老年患者的多药学:八代人中高血压的管理
Athanase Benetos1, Patrick Rossignol2, Antonio Cherubini3
1Department of Geriatrics and FHU-CARTAGE, CHU de Nancy, Université de Lorraine, Nancy, France.
JAMA
|July 15, 2015
概括
高血压治疗有利于健康,独立的八十岁人. 然而,对于使用多种药物的脆弱,老年患者来说,证据不足,需要个性化护理.
科学领域:
- 老年学是指老年学的学科.
- 心血管医学 心血管医学
- 临床药理学 临床药理学
背景情况:
- 对大多数患者来说,高血压管理至关重要.
- 在服用多种药物的非常老,脆弱的个体中治疗高血压的益处不太清楚.
研究的目的:
- 制定80岁及以上患者高血压评估和治疗的建议.
主要方法:
- 搜索了MEDLINE,PubMed Central和Cochrane系统审查数据库 (2015年4月开始).
- 包括80岁以上人群使用抗高血压药物的随机对照试验 (RCT),重点是对非常老年人试验 (HYVET) 中高血压的后期分析.
主要成果:
- HYVET试验 (N=3845) 显示总死亡率和心血管终点降低,但在预防中风方面没有达到统计学意义.
- 后期分析表明,对白袍高血压,认知和潜在的骨折预防有好处.
- 在HYVET中的患者是社区居民,并且比普通八十多岁人口残疾人少.
结论:
- 80岁以上的健康,功能独立的高血压患者应遵循65岁以上患者的指导方针.
- 对于脆弱的,多种药物治疗的八岁老人的治疗缺乏足够的证据,需要个性化的方法.
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