560例老年人高血压的临床特点研究

目的研究本地区老年人高血压的临床特点。方法回顾性分析了560例老年高血压患者的临床资料。结果单纯性收缩期高血压320例(57.1%),脉压差>60mmHg者280例(50%);合并心脑肾损害者376例(67.1%);合并糖尿病者280例(50%);心理障碍者80例(14.2%)。单用一种降压药能控制268例(47.9%),联合两种以上降压药治疗292例(52.1%);因降压较快产生意外的患者为50例(8.9%);死于心脑危害的患者为128例(22.85%)。结论老年单纯性收缩期高血压占的比例较大,且脉压差较大,并发症较多,应用药物对于治疗老年高血压的环节是一个关键的步骤。     

老年人高血压的临床特点分析

目的研究并探讨老年人在患高血压后,临床上的表现和特点。方法选取高血压的老年患者共560例,对他们的临床资料进行回顾性的分析和总结。结果在这560例患者中,有80例患者患有心理障碍;有280例患者是合并糖尿病;有376例患者是合并心、脑、肾、损害;有320名患者收缩期高血压,而且是单纯性的;有280例的患者脉压差高达60 mm Hg(1 mm Hg=0.133 kPa)。在这560名患者中,有128例患者死于心脑的损害;有50例患者产生了意外,原因是降压较快;有292例患者使用两种或两种以上的药物来进行降压;只用一种药物进行降压的患者有268例。结论在高血压的老年患者中,单纯性收缩期的高血压十分多,所占比例也大,并发症也十分多,而且有较大的脉压差。在对老年患者的高血压进行治疗时,最为关键的步骤和方法是药物治疗。     

老年高血压88例临床分析

目的：探讨老年高血压的临床特点，以便尽早对老年高血压进行防治。方法：对来自门诊老年高血压患者88例进行观察分析。结果：患者病程2～30年，无症状30例（34．1％），脉压差〉63mmHg。40例（45．5％）。有合并症者67例（76．1％）；1级高血压43例（48．9％），2级高血压39例（443％），3级高血压6例（6.8％）；单纯收缩期高血压46例（52．3％），混合型高血压42例（47．7％）。结论：老年高血压病程长，起病缓慢，可无症状，合并症多，脉压差大。因此对老年高血压要早诊断、早治疗，才能最大程度地减少心脑血管事件的发生。     

老年高血压与高脂血症的关系探讨

目的：探讨老年高血压与高脂血症之间的关系及用阿托伐他汀降脂治疗后对血压的影响。方法：随机抽查728例50岁以上中、老年人，主要进行血雎与血脂的调查（均排除继发性高血压）．并对再次入围的高血压合并高脂血症的随机40例患者进行5个月的降脂治疗。结果：（1）中、老年人高脂血症的患病率为52．47％，高血压者的患病率为40．52％，其中高脂血症合并高血压者的患病率为23.76％，尤高脂血症的高血压患病率为16．71％，且后两者随年龄的增长而增高。（2）对高脂血症合并高血压患者在原有降压药基础上给予阿托伐他汀治疗后血压较服药前有所下降。结论：揭示了老年高血压与高血脂症的密切关系。阿托伐他汀对高脂血症合并高血压患者在原有降压药的基础上有降压疗效。     

美托洛尔治疗老年收缩期高血压56例疗效分析

我们1994年11月至1996年3月采用美托洛尔治疗老年收缩期高血压56例，现报告如下。临床资料选择老年收缩期高血压（参照Niarchos老年高血压诊断标准）住院病人98例，分美托洛尔治疗组（甲组）56例，男33例，女23例，年龄60～80岁、平均69岁；心痛定治疗组（乙组）42例、男24例、女18例、年龄60～79岁、平均68岁。两组病例均除外心功能1～IV级、刀～K度房室传导阻滞、糖尿病、支气管哮喘、病窦综合征等疾病。治疗前均停用各类降压药及血管活性药5天，甲组予美托洛尔100～200mg／d晨起顿服；乙组予心痛定10～20mg，每日三次，口眼。治疗时可…     

老年单纯性收缩期高血压临床分析

目的观察老年单纯性收缩期高血压临床治疗的疗效。方法随机选取我院门诊及住院的老年单纯性收缩期高血压患者120例,采用药物给予：口服硝酸异山梨酯缓释片及非洛地平片进行治疗。结果经治疗后,120例患者老年单纯性收缩期高血压中,显效人数达113例,无效7例,有效率达94%。结论硝酸异山梨酯缓释片能使收缩压明显下降,舒张压下降不明显,而脉压差明显减小,疗效较为满意,可广泛应用于临床。     

