At present, the definition of hypertension in the elderly in China is: age ≥65 years old, measured systolic blood pressure ≥140mmhg and/or diastolic blood pressure ≥ 90mmhg three times on the same day, without using antihypertensive drugs; If the systolic blood pressure is ≥140mmhg and the diastolic blood pressure is < 90mmhg, it is called "isolated systolic hypertension in the elderly". The patient has a history of hypertension and is currently taking antihypertensive drugs. Although his blood pressure was lower than 140/90mmhg, he was still diagnosed with hypertension.
The main therapeutic goal of elderly patients with hypertension is to keep their blood pressure at a normal level. However, because they are old and weak, and suffer from many diseases, the target value of blood pressure reduction should be determined individually after comprehensive evaluation of patients.
For the elderly aged 65~79, the blood pressure should be reduced to below150/90mm Hg. If the blood vessels of the heart, brain and kidney can tolerate it, the target blood pressure can be reduced to below140/90mm Hg. If the age is above 80, it is reasonable to fall below 150/90mm Hg. If there is definite bilateral carotid artery stenosis, excessive hypotension is not recommended to ensure cerebrovascular blood flow. For elderly hypertensive patients with postural hypotension and postprandial hypotension, avoid excessive hypotension.
Although the absolute range of healthy blood pressure standards for elderly patients cannot be determined, it is beneficial to reduce blood pressure appropriately on the basis of ensuring the normal operation of organs. For elderly hypertensive patients who are generally in good health and have no obvious target organ damage, the lower limit of antihypertensive target can be relatively low without causing discomfort to patients. For patients with poor condition, blood pressure should not be too aggressive, and relatively loose strategy should be given priority to.