氯沙坦氢氯噻嗪联用氨氯地平治疗老年难治性高血压临床观察

目的:观察氯沙坦钾氢氯噻嗪联合苯磺酸氨氯地平治疗老年难治性高血压的临床效果.方法:将72例老年难治性高血压患者按随机数字表法分为观察组及对照组各36例,对照组给予卡维地洛与螺内酯治疗,观察组给予氯沙坦钾氢氯噻嗪片与苯磺酸氨氯地平治疗,两组疗程均为8周.比较治疗前、后两组动态SBP、DBP,临床疗效及不良反应发生情况.结果:治疗8周后观察组24h动态SBP、DBP下降幅度均明显优于对照组,组间比较差异显著(P<0.05);观察组显效率、总有效率均优于对照组,但组间比较无显著差异(P>0.05);治疗期间两组均无明显不良反应.结论:氯沙坦钾氢氯噻嗪联合应用苯磺酸氨氯地平治疗老年难治性高血压能明显改善血压控制水平,提高临床疗效,安全性良好.     

老年高血压患者应用厄贝沙坦氢氯噻嗪片联合苯磺酸氨氯地平片治疗的临床效果观察

目的 探究厄贝沙坦氢氯噻嗪片联合苯磺酸氨氯地平片治疗老年高血压患者的效果。方法 100例老年高血压患者,经随机数字表法分为对照组和观察组,每组50例。对照组采用厄贝沙坦氢氯噻嗪片治疗,观察组实施厄贝沙坦氢氯噻嗪片联合苯磺酸氨氯地平片治疗。比较两组患者治疗效果,治疗前后血压水平、生化指标水平及不良反应发生情况。结果 观察组治疗总有效率为96.00%(48/50),明显高于对照组的84.00%(42/50),差异具有统计学意义(P<0.05)。治疗前,两组患者收缩压(SBP)、舒张压(DBP)水平比较,差异无统计学意义(P>0.05)。治疗后,两组患者SBP、DBP水平均明显低于本组治疗前,且观察组SBP、DBP水平分别为(123.21±9.89)、(80.21±4.87)mm Hg(1 mm Hg=0.133 kPa),均明显低于对照组的(142.89±10.11)、(94.89±5.89)mm Hg,差异有统计学意义(P<0.05)。治疗前,两组患者尿素氮和尿微量白蛋白水平比较,差异无统计学意义(P>0.05)。治疗后,两组患者的尿素氮和尿微量白蛋白水平均明显低...     

奥美沙坦酯氢氯噻嗪片治疗原发性高血压患者的临床有效性及安全性分析

目的 观察原发性高血压患者应用奥美沙坦酯氢氯噻嗪片治疗的效果及安全性.方法 80例原发性高血压患者,依据用药方案不同分为对照组和观察组,每组40例.对照组患者应用氯沙坦钾片进行治疗,观察组患者应用奥美沙坦酯氢氯噻嗪片进行治疗.对比两组患者的舒张压(DBP)、收缩压(SBP)、临床疗效、血清超敏C反应蛋白(hs-CRP)...     

厄贝沙坦氢氯噻嗪片对原发性高血压患者血压及血压变异性的影响

目的 观察厄贝沙坦氢氯噻嗪片对原发性高血压病患者血压及血压变异性(BPV)的影响.方法 60例2级原发性高血压患者服用厄贝沙坦氢氯噻嗪片150 mg/d,动态监测治疗前与治疗8周后24h血压,分析比较治疗前后血压及BPV的变化.结果 治疗过程中,3例患者因1周后血压未达标而加服苯磺酸氨氯地平片,退出本研究,有效例数57例.①治疗后与治疗前相比,24 h SBP均值、白昼SBP均值、白昼DBP均值及夜间SBP均值差异有统计学意义[(122 ±8)mm Hg(1 mm Hg=0.133 kPa)比(151 ±24) mm Hg,(127±18) mm Hg比(156±19)mm Hg,(86 ±8)mm Hg比(90±9)mmHg,(118±9)mmHg比(127±8)mm Hg;均P＜0.01].②治疗后BPV均有所减少,24 h SBP变异、白昼SBP和白昼DBP变异、夜间SBP变异差异有统计学意义[(11.2 ±2.3)mm Hg比(14.7±3.1)mm Hg,(15.1±8.5)mm Hg比(18.3±7.0)mm Hg,(9.2±3.2)mm Hg比(10.4 ±2.5) mm Hg; (13.7±7.7)mm Hg比(16.6±7.3)mm Hg;P＜0.05或P＜0.01].结论 厄贝沙坦氢氯噻嗪片不仅能降低血压,而且能降低BPV,改善预后.     

