In the face of the common problem of hypertension in the elderly, it is particularly important to identify its unique characteristics. As we age, the physiological structure and function of the human body changes, and these changes pose particular challenges to the management of hypertension. The purpose of this article is to explore the characteristics of hypertension in the elderly, how to choose drugs scientifically, and the key points that should be paid attention to in daily life.
1. The unique characteristics of hypertension in the elderly
Increased blood pressure volatility: The elderly have large blood pressure fluctuations, and are easily affected by environment, emotions and other factors, and blood pressure instability increases.
Decreased diastolic blood pressure versus increased systolic blood pressure: As we age, blood vessel elasticity decreases, resulting in a slight or constant decrease in diastolic blood pressure and a persistent increase in systolic blood pressure.
Many concomitant diseases: elderly patients with hypertension often have other chronic diseases, such as diabetes, heart disease, kidney disease, etc., which should be considered comprehensively in treatment.
Second, the principle of drug selection
Individualized treatment: Individualized drug selection is based on the patient's specific situation, such as age, concomitant diseases, drug tolerance, and other factors.
Small starting dose: Considering the reduced ability to metabolize and excrete drugs in older adults, treatment should be started at a low dose and titrated to ideal blood pressure control.
Multi-drug use: When blood pressure is difficult to control with a single drug, a low-dose multidrug combination strategy may be considered to reduce the risk of side effects.
3. Types and selection of commonly used drugs
Diuretics: suitable for the elderly with heart disease and renal insufficiency, can help reduce edema.
Calcium channel blockers: effective in lowering blood pressure in the elderly, especially in patients with significantly elevated systolic blood pressure.
ACE inhibitors/ARBs: suitable for older patients with diabetes mellitus or chronic kidney disease, and have a protective effect on the heart and kidneys.
4. Suggestions for daily life management
Monitor blood pressure: Monitor your blood pressure regularly at home and adjust your treatment plan in a timely manner.
Eat a healthy diet: Reduce salt intake, increase the proportion of vegetables and fruits, and maintain a balanced diet.
Moderate exercise: Choose a suitable exercise method according to your personal situation, such as walking, tai chi, etc., at least 150 minutes per week.
Weight control: Maintain a healthy weight and avoid obesity.
Quit smoking and limit alcohol: Avoid smoking and excessive alcohol consumption to reduce the negative effects on blood pressure.
The management of hypertension in the elderly is a comprehensive challenge, which requires consideration of unique physiological characteristics, rational selection of drugs, and lifestyle adjustment. Through comprehensive treatment strategies, hypertension in the elderly can be effectively controlled and quality of life can be improved. The support of family members and good communication between doctors and patients are essential to achieve blood pressure control goals.