在老年人中管理高血压
Brent M Egan1, Holly J Mattix-Kramer2, Jan N Basile3
1American Medical Association, Improving Health Outcomes, 2 West Washington Street, Suite 601, Greenville, SC, 29601, USA. brent.egan@ama-assn.org.
Current hypertension reports
|December 27, 2023
概括
由于全球人口的增加和心血管风险的增加,对老年人高血压的管理至关重要. 密集的血压控制为独立的老年人提供了显著的好处,但需要仔细评估脆弱性和认知状态.
科学领域:
- 老年学和心血管医学.
- 公共卫生和流行病学
背景情况:
- 全球老年人 (60-79岁和≥80岁) 的人口正在迅速增加.
- 心血管事件的风险随着年龄和静脉压升高而升级,突出了有效高血压管理的必要性.
- 高血压不成比例地影响老年女性,对妇女的健康造成重大关注.
研究的目的:
- 审查高血压管理在老年人中的关键作用.
- 分析不同年龄组和脆弱程度的密集血压控制的益处和风险.
- 强调功能和认知评估在定制高血压治疗目标中的重要性.
主要方法:
- 对老年人群中高血压的当前文献的综述.
- 对心血管事件率和与不同血压控制强度相关的不良事件的比较分析.
- 评估虚弱和认知功能对治疗疗效的影响.
主要成果:
- 较年长的成年人 (≥80岁) 经历了高血压控制的绝对益处比较年轻的老年人 (60-79岁) 更大.
- 虽然不良事件随着年龄的增长而增加,但强化疗法与标准护理相比,只显示出中度的过量风险.
- 强化治疗的益处在虚弱的老年人 (≥80岁) 显著认知障碍下减少或逆转.
结论:
- 高血压管理对于减轻日益增长的老年人群中心血管疾病负担至关重要.
- 根据功能和认知状态来定制血压目标对老年人来说至关重要.
- 建议在独立生活的老年人中就高血压目标进行共享决策,因为这对心血管有很大的益处.
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