氯沙坦钾氢氯噻嗪片治疗T2DM合并高血压的临床分析

目的观察氯沙坦钾氢氯噻嗪片治疗2型糖尿病（Type 2Diabetes Mellitus,T2DM）合并高血压的临床效果及安全性。方法将86例T2DM合并高血压患者按照数字表法随机分为两组,对照组采用氯沙坦钾片联合氢氯噻嗪片治疗;观察组则采用氯沙坦钾氢氯噻嗪片复合制剂治疗,并比较两组疗效。结果观察组的总有效率（95．35％）明显高于对照组（81．40％）（P〈0．05）．两组患者治疗前SBP、DBP相比较差异均无统计学意义（P〉0．05）,两组患者治疗后SBP、DBP与治疗前比较差异有统计学意义（P〈0．05）,观察组治疗后的SBP、DBP明显低于对照组（均P〈0．05）,对照组患者治疗后FPG、P2hBG较前升高（P〈0．05）,观察组患者治疗前后FPG、P2hBG无明显变化（P〉0．05）;观察组治疗后FPG、P2hBG与对照组比较差异有统计学意义（均P〈0．05）。结论氯沙坦钾氢氯噻嗪片治疗T2DM合并高血压患者降压效果疗效肯定、起效快、作用强、安全性高、不良反应少,而且对血糖影响小,有利于提高患者服药依从性。     

替米沙坦联合氢氯噻嗪对血压晨峰的影响

目的探讨和总结替米沙坦联合氢氯噻嗪片对原发性高血压患者血压晨峰程度的影响。方法将2010年6月至2011年3月收治的60例原发性高血压患者随机分两组,对照组仅给予替米沙坦片40 mg/d口服,共8周,治疗组给予替米沙坦片40 mg/d加氢氯噻嗪片6.25-12.5 mg/d,共8周,观察血压晨峰在治疗前后的变化情况。结果对照组和治疗组均能使血压晨峰降低,对照组血压晨峰下降的幅度DBP(11.62±2.13)mm Hg,SBP(12.58±2.26)mm Hg,治疗组血压晨峰下降的幅度分别为DBP(38.21±1.73)mm Hg,SBP(34.11±1.32)mm Hg,两组比较有统计学差异(P<0.05)。结论治疗组控制血压晨峰的疗效优于对照组,能够使高血压患者的晨峰现象得到有效的控制。     

氯沙坦钾/氢氯噻嗪治疗老年高血压疗效观察

目的:观察氯沙坦钾/氢氯噻嗪片和氯沙坦钾片治疗老年高血压的临床疗效和安全性。方法:采用随机对照方法,对比观察组(氯沙坦钾50 m g/氢氯噻嗪12.5 m g,每日1次,每次1片),与对照组(氯沙坦钾片50 m g,每日1次,每次1片)治疗老年高血压患者12周的有效率。结果:观察组103例,显效82例(79.6%),有效20例(19.4%),无效1例(0.97%),总有效99.0%。对照组103例,显效56例(54.4%),有效39例(37.9%),无效8例(7.8%),总有效率92.2%。结论:氯沙坦钾/氢氯噻嗪片治疗高血压安全、有效,联合用药比单用效果显著。     

氯沙坦联合氢氯噻嗪治疗单纯收缩期高血压效果观察

目的：观察氯沙坦联合氢氯噻嗪治疗单纯收缩期高血压的效果。方法300例单纯收缩期高血压患者按照入院顺序分为对照组148例和观察组152例。两组均采用非药物治疗加氯沙坦,观察组加用氢氯噻嗪片。结果观察组疗效好于对照组,治疗4周末与8周末时观察组的SBP与DBP均低于对照组,脉压高于对照组,除治疗8周末的脉压外,余各项差异均有统计学意义。两组的SBP、DBP与脉压随治疗时间的增加均呈逐渐下降趋势。结论氯沙坦联合氢氯噻嗪可明显降低单纯收缩期高血压的水平。     

