在老年人中患有系统性高血压
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
概括
对于SBP≥160mmHg,在老年人中治疗静心高血压 (SH) 得到强烈支持. 治疗SH<160mmHg的证据不太强大,需要考虑患者因素.
科学领域:
- 老年学是一门学科.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 系统性高血压 (SH) 是60岁及以上个体的一个重大问题.
- 联合国家委员会第七次报告将SH定义为静缩血压 (SBP) ≥140mmHg,静缩血压<90mmHg.
研究的目的:
- 在老年人群中对静心高血压的临床管理进行系统的文献审查.
- 评估支持老年人SH抗高血压治疗的证据.
主要方法:
- 对1966年至2004年间出版的英语文学进行了全面的MEDLINE搜索.
- 搜索的重点是老年人SH的研究,优先考虑随机临床试验.
- 使用关键词选择了1064项研究:高血压,心缩 (或心缩) 和年龄.
主要成果:
- 强有力的临床试验证据支持在SBP≥160mmHg的老年人中治疗SH.
- 对于140-159毫米平之间的SBP存在有限的大规模试验;建议依赖于显示分级心血管风险的观察数据.
- 化尿剂和长效通道阻断剂被确定为SH的首选一线疗法.
结论:
- 对于SBP≥160mmHg的老年患者,SH的治疗得到了强有力的证据支持.
- 治疗SH以SBP水平为140mm Hg或在140-159mm Hg范围内的证据不那么有说服力.
- 在140-159毫米血压范围内的SH治疗决策应优先考虑患者的偏好和耐受性.
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