ГИПЕРТЕНЗИЯ У ПОЖИЛЫХ
Abstract
Гипертония у пожилых людей связана с неблагоприятными сердечно-сосудистыми исходами, такими как сердечная недостаточность, инсульт, инфаркт миокарда и смерть. Глобальное бремя гипертонии увеличивается из-за старения населения и растущей распространенности ожирения, и, по оценкам, к 2025 году оно затронет одну треть населения мира. Неблагоприятные последствия для пожилых людей усугубляются механическими гемодинамическими изменениями, жесткостью артерий, нейрогормональными и вегетативными нарушениями. нарушение регуляции и снижение функции почек. В этом обзоре освещаются текущие данные и обобщаются последние рекомендации по гипертонии, относящиеся к пожилым людям. Стратегии ведения гипертонии у пожилых людей должны учитывать степень слабости, все более сложные сопутствующие заболевания и психосоциальные факторы и, следовательно, должны быть индивидуализированы. Следует поощрять нефармакологические изменения образа жизни для снижения риска развития гипертонии, а также в качестве дополнительной терапии для снижения потребности в лекарствах. Фармакологическая терапия диуретиками, блокаторами ренин-ангиотензиновой системы и блокаторами кальциевых каналов показала положительный эффект на сердечно-сосудистые исходы у пожилых пациентов. Учитывая бремя гипертонии для экономики и общественного здравоохранения в США и во всем мире, крайне важно заняться изменением образа жизни молодого поколения, чтобы предотвратить гипертонию с возрастом.
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