近年来的循证医学实践给收缩性高血压(SH)的处理,带来新的证据和理念。SH患者收缩压的目标值通常定在<140mmHg,对于合并冠心病、糖尿病和肾脏病的老年患者的目标血压还无明确的结论。J型曲线存在于SH患者,应引起警惕。老年人以容量性高血压多见,噻嗪类利尿剂和二氢吡啶类钙拮抗剂是适宜的治疗选择,血管紧张素转换酶抑制剂和血管紧张素受体阻断剂也可用于SH的初始和维持用药。联合用药已成为降压达标的最重要的治疗策略。 Evidence-based medicine in recent years has brought new evidence and ideas to the treatment of systolic hypertension (SH). The target value for systolic blood pressure in patients with SH is usually set at <140 mmHg, with no clear conclusion about the target blood pressure in elderly patients with coronary heart disease, diabetes, and kidney disease. J-type curve exists in SH patients, should be alert. Elderly with capacity more common high blood pressure, thiazide diuretics and dihydropyridine calcium antagonists is the appropriate treatment options, angiotensin converting enzyme inhibitors and angiotensin receptor blockers can also be used SH Initial and maintenance medication. Combination therapy has become the most important antihypertensive treatment strategy.