动态血压监测评价苯磺酸氨氯地平和氯沙坦对老年单纯收缩期高血压的降压疗效

目的：应用动态血压监测评价苯磺酸氨氯地平和氯沙坦对老年单纯收缩期高血压的降压疗效及谷峰比值（T／P）。方法：60例老年单纯收缩期高血压患者随机分为2组，即氨氯地平组和氯沙坦组，各30例，分别服药治疗8周，于治疗前后测定动态血压、诊室随测血压、心率、生化指标。结果：治疗8周末，2组的诊室随测血压和24h、白昼及夜间平均收缩压、收缩压负荷值均显著降低（P〈0．05），而心率则无明显变化。8周末，2组的降压总有效率分别为90％和93％。2组降压幅度比较差异无显著性（P〉0．05）。降压T/P比值均大于50％，2组患者出现的不良反应均轻微。结论：氨氯地平与氯沙坦均能平稳、有效、安全地降低老年单纯收缩期高血压，不良反应少，可作为老年单纯收缩期高血压的一线用药。     

硝苯地平控释片治疗老年高血压临床疗效

<正>高血压病是老年人群的常见病和多发病,是心、脑、肾并发症的主要病因。我国老年收缩期高血压试验(Syst-China)的研究证明在老年收缩期高血压患者中,经过降压治疗至少可以减少60%患者病死[1],加强老年高血压患者的血压控制,对保护靶器官,预防心脑事件具有重要意义。1临床资料1.1病例选择2007-05～2007-12笔者所在门诊老年原发性高血压患者42例。男25例,女17例;年龄60～87岁,平均     

氨氯地平联合阿托伐他汀钙片治疗老年性收缩期高血压对脉压的影响和临床观察

目的:研究氨氯地平联合阿托伐他汀治疗老年单纯性收缩期高血压对脉压的影响和临床观察。方法:选择140例老年单纯性收缩期高血压患者随机分成治疗组和对照组,治疗组予以服用氨氯地平及阿托伐他汀钙片,观察组仅予以氨氯地平口服。两组均连续治疗6个月,观察治疗前后两组患者收缩压、舒张压、脉压、低密度脂蛋白的变化并予以比较。结果:治疗6个月后,两组患者均无明显不良反应,血压均有下降,治疗组脉压差小于对照组、LDL-C明显降低,对照组血脂影响基本无变化。结论:氨氯地平联合阿托伐他汀治疗老年单纯性收缩期高血压能有效减少脉压差,降低LDL-C,耐受性良好,适合老年性单纯性收缩期高血压的治疗。     

老年高血压合并多重危险因素患者降压药物的选择

老年高血压主要是指60岁以上老年人的高血压（≥140/90mmHg）,其特点不同于其他年龄的高血压。老年高血压多表现为单纯收缩期高血压,即收缩压≥140mmHg,而舒张压〈90mmHg。老年高血压患者患高血压性心脏病、冠状动脉粥样硬化性心脏病、脑缺血、脑卒中、心力衰竭等心脑血管病的患病率和死亡率明显高于正常血压者。因此,老年单纯收缩期高血压同样应积极治疗,争取早日控制。本文就老年高血压合并多重危险因素患者如何选择降压药物进行深入探讨,旨在为临床工作提供建议和好的治疗方法。     

芥子碱氯化盐的制备及其对自发性高血压大鼠的降压作用

目的利用菜籽粕制备芥子碱氯化盐,探讨其对自发性高血压大鼠(spontaneous hypertension rat,SHR)的降压作用。方法菜籽粕经水提法制备芥子碱硫氰酸盐,用氯型717阴离子交换树脂转换为芥子碱氯化盐,并通过理化性质和波谱数据对其进行结构鉴定。对随机分组的SHR大鼠连续给药28 d,间隔4 d测定其收缩压、舒张压、平均脉压和心率。结果采用1H-NMR、13C-NMR和IR法鉴定芥子碱硫氰酸盐与芥子碱氯化盐,HPLC归一化法测定芥子碱氯化盐纯度质量分数达99%。芥子碱氯化盐能显著降低SHR大鼠的收缩压、舒张压和平均脉压(P<0.05～0.01),但对心率无明显影响。结论该制备工艺简单,所得产品纯度高,对SHR大鼠降压作用显著,具备较好的药物开发前景。     

