患者におけるSHの治療は,堅実な証拠によって十分に支持されています.
- SHをSBPレベル140mmHgまたは140-159mmHgの範囲で治療するための証拠は,より決定的ではありません.
- 140~159mmHgの範囲のSHに対する治療の決定は,患者の好みと耐性を優先すべきである.
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