降压目标之争-SPRINT是终结者吗
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16-12-04 S610-GB-0444ACO5000 – USER MANUALDANAHER MOTION S.A. La Pierreire 2, CH-1029 Villars-Ste-CroixTelephone +41-21-631 33 33, Telefax +41-21-636 05 09E-mail: info@danaher-motion.chwww.danaher-motion.chDANAHER MOTION S.A.Empty pagePage 2 / 16 User Manual ACO5000 S610-GB-0444DANAHER MOTION S.A.S610-GB-0444 User Manual ACO5000 Page 3 / 16Table of contentSafety instructions.....................................................................................................................................4 Information on the Operating Manual ......................................................................................................4 The Basic Safety Rules (4)First read the user manual.................................................................................................................4 Electric drives are potentially dangerous...........................................................................................4 Your qualification...............................................................................................................................4 Working instruction............................................................................................................................5 Over speed protection.......................................................................................................................5 Overload protection...........................................................................................................................5 Proper installation..............................................................................................................................5 Responsibility.....................................................................................................................................5 Product description (6)Highlights...........................................................................................................................................6 Power supply module........................................................................................................................6 External braking resistor module.......................................................................................................6 Power Drive module..........................................................................................................................6 Power ratings.....................................................................................................................................6 General technical data...............................................................................................................................7 Examples of product configuration and weight......................................................................................7 Mounting and installation..........................................................................................................................8 Mechanical dimensions.............................................................................................................................8 Description and connection......................................................................................................................9 Power terminals (9)Input specifications............................................................................................................................9 Output specification...........................................................................................................................9 How to unlock the power terminals........................................................................................................10 Power terminal coding.............................................................................................................................10 Front panel description. (11)Power supply