脉压差在原发性高血压患者并发冠心病诊断中的意义分析

目的：探讨脉压差在原发性高血压患者发生冠心病诊断中的临床价值。方法选择2013年1月至2015年6月收治的原发性高血压住院患者677例,按照冠状动脉造影(CAG)结果分为研究组(存在冠心病患者)350例和对照组(未合并冠心病患者)327例,比较两组收缩压、舒张压、脉压差等一般情况。将研究组根据不同脉压差(≥60mmHg和<60mmHg)进行分组,比较冠状动脉病变支数、长度和左心室射血分数( LVEF)。结果研究组和对照组年龄、男性比例、收缩压、脉压差比较差异均有统计学意义(P<0.05)。两组吸烟比例、舒张压比较,差异无统计学意义(P>0.05)。脉压差≥60 mmHg组冠状动脉双支及以上病变增多、病变长度增加、LVEF<50%比例增加,差异均有统计学意义(P<0.05)。结论脉压差对冠状动脉的病变有指示意义,且差值越大,病变越严重,心功能越差,这在早期诊断心功能不全、冠心病中具有很大的意义。     

Epidemiology of hypertension in the elderly.

Epidemiological studies confirm that hypertension, particularly systolic hypertension, is a major cardiovascular and cerebrovascular risk factor in the elderly. Clinical trials convincingly demonstrate the benefits of treating both diastolic hypertension in persons up to age 80 years, and isolated systolic hypertension in persons over age 60. The European Working Party on Hypertension in the Elderly (EWPHE) trial showed that reducing elevated blood pressure resulted in a 27% reduction in overall cardiovascular mortality, as well as significant reductions in severe congestive heart failure, strokes and deaths from myocardial infarction. The Systolic Hypertension in the Elderly Program (SHEP) also reported a 36% reduction in the incidence of stroke and decreases in cardiovascular events, including myocardial infarctions, when hypertension was treated. Additional EWPHE data suggest that the optimal level of systolic blood pressure control is between 146 and 158mm Hg, while patients in the SHEP trial with isolated systolic hypertension derived benefits at an average treated systolic blood pressure of 143mm Hg. Elderly study populations comply well with antihypertensive treatment, and blood pressure can be safely lowered with simple drug regimens. Nonpharmacological treatment is recommended for initial treatment of mild diastolic hypertension and isolated systolic hypertension, and as adjuvant treatment with medication. Since all antihypertensive agents can lower blood pressure in the elderly, therapy should be chosen based on its potential for side effects, drug interactions and effects on concomitant disease states.     

Hypotensive effect of oxprenolol in mild to moderate hypertension: a multicentre controlled study

Summary In a multicentre, double-blind, between-patient study the hypotensive effect of oxprenolol was investigated in 329 patients with mild to moderate hypertension. A factorial experimental design with three factors was chosen: oxprenolol — none or daily doses of 20, 40, 60 and 80 mg; dihydralazine and hydrochlorothiazide, respectively, none or 30 mg daily. Each treatment was given for 4 weeks after an adequate period of withdrawal from any other possible hypotensive therapy and one week of placebo wash-out. Irrespective of the association with dihydralazine and/or hydrochlorothiazide, oxprenolol had a hypotensive effect linearly related to dose for standing systolic (P<0.05) and diastolic (P<0.01) pressure, and for lying diastolic (P<0.05) pressure. The addition of dihydralazine enhanced the time-course of the hypotensive effect of oxprenolol, particularly the 80 mg dose level. In general, the combination of oxprenolol with dihydralazine and hydrochlorothiazide caused larger reductions in blood pressure, particularly with oxprenolol 80 mg. In the latter group, the eventual falls in blood pressure were 30.5 and 14.4 mmHg for lying systolic and diastolic, respectively; and 32.1 and 20.0 mmHg for the standing systolic and diastolic pressures. The drug was well tolerated; major side effects (heart failure and bronchospasm) occurred in three patients.A brief communication on this study was presented at the Second Meeting of the International Society on Hypertension, Milan, Sept. 20 – 23, 1972     

Combined labetalol plus flunarizine treatment for arterial hypertension

Forty-one patients (21 males and 20 females) suffering from arterial hypertension associated with peripheral and cerebral vascular distress were treated for a period of 60 days with an extempore combination of labetalol (an antihypertensive drug with an alpha- and beta-blocking action) and flunarizine (a calcium-antagonist). Changes in supine and standing arterial blood pressure and in supine heart rate were evaluated periodically. Haematological and urinary controls of a number of biomedical indices were performed in basal conditions and after 60 days. The combination was found to show a rapid efficacy in the entire patient group: both supine and standing systolic and diastolic blood were significantly reduced as early as the tenth day of treatment. No significant changes in heart rate were observed. The combination revealed neither orthostatic hypotensive effects nor side-effects of such a degree of severity as to require reduction of the dose or discontinuation of the treatment.     

