老年原发性高血压降压治疗并发缺血性脑卒中12例临床分析

Clinical analysis of 12 cases of antihypertensive treatment complicated by cerebral arterial thrombosis

目的通过病例分析探讨老年原发性高血压降压治疗原则及并发缺血性脑卒中后的降压处理措施。方法比较12例老年原发性高血压降压治疗并发缺血性脑卒中临床病例,分析老年原发性高血压降压方案及并发缺血性脑卒中后的降压措施。结果老年原发性高血压在明确有无脑血管病变前不可盲目、过度降压治疗,并总结了一套处理老年原发性高血压并发缺血性脑卒中的措施。结论老年原发性高血压降压宜平缓;老年原发性高血压并发缺血性脑卒中时在缺乏证据预判保障脑供血的主干血管病变之前,如果收缩压不高于180mm Hg(1mm Hg=0.133kPa),一般不考虑降压处理。

Objective To discuss the antihypertensive management of elderly patients with primary hypertension complicated by cerebral arterial thrombosis. Methods Antihypertensive management of primary hypertension in the elderly and antihypertensive measures to primary hypertension complicated cerebral arterial thrombosis were analyzed through comparing the antihypertensive treatments of 12 cases of primary hypertension complicated by cerebral arterial thrombosis. Results Aimless, excessive antihypertensive treatment must not be considered when there was no definite evidence of cerebrovascular lesions in elderly patients with primary hypertension. In addition, the measures to treat primary hypertension complicated by cerebral arterial thrombosis in the elderly were summarized. Conclusion Blood pressure should be lowered slowly in elderly patients with primary hypertension. Antihypertensive treatment is usually not considered for elderly patients with primary hypertension complicated by cerebral arterial thrombosis, if there is no evidence of lesions of major cerebral arteries and if systolic blood pressure is not higher than 180ram Hg.