Optimal drug treatment of systolic hypertension in the elderly.

摘要: Approximately two-thirds of the elderly population has hypertension, mainly isolated systolic hypertension (ISH) type. However, while large-scale, randomized controlled intervention trials have demonstrated that treatment ISH reduces rates total mortality, cardiovascular mortality and stroke in older hypertensives, control remains poor. The aim this review drug is to provide a succinct, practical clinically orientated guide summarizes international recommendations practices with special emphasis on newer approaches. Knowledge pathophysiological changes subjects (decreased elastic artery compliance, reduced plasma renin activity, increased salt sensitivity) evidence from epidemiological surveys give clear clues thiazide(-like) diuretics long-acting dihydropyridine calcium channel antagonists are drugs choice ISH. Thus, based evidence, American, European guidelines for management still offer best available optimal elderly. Newer combination treatments, especially fixed antagonist an ACE inhibitor, valuable benefits terms efficacy tolerability. Use nitrates added other antihypertensive medications can practising physician further unconventional therapeutic strategy.