1.0 Introduction引言
高血压（HTN）被列为最常见的成年人病之一，需要寻求医疗照顾。它影响了1/3的成年人，其在所有特定类别中的患病率都在上升，尤其是60岁以上的人。
Hypertension (HTN) listed as one of the most common primary diagnosis adults seek medical attention. Affects 1 in 3 adults, its rising prevalence in all specific category, especially over 60 years old.
虽然老年人HTN负的增加率一直在控制，但2020年HTN的控制率仍远低于健康人50％目标。2005-2008年“全国健康和营养检查调查数据分析”，是在43.7%的成年人的基础上进行控制的。改善HTN与心血管疾病（CVD）、心力衰竭、中风、肾病、视网膜疾病之间关系的挑战是具有重要意义的。医生的医疗负担是正确识别和干预，可以鼓励和支持高血压的自我管理行为，以达到控制和减少并发症的发展。可以参与自我管理行为，预测模型的风险，为指导医疗互动提供依据。
长期以来，高血压是最常见的疾病之一，而居住社区中65岁以上人口的患病率为50%以上。研究表明，抗高血压治疗对降低老年人心血管发病率和死亡率具有重要意义。2-4高血压与痴呆风险增加有关。通过治疗高血压来减少痴呆的发病率已经在许多研究中得到证实：sys-eur 6 progress7和scope。Although HTN burden increase in older adults can control the HTN is still far lower than healthy people 2020's 50% target. The 2005-2008 "national health and nutrition examination survey data analysis, is on the basis of control 43.7% of all adults. The challenge of improving the relationship between the HTN controls is of great significance, especially the uncontrolled HTN and cardiovascular disease (CVD), heart failure, stroke, kidney disease, diseases of the retina. The burden of health care a doctor is to identify and intervene appropriately, to encourage and support for hypertension self-management behavior to achieve the development of control and reduce the complications. May participate in the self-management behavior can predict the risk of model for single sand to guide medical interactions.
High blood pressure is one of the most common conditions for a long time, and the prevalence of residential community, a 65 - year - old population is 50% or more. Studies have shown important to reduce cardiovascular morbidity and mortality with antihypertensive therapy in the elderly. 2-4 high blood pressuresare associated with an increased risk of dementia. Reduce incident dementia by treating hypertension has been shown in much research: Sys - Eur 6 PROGRESS7 and scope. However, HYVET - COG9 SHEP10 failed to show that such a society; This may but with subsequent periods9 and differential loss to follow-up, 10 respectively. Whether there is a lack of consensus to treat high blood pressure is beneficial in elderly patients with cognitive impairment, worry that antihypertensive therapy may accelerate cognitive decline. Developing Alzheimer’s disease in patients with high blood pressure have contradiction drop in blood pressure before diagnosis, may be due to autonomic nerve disorder. This fall in blood pressure can induce brain perfusion, deterioration of dementia. Cross-sectional studies have shown that the link between the lower diastolic blood pressure and dementia, especially in patients receiving antihypertensive drugs. Patients with Alzheimer’s disease seem to vulnerability increased cortical tissue perfusion changes. Therefore, antihypertensive therapy from cognitive and potentially dangerous is.
Although the treatment of high blood pressure and increased incidence of cardiovascular, renal and brain, and death, lowering blood pressure is not without risk. Orthostatic hypotension is a major factor can be contributed to the elderly and antihypertensive drugs. In addition, orthostatic hypotension has proven to be associated with the history of myocardial infarction, transient ischemic attack, frequent falls and difficulty walking. Significant changes in lower diastolic blood pressure and postprandial hypotension, rest may have exacerbated the step-down, treatment is associated with poor cognitive results and increase the risk of death. No guiding the management of hypertension in patients with dementia. Combination of antihypertensive treatment of dementia found relevant previous and cohort studies and concluded that antihypertensive seems to reduce the progression of dementia, but not solve the problem of overall risk - benefit. The purpose of this evaluation system is to solve this gap, by evaluating a randomized controlled trial of hypertension and evidence
