在老年人中,更高的血压是高血压的目标
Jamie M Falk1, Liesbeth Froentjes2, Jessica Em Kirkwood2
1College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
The Cochrane database of systematic reviews
|December 17, 2024
概括
在老年人中降低血压目标可能会减少中风和心血管事件,对死亡率的影响很小. 传统的目标可能适用于大多数老年人,但对脆弱或非常老年人群需要进一步的研究.
科学领域:
- 老年学是指老年学的学科.
- 心脏病学 心脏病学
- 临床药理学 临床药理学
背景情况:
- 在65岁以上的成年人中进行的抗高血压试验往往准静缩血压 (BP) < 160 mmHg,显示出对心血管的益处.
- 目前的指导方针各不相同,对于老年人来说,缩血压目标范围从<130 mmHg到<150 mmHg不等.
- 之前的审查没有发现有力的证据表明,较低的BP目标减少了老年人的主要结果.
研究的目的:
- 在65岁以上的高血压成年人中,评估较少激进的血压目标 (150-160/95-105 mmHg) 与常规/激进的目标 (<140/90 mmHg或更低) 的影响.
主要方法:
- 搜索了多个数据库 (Cochrane高血压,CENTRAL,MEDLINE,Embase) 的随机对照试验,直到2024年6月.
- 包括高血压老年人 (≥65岁) 的试验,持续时间≥1年,比较高血压与低血压治疗目标.
- 分析数据使用风险比率 (RR) 和95%置信区间 (CI) 进行二分法结果.
主要成果:
- 这次更新中包括了四项试验 (16,732名参与者).
- 较低的血压目标减少了中风 (RR 1.33,高确定性证据) 和可能减少严重的心血管事件 (RR 1.25,中等确定性证据).
- 在全因死亡率 (RR 1.14,低确定性证据) 中观察到很少或没有差异,由于不良反应而导致的退出没有增加 (RR 0.99,中等确定性证据).
结论:
- 较低的血压目标显著减少中风,并可能减少老年人严重的心血管事件.
- 对全因死亡率的影响尚不清楚,但较低的目标似乎不会增加不良事件的撤销.
- 对于大多数老年人来说,传统的BP目标可能是合适的,对于脆弱或非常老年人来说,需要进一步研究.
相关概念视频
01:18Hypertension and Regulation of Blood Pressure
1.9K
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
1.9K
01:15Assessment of blood pressure in brachial artery(one-step method)
554
This procedural guide systematically measures blood pressure using an oscillometric digital sphygmomanometer, emphasizing accuracy, patient safety, and comfort.
Prepare for the Procedure:
Prepare for the Procedure:
554
01:24Blood Pressure
2.9K
The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
2.9K
01:28Factors affecting Blood pressure
3.0K
Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Physiological Factors:
3.0K
01:30Alterations in Blood Pressure
1.2K
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
1.2K
01:28Special considerations while measuring blood pressure
703
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
703