Comparison of the haemodynamic effects of bucindolol, propranolol and pindolol in healthy volunteers.

The effects of single oral doses of bucindolol (50, 100, 200 and 400 mg), pindolol (10 mg), propranolol (160 mg) and placebo on arterial pressure and heart rate in the supine and standing positions and exercise heart rate were compared in 12 healthy male volunteers. Supine heart rate was significantly greater after all four doses of bucindolol and pindolol in comparison to propranolol. Bucindolol had no significant effect on standing heart rate which was significantly reduced by pindolol and propranolol. Bucindolol, pindolol and propranolol significantly reduced an exercise tachycardia for at least 24 h after drug administration. Supine systolic pressure was not affected by any treatment but supine diastolic pressure was significantly reduced by bucindolol (200 and 400 mg) and by pindolol. All doses of bucindolol, propranolol and pindolol significantly reduced standing systolic blood pressure. There was a significant linear trend for reductions in standing systolic blood pressure and increasing doses of bucindolol. Standing diastolic blood pressure was significantly reduced by bucindolol 200 and 400 mg. Faintness and light headedness occurred in 6 of 12 subjects after 200 mg bucindolol and in 8 of 10 subjects after 400 bucindolol. After bucindolol, analysis of plasma samples demonstrated the presence of bucindolol, 5-hydroxy and 6-hydroxy bucindolol and indolyl-t-butylamine. These observations indicate that in man, bucindolol is a beta-adrenoceptor blocking drug with hypotensive activity and probably partial agonist activity. It is unlikely that the hypotensive effects result from blockade of beta-adrenoceptors or from the drug's partial agonist activity.     

地尔硫静脉滴注治疗高血压急症

目的：观察地尔硫静脉滴注治疗高血压急症的疗效。方法：３２例病人（男性２１例，女性１１例，年龄５７±ｓ１４ａ），以地尔硫５０ｍｇ加于５％葡萄糖注射液２５０ｍＬ中静脉滴注，于６０～１２０ｍｉｎ滴完。结果：观察血压总有效率为９０％，在用药后５ｍｉｎ血压已开始下降，在１５～２０ｍｉｎ时已降至正常。结论：本品为治疗高血压急症的安全有效降压药。     

社区高血压患者收缩压和脉压差增高与C-反应蛋白的相关性分析

目的探讨社区高血压患者收缩压和脉压差增高与C-反应蛋白之间的相关性。方法选择443例原发性高血压C-反应蛋白升高患者,探讨社区高血压患者收缩压和脉压差增高与C-反应蛋白之间的关系。结果收缩压超过160mmHg、脉压差超过60mmHg、合并糖尿病、合并冠心病及合并高脂血症等为高血压发生的相关危险因素,收缩压超过160mmHg及脉压差超过60mmHg为高血压发生的独立危险因素。结论社区高血压患者收缩压升高和脉压差增大与C-反应蛋白升高存在相关性,炎症反应参与老年高血压收缩压升高和脉压差增大。     

The antihypertensive effect of lexotan (bromazepam)- a new benzodiazepine derivative.

Clinical observations led to the assumption that there is an antihypertensive effect of bromazepam in patients suffering from mild benign hypertension. Because of this observation we studied the antihypertensive effect of bromazepam by means of a standardized simple submaximal ergometric load performed weekly over a 4-week period of observation. A control group of 68 hypertensive patients without any drug therapy but under active physical training combined with physiotherapy and medicinal baths showed only a slight decrease in systolic and diastolic blood pressure at rest (about 4%). Furthermore, the pulse frequency did not change. In contrast, there was a distinct and significant decrease in blood pressure at rest and during exercise after a 3-week period of additional treatment with bromazepam, especially in hypertensive patients. One group of 68 hypertensive patients receiving 9 mg bromazepam daily showed a mean reduction in blood pressure by 14.4% systolic and 12.7% diastolic at rest, and during exercise by 7.5% systolic and 6.8% diastolic. The heart remained practically unchanged. A somewhat slighter decrease of the blood pressure values was seen in an additional group of 31 hypertensive patients receiving 6 mg bromazepam per day and in a group of 30 normotensive patients receiving 9 mg bromazepam daily. The calculated indices such as the product of heart rate and mean systolic pressure and the tension time index in the groups receiving bromazepam pointed to a better economic work performance under reduced myocardial pressure effort and reduced oxygen demand on the myocardium. The possible action of bromazepam in reducing blood pressure will be discussed.