衰弱和高血压作为老年人常见的综合征与慢性疾病，两者之间关联密切、相互影响。衰弱可能与老年患者降压治疗存在反向因果关系，老年衰弱患者是否应该积极控制高血压尚存在争议。值得注意的是，现阶段临床在制定老年衰弱患者高血压管理策略前需对患者进行充分的衰弱评估，并根据是否存在功能依赖和衰弱时自主活动能力损伤的程度制定降压方案。此类患者高血压的综合管理需要患者、医护、照护者等共同决策，通过生活方式、药物治疗等多种措施进行个体化干预，并根据患者的血压控制情况、不良反应等动态化调整管理方案，从而提高患者的依从性，达到预期管理目标。文章围绕老年衰弱人群高血压治疗的特殊性、具体策略、干预方式、随访管理等方面进行分析与阐述。

Frailty and hypertension are common syndromes and chronic conditions among older adults, sharing a close and bidirectional relationship. A potential reverse causality may exist between frailty and antihypertensive therapy in the elderly, and whether frail older patients should undergo intensive hypertension management remains debated. It is particularly important to note that current clinical practice necessitates a comprehensive frailty assessment before formulating hypertension management strategies for this population. Antihypertensive regimens should be formulated based on the presence of functional dependence and the extent of impairment in autonomous mobility due to frailty. The comprehensive management of hypertension in these patients requires shared decision-making among patients, healthcare professionals, and caregivers. This involves individualized interventions for frailty or hypertension through measures such as lifestyle modifications and pharmacological treatments, with dynamic adjustments to the management plan based on the patient’s blood pressure control status and adverse reactions. This approach aims to enhance patient adherence and achieve desired management outcomes. This article analyzes and elaborates on the particularities of hypertension treatment in frail older adults, specific strategies, intervention methods, and follow-up management.