module......................................................................................................................11 Power Drive module........................................................................................................................11 Control terminals description.................................................................................................................11 Control terminals description.................................................................................................................12 Sensor input..............................................................................................................................................13 7 Segments display..................................................................................................................................13 Codification of failure...............................................................................................................................14 DECLARATION OF CONFORMITY..........................................................................................................15 Assistance and Trouble shooting.. (15)CAUTIONDO NOT INSTALL THE WINDOW PROGRAMMING SOFTWARE BEFORE TO INSTALL THE USB PORT CONNECTION AND DRIVER.FOLLOW THE INSTRUCTION OF THE INSTALLATION CARD DELIVERED WITHTHE WINDOWS SOFTWARE.DANAHER MOTION S.A.Page 4 / 16 User Manual ACO5000 S610-GB-0444Safety instructionsInformation on the Operating ManualThis operating manual applies to the ACO5000 frequency inverter family. It describes the connections and basic functions of the standard models.CAUTION ! Danger of death by electrocutionCAUTION ! Absolutely essentialBe careful ! Incorrect operation, may lead to damage.The Basic Safety RulesFirst read the user manualBefore installing and commissioning, it is important for such personal to read carefully the operating instructions and safety warnings. Electric drives are potentially dangerousElectrical voltages > 230 V/460 VHigh voltages may still be present up to 5 minutes after the power has been cutoff. Therefore you must always check for presence of power and voltages! In STOP mode, the drive remains active and the motor terminals are at apotential of 300 VDC against the ground. Rotating parts Hot surfacesYour qualificationIn order to prevent personal injury and damage to property, only personnel with electrical engineering qualifications may work on the device.According to IEC364, DIN VDE0100, the qualified personnel must be familiar with the User ManualHave knowledge of national standards and accident prevention regulationsDANAHER MOTION S.A.S610-GB-0444 User Manual ACO5000 Page 5 / 16Working instructionDuring installation observe the following instructions:Always comply with the connection conditions and technical specifications.Comply with the standards for electrical installations, such as regarding wire gauges, groundinglead and ground connections.Without prior writing agreement you are not allowed to open the drive. If you do it, the warrantywill be void. Over speed protectionIf an over speed protection is required, it must be provided by the motor manufacturer, as this function is not integrated in the drive.Overload protectionThe drive doesn't integrate any input line overload protection. An external overload protection is required for the AC main and the supplied 24 VDC.Proper installationInverter drives are components that are intended for installation within electrical systems or machines. The inverter may not be commissioned or put into operation until it has been established that the machine as a unit complies with the provisions of the EC Machinery Directive (89/392/EEC) as well with the standard EN 60204 (Safety of machines).If the frequency inverter is used for special applications the specific standards and regulations for this environment must always be observed.Repairs may only be carried out by authorized repair workshops. Unauthorized opening and incorrect intervention could lead to physical injury or material damage. The warranty provided by DANAHER-MOTION