Via practica 2/2013

Možnosti liečby hypertenzie u seniorov

MUDr. Karol Trejbal

Artériová hypertenzia (AH) je globálnou pandémiou s vysokou prevalenciou, pričom iba 13 % pacientov je liečbou dobre kontrolovaných. Zlepšenie socioekonomickej situácie vo vyspelých krajinách je spojené s progresívnym nárastom seniorskej populácie. Incidencia AH u seniorov v európskych krajinách sa odhaduje na 53 % až 72 %, pričom AH je zodpovedná za 17 % celkovej mortality. Absolútny benefit z adekvátnej liečby AH u seniorov je kvôli väčšiemu absolútnemu kardiovaskulárnemu riziku vyšší ako u mladších hypertonikov. Podľa záverov štúdie HYVET z liečby AH profitujú aj seniori vo veku nad 80 rokov, a to nielen znížením morbidity, ale aj mortality. Liečba AH u seniorov musí byť komplexná, zameraná jednak na nefarmakologické opatrenia, jednak na adekvátnu farmakoterapiu, ktorá zodpovedá špecifikám starnúceho organizmu.

Kľúčové slová: artériová hypertenzia u seniorov, izolovaná systolická hypertenzia, antihypertenzívna liečba

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The possibillities in the treatment of arterial hypertension in the elderly

Arterial hypertension (AH) is a global pandemic with high prevalence rate, while only about 13% of cases are successfully controlled by treatment. Continuously improving socio-economic environment in developed countries brings progressive growth of senior population. Incidence of AH in aging population in European countries is estimated at 53% to 72%, while AH causes 17% of all mortalities. Absolute benefit of the adequate treatment of AH is higher with seniors than with younger hypertonic population, mainly due to higher absolute cardiovascular risk. According to results of study HYVET show that seniors of 80+ years of age benefit from this treatment not only by lower morbidity rate, but also by lower mortality rate. It is necessary that treatment of seniors with AH is complex. It should be focused primarily on non-pharmacological treatments, as well as adequate pharmacotherapy that takes specifics of aging population into consideration.

Keywords: arterial hypertension in the elderly, isolated systolic hypertension, antihypertensive medications