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如何降壓更好,高齡老人如何降壓

  對于高血壓患者來說,降低血壓是一個永恒的話題。

  For people with high blood pressure, lowering blood pressure is a permanent topic.

  如何降壓更好

  將收縮壓降至140毫米汞柱就足夠了,還是將收縮壓降至120毫米汞柱以下更好?

  Is it better to reduce the systolic blood pressure to 140 MMHG or to 120 MMHG?

  這個問題的答案一直存有爭議。

  The answer has always been controversial.

  有人擔憂,強化降壓雖然能更好地保護心血管,卻可能損害大腦健康,增加患癡呆的風險。

  There are concerns that strengthening blood pressure, while better at protecting the cardiovascular system, could damage brain health and increase the risk of dementia.

  高齡老人如何降壓

  近日,美國國立衛生研究院開展的一項研究探究了強化降壓和標準降壓對大腦的保護作用。

  A recent study from the national institutes of health explored the protective effects of enhanced and standard blood pressure on the brain.

  強化降低收縮壓治療是以把收縮壓降到<120毫米汞柱為目標,標準降低收縮壓治療是以把收縮壓降到<140 毫米汞柱為目標。

  Intensive systolic blood pressure reduction therapy aims to reduce the systolic blood pressure to < 120 mm hg, while standard systolic blood pressure reduction therapy aims to reduce the systolic blood pressure to < 140 mm hg.

  新研究顯示,在50歲以上高血壓患者中,與標準降壓相比,強化降壓與腦白質病變體積增加較小和總腦容量降低較多顯著相關。

  The new study shows that in patients over 50 years of age with hypertension, enhanced hypotension is significantly associated with a smaller increase in leukodystrophy volume and a larger decrease in total brain volume, compared with standard hypotension.

  也就是說,相比把血壓降到140毫米汞柱以下,降到120毫米汞柱能更好地保護大腦健康和認知。

  That is, lowering blood pressure to 120 MMHG is better for brain health and cognition than lowering it to 140 MMHG or less.

紐約時報中英文網 http://www.244129.buzz/

  不過,老年人作為合并多種疾病的特殊群體,其血壓目標值仍需要基于患者整體的風險來制定,而非“越低越好”。

  However, as a special group with multiple diseases, the blood pressure target of the elderly still needs to be set based on the overall risk of the patient, rather than "lower is better".

  老年人患高血壓一般具有幾個特點:高壓高,低壓正常;

  Hypertension in the elderly generally has several characteristics: high pressure, low pressure normal;

  脈壓(收縮壓和舒張壓之間的差值)增大;

  Increased pulse pressure (the difference between systolic and diastolic blood pressure);

  血壓波動大,易發生體位性低血壓,常合并餐后低血壓;

  Blood pressure fluctuates greatly, prone to postural hypotension, often combined with postprandial hypotension;

  并發癥多;

  More complications;

  繼發性高血壓易漏診;

  Secondary hypertension is easy to be missed;

  鹽敏感性更強。

  Salt is more sensitive.

  基于這些特點,醫生在面對老年高血壓患者時,一般不會都按照120毫米汞柱要求每位老人。

  Based on these characteristics, doctors in the face of elderly patients with hypertension, generally do not follow the 120 MMHG requirements for each elderly.

  醫生會結合高血壓指南,給老人降壓提出以下建議。

  The doctor will combine hypertension guidelines, to the elderly antihypertensive proposed the following recommendations.

  65~79歲者,應將血壓控制在150/90毫米汞柱以下,如果老人沒有不舒服,還需要繼續降到140/90毫米汞柱以下。

紐約時報中英文網 http://www.244129.buzz

  People aged 65 to 79 should keep their blood pressure below 150/90 MMHG. If the elderly do not feel ill, they need to keep their blood pressure below 140/90 MMHG.

  如果能耐受,可以降到120毫米汞柱左右。

  If tolerated, it can be reduced to about 120 MMHG.

  80歲以上老人,應將血壓保持在150/90毫米汞柱以下,尤其是收縮壓要控制在140~150毫米汞柱之間,不建議強化降壓。

  People over 80 years old should keep their blood pressure below 150/90 MMHG, especially the systolic blood pressure should be controlled between 140-150 MMHG.

  高齡老年人常合并腦供血不足,血壓可以適當放寬,不能強行按照140/90毫米汞柱來降壓。

  Old age old person often amalgamates cerebrum to supply blood to be short of, blood pressure can be relaxed appropriately, cannot force according to 140/90 millimeter amalgam will fall pressure.

  由于老年高血壓患者多合并其他慢性疾病,藥物選擇應從小劑量開始,逐漸加量,若降壓太快,會導致腦梗塞。

  As elderly patients with hypertension are often associated with other chronic diseases, the choice of drugs should start with a small dose and gradually increase the amount.

  此外,非選擇性β受體阻滯劑有使氣管收縮的可能性,合并慢性阻塞性肺疾病及II度以上心臟傳導阻滯者,應避免使用β受體阻滯劑;

  In addition, non-selective beta blockers have the possibility of tracheal constriction. Patients with chronic obstructive pulmonary disease and grade II or above heart block should avoid beta blockers.

  合并痛風、明顯低鈉或低鉀血癥者慎用利尿劑。

  Diuretics should be used with caution in patients with gout, significantly low sodium or hypokalemia.

  而且,利尿劑可能引起代謝紊亂、血尿酸增高、低鉀低鈉、低血容量而升高血糖,因此糖尿病患者不建議首選利尿劑;

  In addition, diuretics may cause metabolic disorders, increased blood uric acid, low potassium, low sodium, low blood volume and increase blood glucose. Therefore, diuretics are not recommended as the first choice for diabetics.

  合并前列腺肥大導致排尿困難但無體位性低血壓者,可酌情選用α受體阻滯劑;

  Concomitant prostatic hypertrophy leads to dysuria but without postural hypotension.

  使用非激素類抗炎藥可能引起鈉潴留而加重高血壓,患者可選擇小劑量利尿劑聯合應用。

  The use of non-hormonal anti-inflammatory drugs may cause sodium retention and aggravate hypertension.

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