83例老年药源性高血压的临床分析

Clinic analysis in 83 cases of elderly patients with drug-induced hypertension

目的:探讨老年药源性高血压的临床特点、发病规律,为临床老年患者用药提供相关的参考依据。方法:回顾分析2011年1月—2012年12月医院老年科诊治的83例老年药源性高血压。结果:引起老年药源性高血压的药物有25种药物,其中以糖皮质激素类药物最为常见,占27.7%,其次是促红素,占总数的14.5%,以及非甾体类抗炎药和影响中枢神经的药物,各占13.3%。此外,中药制剂、血管生成抑制剂、含钠药物等也可导致药源性高血压。老年药源性高血压的临床症状与原发性高血压类似,但以高血压3级为主,收缩压平均增高幅度在(37.3±19.5)mmHg,舒张压平均增高的幅度在(12.0±9.9)mmHg。结论:老年药源性高血压在临床上并不少见,对于可能导致高血压的药物,用药时需要加强血压的监测,一旦发生药源性高血压,尽可能地撤药或更换其他药物。

OBJECTIVE To investigate the clinical features, pathogenesis in elderly patients with drug-induced hypertension. METHODS Retrospective analysis was performed in 83 cases of elderly patients with drug-induced hypertension between Jan. 2011 and Dec. 2（112. RESULTS Drug-induced hypertension was caused by 25 kinds of drugs in these patients. Glucocorticoid was the most common of these drugs,accounting for 27. 7%. The second was erythropoietin,accounting for 14. 5 %. 13. 3% of drug-induced hypertension patients were induced by non-steroidal anti-inflammatory drugs and the drugs impacting central nerv ous system. In addition, drug-induced hypertension could be induced by Chinese medicine, angiogenesis inhibitors, and some drugs with sodium. Clinical symptoms of drug-induced hypertension in the elderly were similar to primary hypertension, but most of them showed hypertension grade 3. The average increase was （37. 3 ± 19. 5） mmHg in systolic blood pressure and was （12. 0 ±9. 9） mmHg in diastolic blood pressure. CONCLUSION Drug-induced hypertension is not scarce in elderly patients. Blood pressure should be monitored in elderly patients using these drugs. Once drug-induced hypertension was observed, these drugs should be withdrawn or replaced as much as possible.