would thereby be void.If you have to do it, bear in mind that the converter control board uses a large number of MOS (Metal Oxide Semiconductor), which are highly sensitive to electrostatic charge.To avoid any damages to the control board:make sure you are working on an earthen anti-static floor use anti-static packing material onlyResponsibilityElectronic devices are fundamentally not fail-safe. The company setting up and/or operating the machine or plant is itself responsible for ensuring that the drive is rendered safe if the device fails.The standard EN 60204-1/DIN VDE 0113 “Safety of machines”, in the section on “Electrical equipment of machines”, stipulates safety requirements for electrical controls. The requirements to comply with are intended to protect the integrity of personnel and machines and to maintain the function capability of the machine or plant. The function of an emergency off system does not necessarily have to cut the power supply to the drive.To protect against risk of injury, it may be more beneficial to maintain individual drives in operation or to initiate specific safety sequences. The emergency stop process may be assessed by means of a risk analysis of the machine or plant, including the electrical equipment to EN 1050. Part of this analysis is determined by the selection of the circuit category in accordance with EN 954 “Safety of machines – Safety related parts of controls”.We strongly suggest the use of the provided certified safety relay in accordance with the EN954-1 recommendations (see paragraph "Control terminals description").DANAHER MOTION S.A.Page 6 / 16 User Manual ACO5000 S610-GB-0444Product descriptionHighlightsPAM – Pulse Amplitude Modulation – a technology with regulated intermediate DC bus Traditional ACOMEL SHS – Selective Harmonic Suppression – modulation Windows based programming softwareCan be operated via Terminal Block, dedicated KeyPad KP5, CAN or Profibus Large number of free programmable parameters32 complete sets of motor parameters can be stored and selected CE and UL (pending) Power supply moduleInput voltage 200 – 480 VAC, +10% / -15%, 50/60 Hz, auto-ranging DC power output max. 36 A Power IN connect to the bottomIntegrated dynamic braking resistor, 330 Ω /1000 W peak Possibility to add an external braking resistor module24 VDC, auxiliary power input supplied by customer, 2 to 4 A depending of the number of axis CAN port, internally interconnected to the drive(s) USB port, internally interconnected to the drive(s) RS485 port dedicated to remote KeyPad Article designation: ACO5000A External braking resistor moduleSame dimensions as the power supply module Internal connection to the power supply module Used when full braking power is required Rating 22 Ω / 1200 W (5 kW peak) Article designation: ACO5000RPower Drive moduleInternal connections to the power supply moduleMotor power OUT and PTC input connect to the bottomPluggable screw terminals – see "Control terminals description" All "Control terminals" are opto-insulated CAN portPROFIBUS port (Option)Sensor feedback connector (not compulsory to drive a motor) 7 segments status display4 power ratings: 5, 8, 12 and 20 A, 2 physical sizes Max output frequency 5000 HzArticle designation: ACO50xxD (see "Power ratings" table) Power ratingsDrive Nominal current Peakcurrent Max output Power @ 230 VMax. Output Power @ 400 VACMax. power dissipation ACO5005DACO5008D ACO5012D ACO5020D 5 A 8 A 12 A 20 A7.5 A 12 A 18 A 30 A3 kVA 5 kVA 7 kVA 12 kVA5 kVA 8 kVA 12 kVA 20 kVA200 W 320 W 480 W 800 WDANAHER MOTION S.A.S610-GB-0444 User Manual ACO5000 Page 7 / 16General technical dataUnit Comment Output frequency step Hz ≤ ± 0.5l of the set frequency Type of load Resistive / Inductive Short-circuit protection between phases At terminals Ground short-circuit protection At power ON and at terminals Efficiency at nominal load % 96 Max. ambient temperature °C 40 Output power derating relative to the operating altitude > 1000 m, derating of 5% per 1000 m. Max. operating altitude 2000 m – derating 10% Output