论文部分内容阅读
老年高血压的特点是半数以上以收缩压升高为主。其血液动力学特点常取决于高血压的类型,属舒张压型高血压者常有心排出量降低及外周血管阻力增高;而收缩压升高为主者心排出量和外周血管阻力多属正常,且多属低肾素型高血压。治疗一般采用阶梯疗法,舒张压宜控制在100mmHg 以下,收缩压≥180mmHg 无论有无症状均需降压治疗。首选利尿剂,其次是钙拮抗荆。β阻滞剂降压作用较差,且副作用多,故应用较少。上述药物无效时可采用交感神经阻滞剂如甲基多巴、可乐宁等。除非收缩压和舒张压均很高,一般情况下不宜采用强烈降压药,尤其是静脉给药.
Elderly hypertension is characterized by more than half of the systolic blood pressure-based. Its hemodynamic characteristics often depend on the type of hypertension, diastolic hypertension often have decreased cardiac output and peripheral vascular resistance increased; and systolic blood pressure-based cardiac output and peripheral vascular resistance are mostly normal, And mostly belong to low renin hypertension. Treatment generally use the ladder therapy, diastolic pressure should be controlled at 100mmHg below, systolic blood pressure ≥ 180mmHg regardless of asymptomatic need antihypertensive treatment. Diuretics preferred, followed by calcium antagonist Jing. β-blocker antihypertensive effect is poor, and side effects and more, so less used. Sympathetic nerve blockers such as methyldopa, clonidine and the like can be used when the above drugs are ineffective. Unless systolic and diastolic blood pressure are high, under normal circumstances should not be used strongly antihypertensive drugs, especially intravenous administration.