氨氯地平联合氯沙坦钾氢氯噻嗪治疗难治性高血压患者的效果及对动脉粥样硬化的影响观察

目的 观察氨氯地平联合氯沙坦钾氢氯噻嗪治疗难治性高血压患者的效果及对动脉粥样硬化的影响。方法 60例难治性高血压患者,以电脑随机法分成对照组(30例)及观察组(30例)。对照组应用氨氯地平开展治疗,观察组应用氨氯地平联合氯沙坦钾氢氯噻嗪开展治疗。对比两组治疗前后临床症状积分、血压水平、血管内皮功能、动脉粥样硬化情况以及预后质量。结果 两组治疗后头痛、眩晕、胸闷积分较本组治疗前均降低,且观察组治疗后头痛积分(1.47±0.52)分、眩晕积分(1.54±0.63)分、胸闷积分(1.27±0.30)分较对照组的(2.43±0.69)、(2.33±0.81)、(2.14±0.48)分均更低(P<0.05)。两组治疗后24 h收缩压、24 h舒张压及平均动脉压水平较本组治疗前均降低,且观察组治疗后24 h收缩压(121.50±17.39)mm Hg(1 mm Hg=0.133 kPa)、24 h舒张压(85.71±9.51)mm Hg及平均动脉压(108.87±5.15)mm Hg较对照组的(136.11±18.04)、(97.00±11.70)、(123.60±6.74)mm Hg均更低...     

氯沙坦钾联合氢氯噻嗪治疗原发性高血压的疗效观察

目的：观察氯沙坦钾联合氢氯噻嗪治疗原发性高血压的临床疗效。方法选取2010年12月～2011年11月收治的原发性高血压患者80例,随机分为试验组和对照组,每组各40例。试验组给予氯沙坦钾和氢氯噻嗪片（氯沙坦钾50 mg＋氢氯噻嗪片12.5 mg）,1片/天,口服;对照组给予口服氢氯噻嗪片（12.5 mg）,1片/天,两组总疗程均为8周。观察两组治疗后血压变化情况和不良反应的发生情况。结果试验组患者治疗的总有效率（92.5%）高于对照组（83.0%）,差异具统计学意义（P＜0.05）;两组不良反应发生率比较,差异无统计学意义（P＞0.05）。结论氯沙坦钾联合氢氯噻嗪治疗原发性高血压,疗效肯定,无明显不良反应。     

Trough-to-peak ratio,smoothness index,and circadian blood pressure profile after treatment with once-daily fixed combination of losartan 100 and hydrochlorothiazide 25 in essential hypertension

The once-daily fixed combination of losartan 100 mg/hydrochlorothiazide 25 mg was evaluated for safety and efficacy in a multicenter open study by using 24-h ambulatory blood pressure monitoring in untreated patients with moderate-to-severe essential hypertension or patients with uncontrolled hypertension despite treatment with monotherapy or low-dose combination. After a 2-week washout period, 41 patients (22 men, 19 women) aged 34-74 years, showing a mean daytime blood pressure > 135/85 mm Hg, were treated with losartan 100 mg/hydrochlorothiazide 25 for 8 weeks. Ambulatory blood pressure was monitored at the end of the washout period and during the last week of treatment. A significant reduction in the average values of clinic blood pressure (from 169.9 +/- 13.5 mm Hg to 139.5 +/- 15.6 mm Hg, p < 0.001 for systolic blood pressure [SBP]; and from 102.2 +/- 7.1 mm Hg to 85.1 +/- 9.5 mm Hg, p < 0.001 for diastolic blood pressure [DBP]) was observed after treatment in the whole group of 41 patients. Likewise, average values of both 24-h SBP and 24-h DBP were significantly reduced (from 145.7 +/- 13.1 mm Hg to 128.3 +/- 14.6 mm Hg, p < 0.001 for 24-h SBP; and from 90.3 +/- 7.3 mm Hg to 79.2 +/- 8.6 mm Hg, p < 0.001 for 24-h DBP). The average lowering at peak was 20.2 +/- 11.8 mm Hg for 24-h SBP and 12.1 +/- 7.4 mm Hg for 24-h DBP, whereas the lowering at trough was 17.8 +/- 12.0 mm Hg and 10.4 +/- 8.1 mm Hg, respectively. The trough-to-peak ratio (T/P) was 0.88 for SBP and 0.86 for DBP, and the smoothness index was 7.36 for SBP and 6.37 for DBP. The response rate was 87.8% (blood pressure lowering > 5 mm Hg of either 24-h SBP or 24-h DBP average values). Among responders, T/P ratio was 0.89 for SBP and 0.87 for DBP, and the smoothness index was 8.09 for SBP and 7.15 for DBP. No side effects or changes in metabolic parameters were observed. The fixed combination of losartan 100 mg/hydrochlorothiazide 25 was very effective and well tolerated.     

