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如何降压更好,高龄老人如何降压

  对于高血压患者来说,降低血压是一个永恒的话题。

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

  如何降压更好

  将收缩压降至140毫米汞柱就足够了,还是将收缩压降至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?

  这个问题的答案一直存有争议。

  The answer has always been controversial.

  有人担忧,强化降压虽然能更好地保护心血管,却可能损害大脑健康,增加患痴呆的风险。

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

  高龄老人如何降压

  近日,美国国立卫生研究院开展的一项研究探究了强化降压和标准降压对大脑的保护作用。

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

  强化降低收缩压治疗是以把收缩压降到<120毫米汞柱为目标,标准降低收缩压治疗是以把收缩压降到<140 毫米汞柱为目标。

  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.

  新研究显示,在50岁以上高血压患者中,与标准降压相比,强化降压与脑白质病变体积增加较小和总脑容量降低较多显著相关。

  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.

  也就是说,相比把血压降到140毫米汞柱以下,降到120毫米汞柱能更好地保护大脑健康和认知。

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

纽约时报中英文网 http://www.qqenglish.com/

  不过,老年人作为合并多种疾病的特殊群体,其血压目标值仍需要基于患者整体的风险来制定,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".

  老年人患高血压一般具有几个特点:高压高,低压正常;

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

  脉压(收缩压和舒张压之间的差值)增大;

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

  血压波动大,易发生体位性低血压,常合并餐后低血压;

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

  并发症多;

  More complications;

  继发性高血压易漏诊;

  Secondary hypertension is easy to be missed;

  盐敏感性更强。

  Salt is more sensitive.

  基于这些特点,医生在面对老年高血压患者时,一般不会都按照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.

  医生会结合高血压指南,给老人降压提出以下建议。

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

  65~79岁者,应将血压控制在150/90毫米汞柱以下,如果老人没有不舒服,还需要继续降到140/90毫米汞柱以下。

纽约时报中英文网 http://www.qqenglish.com

  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岁以上老人,应将血压保持在150/90毫米汞柱以下,尤其是收缩压要控制在140~150毫米汞柱之间,不建议强化降压。

  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.

  高龄老年人常合并脑供血不足,血压可以适当放宽,不能强行按照140/90毫米汞柱来降压。

  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.

  由于老年高血压患者多合并其他慢性疾病,药物选择应从小剂量开始,逐渐加量,若降压太快,会导致脑梗塞。

  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,非选择性β受体阻滞剂有使气管收缩的可能性,合并慢性阻塞性肺疾病及II度以上心脏传导阻滞者,应避免使用β受体阻滞剂;

  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.

  合并痛风、明显低钠或低钾血症者慎用利尿剂。

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

  而且,利尿剂可能引起代谢紊乱、血尿酸增高、低钾低钠、低血容量而升高血糖,因此糖尿病患者不建议首选利尿剂;

  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.

  合并前列腺肥大导致排尿困难但无体位性低血压者,可酌情选用α受体阻滞剂;

  Concomitant prostatic hypertrophy leads to dysuria but without postural hypotension.

  使用非激素类抗炎药可能引起钠潴留而加重高血压,患者可选择小剂量利尿剂联合应用。

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

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