2011ACCF/AHA老年高血壓專家共識
《2011ACCF/AHA老年高血壓專家共識》內(nèi)容簡介：
This document was written with the intent to be a completereference at the time of publication on the topic of managinghypertension in the elderly. Given the length of the document,the writing committee included this executive summary toprovide a quick reference for the busy clinician. Becauseadditional detail is needed, please refer to the sections ofinterest in the main text. The tables and figures in thedocument also delineate important considerations on thistopic, including the treatment algorithm in Section 4.2.2.1.
《2011ACCF/AHA老年高血壓專家共識》內(nèi)容預覽：
End-Organ Effects
The following are highly prevalent among the elderly andassociated with poor blood pressure （BP） control: cerebro-vascular disease （ischemic stroke, cerebral hemorrhage, vas-cular dementia, Alzheimer's disease, and accelerated cogni-tive decline）； CAD （including myocardial infarction [MI]and angina pectoris）； disorders of left ventricular （LV）structure and function （including LVH and heart failure[HF]）； cardiac rhythm disorders （atrial fibrillation [AF] andsudden death）； aortic and pe**heral arterial disease [PAD]）（including abdominal aortic aneurysm [AAA], thoracicaortic aneurysm, acute aortic dissection and occlusive PAD）；CKD （estimated glomerular filtration rate [eGFR] 60mL/min/1.73 m2; ophthalmologic disorders （including hy-pertensive retinopathy, retinal artery occlusion, nonarteriticanterior ischemic optic neuropathy, age-related maculardegeneration, and neovascular age-related macular degen-eration）； and quality of life （QoL） issues.
Considerations for Drug Therapy
Drug treatment for elderly hypertensive patients has beengenerally recommended but with a greater degree of cautiondue to alterations in drug distribution and disposal andchanges in homeostatic CV control, as well as QoL factors.However, patients in most hypertension trials were 80years of age. Pooling the limited number of octogenarians fromseveral trials mainly composed of younger patients, treatedpatients showed a reduction in both stroke and CV morbidity,but a trend toward increased all-cause mortality compared tocontrols. Thus, the overall benefits of treating octogenariansremain unclear despite epidemiological evidence that hyper-tension remains a potent CV risk factor in this age group.Results of HYVET, documenting reduced adverse outcomeswith antihypertensive drugs in persons 80 years of age,requires updating previous recommendations.
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