power derating relative to the operating ambient temperature %/°C 3% / °C over the ambient of 40°C Max. ambient temperature 50° C Relative humidity % 15 … 85 not condensing Storage temperature °C -25 to +55 according VDE0160 Shipping temperature °C -25 to +70 according VDE0160Examples of product configuration and weightDesignationACO 5000A ACO 5005D ACO 5008D ACO 5012D ACO 5020D ACO 5000R Size Weight kgSINGLE AXISACO5-0005T 1 1 2 11.5 ACO5-0005R 1 1 1 3 13.8 ACO5-0008T 1 1 2 11.5 ACO5-0008R 1 1 1 3 13.8 ACO5-0012T 1 1 3 18.6 ACO5-0012R 1 1 1 4 20.7 ACO5-0020T 1 1 3 18.6 ACO5-0020R 1 1 1 4 20.7MULTI-AXISACO5-0055T 1 2 3 16.9 ACO5-0055R 1 2 1 4 19.2 ACO5-0085T 1 1 1 3 16.9 ACO5-5555T 1 4 5 27.6 ACO5-5555R 1 4 1 6 29.9 ACO5-0888R 1 3 1 5 24.5 ACO5-1255T 1 2 1 5 26.7 ACO5-1285R 1 1 1 1 1 6 29.0 ACO5-1212R 1 2 1 6 33.3 Any configuration up to size 6 (6 modules units) so far at any time, the sum of the currents doesn't exceed 36A as peak power. Any configuration exceeding the max. is not allowed, the power supply being not protected for overload. Only the drive(s) integrated a current limitation and an overload protection.DANAHER MOTION S.A.Mounting and installationMechanical dimensionsPage 8 / 16 User Manual ACO5000 S610-GB-0444DANAHER MOTION S.A.S610-GB-0444 User Manual ACO5000 Page 9 / 16Description and connectionPower terminalsInput specificationsAC lineo Input voltagemin. 200 V single phase –15% max. 3 phases 480 V 50 / 60 Hzo Single phase input connect to any 2 of L1, L2 or L3 o External overload protection (fuse) required, max. 32 A o Use copper conductors 75°C24 VDC power supplyo Voltage tolerances ±10%o Required power min. 1 A per moduleo External overload protection required if not short-circuit proofOutput specificationMotor powero Use power cable according to the recommendation of the motor manufacturer o Cable gauge according the motor current requirementsPTC inputo This input is over voltage proof up to 500 VACo In case of use of temperature sensor, program the appropriate input calibration.DANAHER MOTION S.A.Page 10 / 16 User Manual ACO5000 S610-GB-0444How to unlock the power terminalsPower terminal codingTo avoid the risk of inverting the connectors of the power supply and the drive(s), bothconnectors are coded. The pictures show the coding position (white square) and the way to insert the coding tag (the right pictures show a half inserted tag).PRESSPULLCoding of the power supplyCoding of the drive(s)Front panel description Power supply modulePower Drive moduleControl terminals descriptionNOTE: All digital and analogue inputs and outputs are opto-isolated. All outputs are short-circuit proof.# Name DESCRIPTION1 24V_OUTSame potential as the external supplied 24 VDC. Available to activate an input. This output is short circuit protected.2ENABLEThis enable is given by the CNC or PLC once all START conditions are satisfied. Without this enable, a START is impossible as the drivers of the chopper and the output stage are locked. Apply 24 VDC to energise the safety relay.Note: If this function is not managed by the CNC or PLC, a jumper must be put between terminals X1-1/1 and X1-1/2. If the AC power is not applied to the drive when the "enable" is powered, an error message will be displayed. A RESET is then needed before to start.3 EN_A4 EN_A This NO relay contact will close when the "enable" is powered. This information has normally to be sent back to the CNC or PLC as status confirmation.This relay contact is potential free. Max contact load 230VAC /2A or 24VDC/2A 5 DR_R 6 DR_R This NO relay potential free contact will close when the drive is READY resp. the relay energized, The contact will be open in case of FAILURE.Maximal contact load 125VAC/0.6A resp. 30VDC/2A or 110VDC/0.6A7STARTApply 24 VDC to START the drive. This function is active only if the drive enable has been powered (X1-1/2). The START can be activated with:A permanent signalAn impulse signal, duration min. 5 ms The type of START is selected by program.8 STOPThe drive will STOP when the 24 VDC is not applied to