357例老年单纯收缩期高血压患者的降压治疗

目的：了解住院老年单纯收缩期高血压人群的治疗现状及达标率，探讨治疗合理性。方法：回顾性调查357例住院老年单纯收缩期高血压患者降压治疗情况，评估治疗效果。结果：各类常用降压药物使用频率分别为：钙离子拮抗药（CCB）64.15%，血管紧张素转换酶抑制药（ACEI）32.77%，利尿药26.33%，β受体阻断药（BB）25.77%，血管紧张素Ⅱ受体阻断药（ARB）23.81%，α受体阻断药4.20%。单剂药物治疗方案占42.86%，联合药物治疗方案占57.14%，其中不含利尿药的联合药物治疗组合占40.62%，含利尿药的联合药物治疗组合占16.53%。收缩压达标率为67.79%。舒张压≤70 mmHg发生率为26.89%，其中8例发生心肌缺血事件。结论：合理的降压药物和治疗方案的选择能够提高老年单纯收缩期高血压患者的达标率。努力达标的同时，应避免过度降低舒张压。

Antihypertensive therapy in 357 inpatients ofelderly isolated systolic hypertension

OBJECTIVE: To determine the therapeutic status and rate of reaching target blood pressure in elderly isolated systolic hypertension (EISH) patients who were hospitalized and to discuss the rationality of the drug therapy. METHODS: Three hundred and fifty-seven EISH inpatients were investigated retrospectively. The frequencies of using antihypertensive drugs and the strategy of drug therapy programs were calculated. The drug efficacies were assessed among various drug therapy groups. RESULTS: The frequencies of using antihypertensive medicine categories were calcium channel blocker (CCB) 64. 15%, angiotensin-converting enzyme inhibitor (ACEI) 32.77%, diuretics 26.33%, beta-blocker (BB) 25.77%, angiotensin receptor blocker (ARB) 23.81%, and alpha-blocker 4.20%, respectively. Among the 357 cases 42.86% were treated with monotherapy while 57.14% with combined therapy. Among the combination therapy groups, the diuretic-based multiple therapy occupied 16.53%, and the non-diuretic-based multiple therapy held 40.62%. The systolic blood pressure control rate was 67.79%. The rate of diastolic blood pressure < or = 70 mmHg was 26.89%, 8 cases of them occurred myocardial ischemia. CONCLUSION: How to select the optimal antihypertensive drug therapy for EISH patients is important in achieving the blood pressure goal. While thinking over intervention at lower blood pressure levels to achieve target goals, physicians should prevent from excessively lowering the diastolic blood pressure.