老年单纯收缩期高血压诊疗新进展.pptVIP

老年单纯收缩期高血压诊疗新进展 首都医科大学宣武医院 华 琦 老年高血压 临床特征 单纯收缩期高血压 并发症多而且严重 白大衣高血压和假性高血压 血压波动大 ISH降压治疗的获益 (Syst-Eur) 4,695 patients with ISH CCB vs placebo (median FU of 2 years) SHEP 4,736 patients with ISH diuretic-based antihypertensive vs placebo (mean FU of 4.5 years) Syst-China - 2,394 patients,- mean age 66.5 years, - SBP 160-219 mm Hg - DBP 95 mm Hg Treatment regimen: Nitrendipine, plus captopril, and/or hydrochlorothiazide, if necessary to reach target SBP 150 mm Hg, or placebo 老年ISH降压治疗注意事项 逐步降低血压，避免降压过快 尽量避免体位性低血压 结合危险因素及靶器官损害选择降压药物，确定降压目标值 关注药物不良反应 降压治疗的目的