60岁或以上的成年人高血压的药物治疗
Vijaya M Musini1, Aaron M Tejani1, Ken Bassett1
1Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
The Cochrane database of systematic reviews
|October 9, 2025
概括
抗高血压药物治疗显著降低了60岁及以上高血压成年人的全因死亡率和心血管事件. 这一审查证实了老年人群管理高血压的好处.
科学领域:
- 老年学是一门学科.
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 高血压的患病率随着年龄的增长而显著增加,特别是在60岁之后.
- 了解老年人抗高血压治疗的益处和危害至关重要.
- 本综述侧重于60-79岁和80岁以上的个人.
研究的目的:
- 评估抗高血压药物治疗与安慰剂对60岁以上患有高血压 (SBP> 140 mmHg或DBP> 90 mmHg) 的成年人全因死亡率的影响.
- 评估对心血管特异性发病率和死亡率的影响.
- 为了确定由于不良反应而导致治疗中止的比例.
主要方法:
- 搜索了多个数据库,查找随机对照试验 (RCT) 到2024年6月.
- 包括至少为期一年的RCT,比较60岁以上高血压患者的抗高血压药物与安慰剂.
- 使用Cochrane RoB 1工具评估偏差风险,并使用RevMan.com合成数据.
主要成果:
- 抗高血压治疗降低了全因死亡率 (RR 0.91,高确定性证据).
- 治疗可能会降低心血管 (RR 0.72),脑血管 (RR 0.66) 和冠心病 (RR 0.78) 发病率和死亡率 (中等确定性证据).
- 由于不良影响而导致的退出可能有所增加 (RR 2.91,低确定性证据).
结论:
- 抗高血压药物治疗对60岁以上中度至重度高血压的健康成年人有益,减少死亡率和心血管事件.
- 证据,主要来自于 thiazide 利尿剂试验,具有中等到高的确定性.
- 该审查被认为是稳定的,并且由于没有新的确定的试验,因此不会进一步更新.
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