cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2017-3-87-96cardiovascular-578Research ArticleОБЗОРЫREVIEWSАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯ У ОЧЕНЬ ПОЖИЛЫХ: ЗНАЧЕНИЕ БИОЛОГИЧЕСКОГО ВОЗРАСТАARTERIAL HYPERTENSION IN A VERY OLD: SIGNIFICANCE OF THE BIOLOGICAL AGEКотовскаяЮ. В.KotovskayaYu. V.

Котовская Юлия Викторовна — доктор медицинских наук РНИМУ им. Н. И. Пирогова, профессор, зав. кафедрой кардиологии и персонифицированной медицины ФПК МР Ми, руководитель лаборатории сердечно-сосудистого старения РУДН.

Москва

Moscow

kotovskaya@bk.ruТкачеваО. Н.TkachevaО. N.

Ткачева Ольга Николаевна — доктор медицинских наук, профессор, директор РГНЦ,  зав.  кафедрой болезней старения  РНИМУ им. Н.И. Пирогова.

Москва

tkacheva@rambler.ruРунихинаН. К.RukikhinaN. К.

Рунихина Надежда Константиновна — доктор медицинских наук, заместитель директора Российского геронтологического научно-клинического центра.

Москва

Moscow

runishi@rambler.ruОстапенкоВ. С.OstapenkoV. S.

Остапенко Валентина Сергеевна — ассистент кафедры болезней старения факультета дополнительного образования, врач-гериатр.

Москва

Moscow

ostapenkovalent@yandex.ruФГБОУ ВО “Российский национальный исследовательский медицинский университет им. Н. И. Пирогова” Министерства здравоохранения Российской Федерации — ОСП “Российский геронтологический научно-клинический центр”; ФГАОУ ВО “Российский университет дружбы народов” Министерства образования и науки Российской ФедерацииN. I. Pirogov Russian National Research Medical University (RNRMU) — SD “Russian Gerontological Scientific-Clinical Center”; Peoples’ Friendship University of RussiaФГБОУ ВО “Российский национальный исследовательский медицинский университет им. Н. И. Пирогова” Министерства здравоохранения Российской Федерации — ОСП “Российский геронтологический научно-клинический центр”N. I. Pirogov Russian National Research Medical University (RNRMU) — SD “Russian Gerontological Scientific-Clinical Center”2017200620171638796Copyright © Котовская Ю.В., Ткачева О.Н., Рунихина Н.К., Остапенко В.С., 20172017Котовская Ю.В., Ткачева О.Н., Рунихина Н.К., Остапенко В.С.Kotovskaya Y.V., Tkacheva О.N., Rukikhina N.К., Ostapenko V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/578

Популяция пожилых людей гетерогенна, и люди с одинаковым хронологическим возрастом  значительно различаются  по состоянию здоровья  и функциональному статусу. Планирование терапевтических вмешательств  у людей старческого возраста  невозможно без учета их влияния на физические и когнитивные функции человека. Несмотря  на убедительную доказанность  неблагоприятного  прогностического  значения  повышенного  артериального   давления (АД) у людей среднего  возраста, его влияние на прогноз у очень пожилых продолжает обсуждаться, равно как и вопрос, следует ли лечить  артериальную  гипертонию  (АГ)  в  старческом  возрасте, и если да, то насколько интенсивно. В статье представлены результаты наблюдательных и рандомизированных клинических исследований, которые позволяют судить о том, что не хронологический, а биологический возраст становится важным критерием для принятия решения о тактике лечения АГ у пожилых людей. В статье подробно  обсуждаются  механизмы,  участвующие в  регуляции  АД, а также влияние АД на риск заболеваемости и смертности у пациентов старческого возраста. Приводятся выдержки из существующих рекомендации  по антигипертензивной терапии, а также обсуждаются вопросы лечения АГ у пациентов старшего возраста, требующие дальнейших исследований.

Elderly population is heterogenic, and persons with the same chronological age differ greatly by their physical and cognitive functioning. Regardless the convincing witness on the adverse influence of raised blood pressure (BP) in a middle age persons, its influence on the prognosis of a very old is still debatable, as the question, whether to treat arterial hypertension (AH) in elderly, and if so, how intensively. The article focuses on the results of observational and randomized clinical studies that make it to decide that not  the  chronological,  but  biological age  is an  important  criteria  for decision on AH management in elderly. The article presents in details mechanisms  interacting in BP regulation, and influence of BP on the risk of morbidity and mortality in elderly. Also, the current guidelines are cited, on antihypertension treatment, as the issues dicussed on AH treatment in elderly, that require further investigation.

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The authors declare that there are no conflicts of interest present.