厄贝沙坦联合氢氯噻嗪治疗老年原发性高血压的临床观察

目的观察厄贝沙坦联合氢氯噻嗪治疗老年原发性高血压的疗效。方法2012年1月～2013年1月在我院住院治疗的老年原发性高血压患者80例,全部入选对象随机分为观察组和对照组,各40例,对照组予厄贝沙坦、观察组同时联合氢氯噻嗪,比较两组的疗效,并记录治疗前后血压的变化情况及用药期间的不良反应情况。结果观察组的总有效率达95．00％,对照组的总有效率达75．00％,两组疗效比较,差异有统计学意义（P〈0．05）。观察组患者的SBP治疗后达（123．82±14．18）mmHg,DBP（85．18±12．37）mmHg,分别与对照组治疗后的SBP、DBP比较,差异有统计学意义（P〈0．05）。结论厄贝沙坦联合氢氯噻嗪治疗老年原发性高血压疗效确切,可以明显降低患者的收缩压、舒张压,且无明显不良反应,值得推广和应用。     

厄贝沙坦片联合氢氯噻嗪片治疗92例轻中度高血压的临床分析

目的探讨氢氯噻嗪片联合厄贝沙坦片治疗轻中度高血压的临床疗效。方法选择2010年6月至2011年6月已确诊的轻中度原发性高血压患者184例,随机分为观察组和对照组各92例,对照组予以口服厄贝沙坦片150mg,1次/d,观察组在对照组治疗基础上加服氢氯噻嗪片12.5mg,1次/d,总疗程8周。于治疗前与治疗8周末进行心电图、血尿常规、血生化、电解质、尿酸等检查。每2周随访坐位血压、心率1次。结果观察组总有效率91.30%,对照组总有效率73.91%,两组差异有统计学意义(P<0.01);两组SBP和DBP均下降,且治疗组的收缩压和舒张压下降均较对照组更明显,两组差异显著具有统计学意义(P<0.001)。两组均无因严重不良反应。结论厄贝沙坦片和氢氯噻嗪片二者联合对轻中度高血压患者降压效果更显著,对代谢影响不明显,不良反应小,值得临床推广。     

硝苯地平控释片与氢氯噻嗪治疗老年高血压的研究

目的 探讨盐酸贝那普利联合硝苯地平控释片或氢氯噻嗪治疗老年高血压的临床疗效比较.方法 选取140例3级老年高血压患者,随机分为观察组（70例）和对照组（70例）,观察组给予贝那普利10 mg,早上1次,硝苯地平控释片30 mg,早上1次;对照组贝那普利10 mg,早上1次,氢氯噻嗪25 mg,早上1次,观察入选时和治疗4周后,收缩压和舒张压的变化.结果 治疗前,观察组平均血压为：（187.3±5.2）/（115.5±2.4） mmHg,对照组平均血压为：（186.2±5.5）/（116.2±2.2） mmHg,差异均无统计学意义（P＞0.05）;治疗后,观察组平均血压为：（135.1±1.5）/（83.3±2.2） mmHg,对照组平均血压为：（142.2±2.1）/（89.1±2.5）mmHg,差异有统计学意义（P＜0.05）;观察组的总有效率为90％,对照组的总有效率为80％,差异有统计学意义（P＜0.05）.结论 观察组和对照组均能降低3级老年高血压,观察组疗效优于对照组,具有起效快、作用强、易于达标特点.     

