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(1) Increased SBP and increased pulse pressure: isolated systolic hypertension in the elderly accounts for 60% of hypertension, and its incidence increases with age, and the incidence of stroke increases sharply. Pulse pressure in the elderly was significantly positively associated with total mortality and cardiovascular events.
(2) The blood pressure fluctuates greatly: the phenomenon of "morning peak" of blood pressure increases, and the number of hypertension complicated with orthostatic hypotension and postprandial hypotension increases. Orthostatic hypotension was defined as a >20 mm Hg decrease in SBP or a >10 mm Hg decrease in DBP within 3 minutes of changing position to an upright position, accompanied by symptoms of hypoperfusion, such as dizziness or syncope. Elderly patients with isolated systolic hypertension accompanied by diabetes, hypovolemia, and those who use diuretics, vasodilators or psychotropic drugs are prone to orthostatic hypotension. Postprandial hypotension in the elderly is defined as: blood pressure measured every 15 min within 2 h after meal, SBP decreased by >20 mm Hg compared with preprandial; or preprandial SBP ≥ 100 mm Hg, but postprandial <90 mm Hg; or Although postprandial blood pressure was only slightly decreased, symptoms of cardio-cerebral ischemia (angina pectoris, fatigue, syncope, disturbance of consciousness) occurred. The blood pressure of the elderly fluctuates greatly, which affects the treatment effect. When blood pressure fluctuates sharply, it can significantly increase the risk of cardiovascular events.
(3) Common blood pressure circadian rhythm abnormalities: The incidence of blood pressure circadian rhythm abnormalities is high, manifested as a drop in nighttime blood pressure <10% (non-dipper type) or more than 20% (super-dipper type), leading to targets such as the heart, brain, and kidneys. Increased risk of organ damage.
(4) White coat hypertension increased.
(5) The increase of false hypertension refers to the phenomenon that the blood pressure value measured by the cuff method is higher than the intra-arterial pressure value (SBP increase ≥ 10 mm Hg or DBP increase ≥ 15 mm Hg), which can be seen in normal blood pressure or high blood pressure. Blood pressure in the elderly. The above clinical features of hypertension are related to the increased stiffness of the arteriosclerotic vascular wall and the decreased function of the blood pressure regulating center in the elderly.