Elderly Hypertension - Epidemiology in Chinese Populations

Kai-Hsiang Chang ； Chih-Hsuan Yen

《海峽循環醫學雜誌》 1卷1期 (2019/01) Pp. 27-35

https://doi.org/10.6907/SCJ.201901_1(1).0004

摘要

Hypertension is the most prevalent risk factor for cardiovascular disease in elder patients (60-79 years of age) and elderly patients (≥ 80 years of age). The Incidence rate increases with age, approaching 90% in the whole life span. Hypertension may cause brain damage, heart and renal failure events, and costs a great deal of health care budget. Systolic blood pressure (SBP) rises with the aging process, although the diastolic blood pressure (DBP) plateaus declines gradually since around 50 years of age, especially in older females; in another word, isolated systolic hypertension (ISH) with wide pulse pressure (PP) is related to old age, meaning patients with less compliant vessels and more co-morbidities. From a clinician's perspective, effective antihypertensive therapy should achieve the goal of simultaneously lower both SBP and PP. The drug deemed best suited to be prescribed primarily to patients with ISH is still debatable. Previous meta-analysis data concluded that all classes of commonly-used anti-hypertensive agents were equally successful in reducing the risk of ischemic heart disease and stroke events except beta-blockers (mainly atenolol). Cooperation between physicians and old hypertensive patients is the key to achieving the maximum benefit of any prescribed regimen.

關鍵字

elderly ； hypertension ； isolated systolic hypertension ； pulse pressure ； antihypertensive treatment