二甲双胍对高危血管病变合并葡萄糖耐量减低患者的影响

目的观察二甲双胍对高危血管病变合并糖耐量减低患者代谢紊乱因素及血管病变高危因素的影响。方法回顾性分析173例高危血管病变合并葡萄糖耐量减低患者,单用氯沙坦钾组(100mg/d,n=86)、联合用药组(二甲双胍250mg,3次/d+氯沙坦钾100mg/d,n=87)。入选患者均分别于治疗前、治疗12周后测定空腹血糖(FBG)、餐后2h血糖(PBG)、空腹血胰岛素(INS0)、服糖2h血胰岛素(INS120)、体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、收缩压(SBP)、舒张压(DBP)。结果治疗12周后2组的各代谢紊乱指标下降幅度:单用氯沙坦钾组[FBG(0.55±0.21)mmol/L、PBG(0.82±0.14)mmol/L、INS0(1.91±0.28)mU/L、INS120(8.5±1.5)mU/L、BMI(0.012±0.003)kg/m2],联合用药组[FBG(1.19±0.14)mmol/L、PBG(3.71±0.14)mmol/L、INS0(8.90±0.44)mU/L、INS120(43.7±7.2)mU/L、BMI(5.35±0.79)kg/m2],2组间比较,差异有统计学意义(P均<0.05);高危血管病变指标降低幅度:单用氯沙坦钾组[TC(0.050±0.020)mmol/L、TG(0.011±0.003)mmol/L、SBP(38.1±3.3)mmHg、DBP(34.6±2.2)mmHg],联合用药组[TC(2.24±0.06)mmol/L、TG(0.800±0.020)mmol/L、SBP(56.4±2.3)mmHg、DBP(43.9±2.8)mmHg],2组间比较,血脂及收缩压的差异有统计学意义(P均<0.05),舒张压的差异无统计学意义(P>0.05)。结论二甲双胍可以对高危血管病变合并糖耐量减低患者的多项代谢紊乱因素进行积极处理,降低血管病变高危因素的进程。     

氨氯地平联合阿托伐他汀钙片治疗高血压合并冠心病的效果观察

目的观察高血压合并冠心病患者应用氨氯地平联合阿托伐他汀钙片治疗的临床效果。方法90例高血压合并冠心病患者,根据入院时间先后顺序分为对照组和观察组,每组45例。对照组采用氨氯地平治疗,观察组采用氨氯地平联合阿托伐他汀钙片治疗。比较两组患者的临床疗效及治疗前后血压、Hcy水平变化。结果治疗前,两组舒张压、收缩压及同型半胱氨酸(Hcy)水平比较,差异无统计学意义(P>0.05);治疗后,观察组舒张压(70.17±5.34)mm Hg(1mm Hg=0.133 kPa)、收缩压(120.35±8.50)mm Hg及Hcy(8.74±1.58)μmol/L均低于对照组的(84.04±5.10)mm Hg、(137.47±10.24)mm Hg、(13.58±1.46)μmol/L,差异有统计学意义(P<0.05)。观察组治疗总有效率为91.11%,高于对照组的75.56%,差异有统计学意义(P<0.05)。结论氨氯地平联合阿托伐他汀钙片治疗高血压合并冠心病的临床效果较为理想,在临床中推行的可行性较大。     

Use of 24-Hour Ambulatory Blood Pressure Monitoring to Assess Antihypertensive Efficacy