this input. If you use a permanent signal to START, this input must be connected to 24 VDC by ajumper to terminal X1-1/1 for example. If not, the drive will not start and an error message will be displayed.9 RESETApply 24 VDC to reset. Need always to be done after a failure. Don't apply a permanent 24 VDC as the reset is triggered by the positive edge of the signal. Min. duration of the pulse: 5 msF i r s t t e r m i n a l b l o c s e c t i o n X 1-110 0 VElectronic ground of the drive, linked to the 0 V of the external 24 VDC11 A_OUT1 12 A_OUT2 2 free programmable 0 to 10 V analogue outputs. Allocated parameters selected by program. Refer to 0 V, terminal X1-2/15. Max. load 10 mA, short-circuit proof.13 + 10 VDC Available to connect a potentiometer between X1-2/13 and X1-2/15, with the cursor to the input A_IN to make a manual analogue speed reference. Use a 10 k Ω potentiometer.14 A_IN Analogue speed reference input 0 to 10 V, referred to 0 V – X1-2/15 X 1-2 15 0 VElectronic ground of the drive, linked to the 0 V of the external 24 VDC# NameDESCRIPTION16 24V_OUT Same potential as the external supplied 24 VDC. Available to activate an input17 IN1 18 IN2 19 IN3 20 IN4 21 IN5 22 IN6 23 IN7 24 IN88 programmable digital inputs Function allocated by userAll inputs are opto-isolatedInsulated type 24 VDCVOFF [VDC] -0.3 - 5.0 @ 1 mA (max) VON [VDC] 15 - 30 @ 10 mA (typical)X 1-325 0 VElectronic ground of the drive, linked to the 0 V of the external 24 VDC26 OUT1 27 OUT2 28 OUT3 29 OUT4 4 programmable digital outputs, function allocated by userAll outputs are opto-isolated, max. load 10 mA, 24 VDCBy allocating the output frequency SDIG (6 times the output frequency) to one of these outputs, use a load resistors of max. 3.3 k ΩX 1-430 0 VElectronic ground of the drive, linked to the 0 V of the external 24 VDCSensor input1 Sensor detect +5 VDC 9 RESERVED2 NA 10 RESERVED3 RESERVED 11 RESERVED4 Input magneto-resistive sensor 12 INDEX -5 INDEX + 13 Channel B -6 Channel B + 14 Channel A -7 Channel A + 15 + 5 VDC power supply sensor8 Ground 0 V The case must be connected to earth The sensor input accept either 5 V TTL encoder signals or the signal from a magneto-resistive sensor (Siemens – FP210 D 250-22 or FP212 D 250-22)7 Segments displayCodification of failureDECLARATION OF CONFORMITYWe: Danaher Motion S.ALa Pierreire 2CH - 1029 Villars-Ste-Croixdeclare under our sole responsibility that the products of the family ACO5000, are exclusively designed for incorporation in an other machine. The operation of the product is submitted to the conformity of the complete equipment, following the provisions of the directive 89/392/EECThe conformity of the above specified products with the provisions of the Directive 73/23/EEC is supported by the respect of the standards CEI/IEC 1010-1If the mounting and connecting instructions of the installation’s manual have been respected, this product will be conform to the standards EN 61000-6-4, EN 61000-6-2 and EN61800-3 +A11 relating to the EMC directive 89/336/EEC.Mounting instructions related to the EMC - directive 89/336/EEC1. The frequency converter must be mounted in a closed metal cabinet.2. The power connection between converter and motor must be made using shield cable.3. The control connection must utilize shielded cables.4. The shield of the cables must be grounded at both ends.5. Power connections and control connection must be placed in separated canals.6. No external input filter is required.Assistance and Trouble shootingAll our products are manufactured in accordance with an accurate quality process. Beforedelivery they are checked for many hours under power. The quality system and productionprocess guarantee that all products are shipped free of default.The respect of the installation procedure describes in this manual and a correct definition of theapplication should avoid any commissioning problems.Should you meet some problems during installation or commissioning of the frequency inverterour technical staff are available for assistance. Please contact