合併症のない高齢者高血圧のEBMに基づく治療指針

摘要

Hypertension is one of the most significant risk factors for cerebrovascular and heart diseases, which rank as the second and third most frequent causes of death in Japan,respectively. The prevalence of hypertension rises as the population grows older, affecting approximately 60 % of the Japanese aged 65 yr or older,and there are currently more patients receiving treatment for hypertension than for any other disease in Japan.As the size of the elderly populations in our country continuously increases rapidly, hypertension has become one of the most important diseases to be treated.Based on the results of numerous clinical intervention trials,treatment of hypertension in the elderly, including treatment of systolic hypertension, has generally been of great benefit.However, the efficacy of treatment of so-called very old hypertensive patients aged 85 yr or older is still controversial.Recently, Guidelines for the Management of Hypertension of Japanese Society of Hypertension (JSH 2004) has been reported,which are based on evidence-based medicine (EBM),adopting the results of mega-trials in Japan and in Western countries, but also considering the lifestyle of Japanese.This paper explaines the part of "Antihypertensive Treatment of Elderly Hypertensive Patients without Complications" in the Guidelines.