从近期新指南看老年高血压治疗的新趋势

New trends emerged from the latest guidelines on hypertension treatments of the elderly

近年来,各国指南关于老年人高血压的治疗目标值仍然存在争议。本文比较了最新国际指南关于老年高血压控制的目标值和临床试验证据,以探讨老年高血压治疗的新趋势。根据现有循证医学证据,可将老年人群血压控制在150/90mmHg(1mmHg=0.133kPa)以内。老年人高血压监测要多样化,降压目标应个体化,药物选择要优化,遵循个体化原则,平稳、和缓、持久、简化、优化的降压方案是老年高血压治疗的基本策略。

In recent years, the guidelines on hypertension treatments of the elderly have been various from country to country, and the opinions on the optimal blood pressure （BP） goal remain inconclusive. This review discussed the latest evidence derived from different guidelines which investigated the BP goal and preferred treat- ments to reveal the new trends of the hypertension treatments of the elderly. According to the relevant evidence of Evidence-based Medicine （EBM）, BP can be controlled below 150/90mmHg in the elderly population. However, the optimal BP goal should be individualized. Meanwhile, the application of antihypertensive therapy for the elderly should also follow the principle of being individualized, and the approaches of BP monitoring should be diversified. The basic strategies of the antihypertensive treatments for the elderly ought to be smooth, gentle, lasting, simplified and optimal for the elderly patients.