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首页> 外文期刊>Drugs and aging >Use of calcium channel antagonists for the treatment of hypertension in the elderly.
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Use of calcium channel antagonists for the treatment of hypertension in the elderly.

机译：钙通道拮抗剂在治疗老年人高血压中的用途。

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Systolic blood pressure and pulse pressure increase continuously throughout adult life and the prevalence of arterial hypertension rises accordingly, reaching 53-78% among those aged 65-74 years. Estimates of the prevalence of isolated systolic hypertension in the elderly range from 34-65%, with more women than men affected. It has been shown that within all age groups a difference in usual systolic blood pressure of 20mm Hg or a difference in usual diastolic blood pressure of 10mm Hg is associated with an approximately 2-fold difference in the risk of dying from stroke or ischaemic heart disease. Intervention trials using predominantly diuretics and/or beta-adrenoceptor antagonists have proven the efficacy and tolerability of antihypertensive treatment in elderly patients.For many years there have been ongoing discussions about the safety of calcium channel antagonists, especially in patients with diabetes mellitus. However, according to a recently published large prospective, randomised, double-blind, controlled clinical trial with more than 33 000 patients enrolled, no indications for increased total mortality, cancer rate or gastrointestinal bleeding for participants on amlodipine, a long-acting dihydropyridine calcium channel antagonist, were found. With calcium channel antagonists, protective effects against cardiovascular disease have been proven in large trials with elderly patients, particularly against stroke. There is good evidence to suggest that calcium channel antagonists may be superior to other antihypertensive agents in diabetic patients with isolated systolic hypertension. These agents are well tolerated and probably delay the progression of dementia. The lack of adverse metabolic effects that, in the case of a diuretic-based regimen, may have important long-term implications concerning cardiovascular risk, make calcium channel antagonists an attractive choice when antihypertensive treatment decisions need to be made in a predominantly overweight or obese elderly population.
机译：收缩压和脉压在整个成年后持续增加，动脉高血压的患病率也相应增加，在65-74岁年龄段的人群中达到53-78％。老年人中单纯收缩期高血压的患病率估计为34-65％，受影响的女性多于男性。研究表明，在所有年龄组中，通常的收缩压差为20mm Hg或通常的舒张压差为10mm Hg与中风或缺血性心脏病死亡的风险大约有2倍相关。主要使用利尿剂和/或β-肾上腺素能受体拮抗剂的干预试验已证明了老年患者抗高血压治疗的有效性和耐受性。多年来，关于钙通道拮抗剂安全性的讨论一直在进行，尤其是在糖尿病患者中。但是，根据最近发表的一项大型前瞻性，随机，双盲，对照临床试验，其中招募了33000多名患者，没有迹象表明氨氯地平（一种长效二氢吡啶类钙）的参与者的总死亡率，癌症发生率或胃肠道出血增加通道拮抗剂，被发现。使用钙离子通道拮抗剂，已在老年患者的大型试验中证明了对心血管疾病的保护作用，尤其是对中风的保护作用。有充分的证据表明，在患有单纯收缩期高血压的糖尿病患者中，钙通道拮抗剂可能优于其他降压药。这些药物耐受性良好，可能会延迟痴呆的发展。在以利尿剂为基础的治疗方案中，缺乏不利的代谢作用可能会长期影响心血管疾病的风险，因此当需要在主要是超重或肥胖的高血压患者中做出抗高血压治疗决定时，钙通道拮抗剂成为有吸引力的选择老年人口。

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