your local supplier or the localDANAHER-MOTION subsidiary.Please includes following information:1. Description of the application2. Default or problem you met3. Copy of the programmed parameters4. Wiring diagramIn case of emergency: Danaher Motion S.A.2LaPierreireCH - 1029 Villars-Ste-CroixTel. +41 21 631 33 33Fax. +41 21 636 05 09info@danaher-motion.chE-mail:NOTE: This user manual is subjet to modification without prior notice.Danaher Motion SALa Pierreire 2CH-1029 Villars-Ste-CroixSwitzerlandTel +41 (0) 21 631 33 33Fax +41 (0) 21 636 05 09E-mail info@danaher-motion.ch Internet MANUAL ACO5000_GB / printed in Switzerland © 10/2004 Subject to change without prior notice。
Liyang 分享JAMA:美国成人高血压治疗指南(JNC8)【完整版】JAMA杂志今天发布了2014年成人高血压治疗指南(2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults),新指南包含9条推荐和一种治疗流程图来帮助医生治疗高血压患者。
JNC8九条推荐:表1 2014年美国高血压指南(JNC8)推荐意见表JNC8高血压管理流程图:图1. JNC8推荐管理流程图来源:中国医学论坛报高血压是一种常见疾病,如果不能早期发现和治疗,容易引发心血管事件、中风、肾衰甚至死亡。
新指南中推荐的起始治疗血压水平、治疗目标、以及治疗用药均有严格的证据支持。
该指南制定专家组成员来自于Eighth Joint National Committee协会。
新旧指南有何不同?该指南制定专家组指出,与旧指南相比,新指南的证据级别更高。
新指南的证据均来自于随机对照研究,所有证据级别和推荐均根据它们对于人体健康的影响程度进行了评分。
专家组指出,新指南旨在为高血压人群建立一个相同的治疗目标。
不过,专家小组强调,尽管新指南提供了高血压开始治疗的时间点、治疗用药以及治疗目标等。
但是,指南并不能作为临床决策的替代品,临床医生在具体治疗时仍需考虑患者的个体差异。
表2,高血压新旧指南对比新指南回答了三个常见问题:∙何时开始降压治疗专家组对需要开始治疗的血压水平进行明确。
指南推荐,60岁以上老年人,血压达到150/90即应开始降压治疗;治疗目标值如上述。
但是,专家组强调,新指南规定的这一血压界值并不是重新定义高血压,此前由Joint National Committee 7定义的高血压水平(>=140/90 mm Hg )仍然有效。
血压处于这一范围的人群,均应通过生活方式进行干预。
∙血压治疗目标值新指南对以上三个问题的回答总体概括如下:60岁以上老年高血压患者的高血压治疗目标值应为150/90 mm Hg;30-59岁高血压患者舒张压应低于90mmHg。
单兵自卫武器----P90冲锋枪全解[90P][color=#0000ff]单兵自卫武器(PersonalDefenceWeapon,简称PDW)的概念,最初是在1986年美国战备协会举办的年会上提出的,期后美国本宁堡步兵学校在《美国轻武器总规划》中正式提出开发PDW的设想,其目的是取代手枪、冲锋枪和短突击步枪。
根据该规划的要求,PDW的装备对象是驾驶员、操作员、司令部人员、装甲兵、工兵、无线电员、飞行员、后勤人员或维护保养人员等。
这些人员虽然不是一线步兵,却占军队总人数一半以上,他们很少有时间来提高个人射击技术,而他们所装备的自卫武器——手枪和冲锋枪大多数发射9mmPara手枪弹,不能有效对付穿着防弹衣的人敌人。
因此,对PDW的要求要重量轻,易于携带,容易瞄准和操作,能有效对付防弹衣。
在1989年4月16日,北约组织发布的AC225文件中明确表示需要在北约各国军队中装备这种武器。
而在1986年,FN公司就以异乎寻常的速度开发PDW系统,当时FN公司的设计人员意识到手枪和冲锋枪如果不经严格训练,命中精度很低,而折叠枪托的短突击步枪仍是偏大偏重,自动射击时的后坐力也不好控制,因此必须研制一种全新的武器。
新枪被命名为P90,在1987年10月就进行了第一次的样枪射击表演,1988年,FN公司生产了4支样枪,每支枪均发射了15,000发枪弹,主要零件无破损现象。
到1992年P90正式投产,FNP90成了世界上第一支单兵自卫武器。
这是开发阶段的P90,图片质量不是很好弹夹原理正式定型后的P90,与上面的开发阶段图片比较,在外观上有一些微小的变化,你能看出来吗?在大约生产了300支P90后,FN公司为推广P90枪弹,对SS90弹作了一些修改变为SS190弹,枪管膛线缠距也相应地由178mm改为228mm。
发射SS190的现型P90与投产初期的P90在外观上的一个明显区别就是消焰器的长度和形状。
P90的结构和特点P90外形相当怪异独特,初露面是让人感觉好像科幻片中的武器。
蔓之研三重科技抗糖一键启动5G年轻力作者:来源:《医学美学美容》2020年第02期“只要相信自己,你的平凡也能铸就这个时代的伟大。
”——刘雯我们每个人,一生下来就进入到一个从成长到成熟,再到衰老的自然过程,这个过程是由我们的基因决定的。
但是每个人身上留下的痕迹却并不一样。
除了个体的遗传差异之外,还有许多因素影响着每个人的衰老进程。
近几年,“糖化”正逐渐被定义为“皮肤衰老的终极内因”。
而如何定义并解决“糖化”困局,蔓之研抗糖新品给出了答案。
随着年龄的增长,由于细胞新陈代谢变慢导致多余的糖分整日在血液中游离,葡萄糖与肌肤胶原蛋白反应生成“糖化终极产物AGEs”Ⅱ,AGEs使胶原蛋白和弹性蛋白交链,使他们变得僵硬、无弹性。
最终,胶原断裂,造成衰老。
这个糖化的过程会令肌肤干燥、敏感、粗糙,同时失去弹性、产生干纹细纹、色素沉淀变得暗黄,甚至会产生各种痘痘,斑点。
这就是肌肤的“糖化反应”。
皮肤学家认为,削减体内糖分,是使肌肤保持住年轻状态的重要因素之一。
糖化是一个不可逆的过程,糖化的胶原蛋白是难以被降解和修复的。
一般的抗糖化常见方式是,抑制胶原蛋白被糖化的过程,或者加速排出皮肤中已被糖化的老化物质。
蔓之研抗糖新品采用三重抗糖科技,高能缓解肌肤“糖化反应”。
·控制性阻糖——阻断AGEs生成,在糖化反应发生源头进行预防阻断,同时清除已产生的AGEs,为肌肤对抗糖基化构筑第一道防线。
·牺牲型抑糖——逆转糖化反应,包裹皮肤内残留的糖分,诱导替代AGEs与蛋白质结合,有效逆转并修护被破坏的蛋白质结构,维持肌肤光泽、弹性和柔韧度。
·再生型清糖——修护糖化损伤,触达并降低因糖化家居的基因甲基化,促进基因表达,唤活沉默的皮肤细胞,重新合成胶原蛋白和弹性蛋白,肌肤重现紧致。
·M抗糖紧致专利Ⅲ成分:脱羧肌肽 HCL、肌肽、生物类黄酮从源头抑制AGEs,快速包裹肌肤内多余糖分,代替胶原蛋白与糖发生反应,保护胶原蛋白不被糖化。
老年高血压患者降压治疗的目标值和低限值高血压的患病率随增龄而增加,老年高血压患者占所有高血压人群的60%以上。
已成为我国老年人群心脑血管疾病发病、死亡最重要的危险因素。
老年高血压在发病机制、临床表现及诊断治疗等方面均与非老年人不同,如收缩压增高、脉压增大、血压波动大、昼夜节律异常、易发生直立性低血压和餐后低血压等;常与多种疾病并存,并发症多,如冠心病、心力衰竭、脑血管疾病、肾功能不全、糖尿病等;并且难治性高血压的比率高于非老年人群。
制定适合老年高血压患者降压治疗的目标值和低限值对指导降压治疗、降低高血压导致的致残率和病死率、改善生活质量和提高老年患者的预期寿命具有重要的临床意义。
但目前对老年人群最佳降压目标值和低限值仍存在较大的争议,缺乏更多的循证医学证据。
老年高血压患者降压治疗不宜矫枉过正,血压水平与心血管危险性间可能存在着J型曲线关系,过低的血压可以增加老年患者不良心脑血管事件的发生。
所以探索老年高血压人群降压治疗适宜的目标值和低限值,以制定个体化的降压治疗方案,一直以来受到人们的关注。
一、老年高血压患者积极降压治疗获益的循证证据高血压在老年人群中较为普遍,60岁以后收缩压继续升高而舒张压逐渐降低、脉压增大,这与老年高血压的病理、生理特点有关。
随增龄大动脉弹性回缩能力和顺应性降低、弹性贮备血管中存留的血量减少,导致单纯收缩期高血压。
单纯收缩期高血压是老年人高血压的主要表现形式,控制单纯收缩期高血压,可有效降低卒中、心血管事件和死亡的风险。
一项老年收缩期高血压的临床试验研究中,使用利尿剂和β受体阻滞剂阶梯疗法长期治疗,卒中的发生率较安慰剂下降36%,冠心病事件下降27%,使每1 000人中心血管事件减少55人次。
欧洲收缩期高血压的临床研究中,与安慰剂组患者比较,降压药物治疗组患者收缩压显著下降,卒中发生率下降42%(P=0.003),非致死性卒中的危险下降44%(P=0.007)。
所有心血管疾病的危险下降31%(P<0.001)。