Advances in Clinical and Experimental Medicine

Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 3, May-June, p. 521–526

Publication type: review article

Language: Polish

Creative Commons BY-NC-ND 3.0 Open Access

Skurczowe nadciśnienie tętnicze u osób w wieku podeszłym – kontrowersje i wskazania do leczenia

Systolic Hypertension in Older Persons – Controversies and Indications for Treatment

Zdzisław Juszczyk1,

1 Szpital w Białej Prudnickiej

Streszczenie

Nadciśnienie skurczowe rozpoznaje się wówczas, gdy wysokość ciśnienia skurczowego wynosi co najmniej 140 mm Hg, a wysokość ciśnienia rozkurczowego nie przekracza 90 mm Hg. Choroba ta jest ważnym problemem społecznym, ponieważ w krajach zachodnich stwierdzano ją u 60–80% populacji osób w wieku powyżej 65 lat i bardziej niż nadciśnienie rozkurczowe zwiększa zagrożenia takimi powikłaniami sercowo−naczyniowymi, jak: choroba niedokrwienna serca, udar mózgu lub niewydolność krążenia. W artykule przedstawiono zasady leczenia skurczowego nadciśnienia tętniczego i kontrowersje związane z leczeniem chorych na nadciśnienie „białego fartucha” i chorych w wieku powyżej j 85 lat. 0ceniono również, czy duże wartości ciśnienia tętna zwiększają u chorych na nadciśnienie skurczowe częstość występowania powikłań sercowo−naczyniowych.

Abstract

Systolic hypertension defined as systolic blood pressure of at least 140 mm Hg, and diastolic blood pressure of less than 90 mm Hg is a major public health issue, because in westernized societies 60–80% of people older than 65 years were hypertensive, and systolic hypertension is a more important cardiovascular risk factor than diastolic hypertension, as coronary heart disease, stroke and heart failure. Consequently, the control of systolic blood pressure should be the focus of treatment in this population. In this article several clinically pertinent issues were considered, including what is the management for older persons with hypertension, what is the evidence for treating patients older than 85 years, whether “white coat” hypertension should be treated, and what is the risk of causing widened pulse pressure during treating systolic hypertension.

Słowa kluczowe

podeszły wiek, nadciśnienie skurczowe, leczenie

Key words

elderly, systolic hypertension, treatment

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