Author/Editor		Dobovišek, Jurij
Title		Značilnosti arterijske hipertenzije v starosti
Translated title		Characteristics of arterial hypertension in old age
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 36, št. 9-10
Publication year		1997
Volume		str. 327-32
Language		slo
Abstract		The prevalence of population over 65 years of age is increasing in developed countries and is in some already exceeding 20%. The occurrence of arterial hypertension (AH) increases with age. The prevalence of Ah in the age over 65 is 46,1% according to the epidemiologic data for Slovenia in 1987. it is characterized by arterial pressure of 160/90 mm Hg or more in three successive visits at least. Is isolated systolic AH, diastolic pressure must not exceed 89 mm Hg. Besides age itself and left ventricle hypertrophy, AH is the main announcer of cardiovascular morbidity and mortality. The rigidity of aorta and major arteries increases with age and the lumen of minor arteries becomes narrower. The sensibility of baroreceptors decreases with age which turn increases the susceptibility for orthostatic hypotension. Renin activity decreases and noradrenalin concentration increases in plasma. Due to decreased sensitivity of beta-1 adrenoreceptors elderly people incline to bradycardia. Renal plasma flow and glomerular filtration decrease with age. Hemodynamic characteristics of essential AH in age are an increased total and peripheral arterial restistance and reduction in cardiac output and intravascular volume. Renovascular hypertension due to aterosclerosis is more frequent in the age. Seven extensive researches (Australian, EWPHE, Coope and Warrander, SHEP, STOP-Hypertension, MRC and SYSZ-EUR) have unequivocally demonstrated that the prevalence of strokes, heart complications and total mortality is reduced up to 40% by the treatment of systolic-diastolic and isolated AH in age. Treatment in aged hypertensive patients prevents more complicatons in comparison with younger hypertensives. The cost/benefit relation is therefore more favourable. Non-pharmacologic treatment is in aged hypertensive patients efficient. In pharmacologic treatment drug choice is strictly individual, with special regard to co-existing diseases. (Abstract truncated at 2000 characters.)
Summary		Prevalenca prebivalstva starejšega kot 65 let v razvitih državah narašča in v nekaterih že presega 20%. Pojavljanje arterijske hipertenzije (AH) s starostjo narašča. Slovenski epidemiološki podatki iz leta 1987 navajajo prevalenco AH v starosti več kot 65 let 46,1%. Označuje jo arterijski tlak 160/90 mm Hg ali več pri vsaj treh zaporednih obiskih. Pri izolirani sistolični AH diastolični tlak ne sme preseči 89 mm Hg. V starosti je AH poleg same starosti in hipertrofije levega prekata glavni napovedovalec kardiovaskularne obolevnosti in umrljivosti. V starosti se zveča okorelost aorte in večjih arterij, svetlina manjših arterij pa se zoži. Občutljivost baroreceptorjev se v starosti zmanjša, kar zveča dovzetnost za ortostatsko hipotenzijo. Aktivnost renina se zmanjša, zveča pa se koncentracija noradrenalina v plazmi. Zaradi zmanjšane občutljivosti adrenoreceptorjev beta-1 so starejši ljudje nagnjeni k bradikardiji. Pretok plazme skozi ledvice in glomerulna filtracija se s staranjem zmanjšujeta. Hemodinamske značilnosti esecialne AH v starosti so žvečan celokupni in periferni žilni upor ter zmanjšanje minutnega volumna srca in intravaskularnega volumna. Pogostost aterosklerotično pogojene renovaskularne AH se v starosti zveča. Sedem velikih raziskav (Avstralska raziskava, EWPHE, Coope in Warrander, SHEP, STOP-Hypertension, MRC in SYSZ-EUR) je nedvoumno dokazalo, da zdravljenje sistodiastolične in izolirane sistolične AH v starosti zmanjša pogostost možganskih kapi, srčnih zapletov in celokupne umrljivosti do 40%. V primerjavi z mlajšimi pri starejših hipertonikih z zdravljenjem preprečimo več zapletov. Zato izgleda razmerje med koristmi in stroški ugodnejše. (Izvleček prekinjen pri 2000 znakih.)
Descriptors		HYPERTENSION AGING RISK FACTORS ANTIHYPERTENSIVE AGENTS AGED