INTRODUCTION: Goal rates, the percentage of patients with hypertension achieving recommended SBP/DBP, are a clinically important assessment of an antihypertensive agent's efficacy. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) allows accurate assessment of a patient's hypertension and risk for cardiovascular events, and provides the most accurate measure of an antihypertensive agent's efficacy throughout a 24-hour dosing interval. METHODS: A 12-week (4-week single-blind placebo run-in phase followed by an 8-week double-blind active treatment phase) randomized, parallel-group study reported that the recommended starting dose of the angiotensin II receptor antagonist (angiotensin receptor blocker; ARB) olmesartan medoxomil (Benicar(trade mark)) 20 mg/day was more effective than starting doses of losartan potassium (Cozaar) 50 mg/day, valsartan (Diovan) 80 mg/day, or irbesartan (Avapro) 150 mg/day in reducing cuff DBP in patients with essential hypertension. The present report includes analyses of secondary efficacy variables from this 12-week trial. RESULTS: The mean reduction in blood pressure from baseline to week 8 (end of treatment) was significantly greater with olmesartan medoxomil than with valsartan for all ABPM times analyzed (24 hours, daytime, night-time, and last 2 and 4 hours of monitoring). Statistical significance was reached for comparisons of olmesartan medoxomil with losartan potassium for a majority of times analyzed and with irbesartan for SBP in the last 4 hours of monitoring. Goal rates for accepted critical ambulatory blood pressure (ABP) values of <130/80 mm Hg for mean 24-hour ABP, <135/85 mm Hg for mean daytime ABP, and <120/75 mm Hg for mean night-time ABP were significantly greater for patients receiving olmesartan medoxomil than for those receiving losartan potassium or valsartan. Goal rates were numerically superior, but not statistically significant, to those achieved with irbesartan. Compared with losartan potassium or valsartan recipients, a significantly higher percentage of patients treated with olmesartan medoxomil achieved the 24-hour ABP goal of <130/85 mm Hg. The last 2 and 4 hours of ABPM indicated that olmesartan medoxomil maintained larger mean decreases in blood pressure through the morning surge. DISCUSSION/CONCLUSION: ABP goal rates are a meaningful measure of antihypertensive efficacy. The effects on mean change from baseline in ABP and ABP goal rates after 8 weeks of treatment were numerically better, but not statistically significant, for olmesartan medoxomil than for irbesartan. However, olmesartan medoxomil was significantly more effective than losartan potassium or valsartan.     

老老年与青年高血压病患者血压水平差异的研究

目的 探讨老老年与青年高血压病患者的血压水平差异,以指导老老年患者的临床治疗.方法 选择我院2009年4月至2010年6月高血压科住院的18岁≤年龄≤30岁患者49例作为青年组,≥80岁患者31例作为老老年组.2组患者均做诊室血压测量和24 h动态血压监测,并进行比较.结果 青年组患者诊室测量的舒张压明显高于老老年组[(102±14)mm Hg(1mm Hg=0.133 kPa)比(80±14)mm Hg.P<0.05],老老年组中单纯收缩压升高者明显多于青年组[19例(61.3%)比0例,P<0.01].青年组24 h平均舒张压、24 h平均心率、白昼平均舒张压、夜间平均舒张压均高于老老年组[(81±11)mm Hg比(67±10)mm Hg,(73±11)次/min比(64±15)次/min,(75+28)mm Hg比(59±25)mm Hg,(66±25)mm Hg比(55±23)mm Hg,P<0.05或P<0.01],而24 h脉压低于老老年组[(11±2)mm Hg比(24±4)mm Hg,P<0.01].结论 老老年高血压病患者舒张压、心率低于青年患者,脉压高于青年患者,单纯收缩压升高者明显多于青年患者.老老年高血压病患者应该进行降压治疗,降压药可以首选钙离子拈抗剂和利尿剂.

Abstract：

Objective To discuss the difference of ambulatory blood pressure levels between very elderly and young hypertensives. Methods Eighty inpatients in hypertension department at Anzhen Hospital were enrolled and divided into two groups by age;the young group(49 cases, with age≤30 years old)and very elderly group(31 cases, with age ≥80 years old). Both groups had clinical blood pressure tests and 24-hour ambulatory blood pressure tests, and the outcomes were compared. Results The diastolic blood pressure ( DBP) in the young group is significantly higher than the very elderly group[(102 ±14)mm Hg(l mm Hg =0.133 kPa)vs(80 ±14)mm Hg, P< 0.05]. People simply elevated systolic blood pressure of the very elderly group is significantly more than young group[19 cases(61.3% ) vs 0(0.0% ) , P <0. 01]. The 24 h mean DBP, 24 h mean heart rate, day mean DBP and night mean DBP in young group are higher than the very elderly group[(81 ±11) mm Hg vs(67 ±10) mm Hg, (73 ±ll)beats per minute vs(64 ±15)beats per minute,(75 ±28)mm Hg vs(59 ±25)mm Hg,(66 ±25)mm Hg vs(55 ±23)mm Hg, P<0.05 or P<0.01] , but mean pulse pressure is lower than the very elderly groupf (11 ± 2)mm Hg vs(24 ±5)mm Hg, P<0.01]. Conclusions The DBP and heart rate in the very elderly patients are lower than those in the young patients, while isolated systolic hypertension is significantly higher in the very elderly patients than that in the young patients. The very elderly patients with hypertension should have antihypersive treatment and calcium antagonist as well as diuretic should be the first choices.