Zusammenfassung
Die arterielle Hypertonie ist ein bedeutender kardiovaskulärer Risikofaktor, dessen Diagnostik und Therapie weltweit von immenser gesundheitlicher und sozioökonomischer Relevanz ist. Eine arterielle Hypertonie liegt definitionsgemäß bei einem systolischen Wert ≥140 mmHg und/oder einem diastolischen Wert ≥90 mmHg vor. Neben der Praxisblutdruckmessung sollte die Diagnose mittels praxisunabhängiger Messungen überprüft werden. Pathophysiologisch ist häufig eine gesteigerte Aktivität des Renin-Angiotensin-Aldosteron-Systems mit konsekutiv gesteigertem Sympathikotonus ursächlich für die Entwicklung einer arteriellen Hypertonie. Dies bildet die Grundlage von wesentlichen medikamentösen und interventionellen Behandlungsansätze. Eine Vielzahl von klinischen Studien konnte bisher deren positiven prognostischen Effekt untermauern. Das folgende Buchkapitel bietet – basierend auf aktuellen Leitlinienempfehlungen – einen Überblick über die Definition der arteriellen Hypertonie, deren Diagnostik und Therapie.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Adler A, Agodoa L, Algra A et al (2021) Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet. 397(10285):1625–1636. https://doi.org/10.1016/S0140-6736(21)00590-0
Azizi M, Schmieder RE, Mahfoud F et al (2018) Endovascular ultrasound renal denervation to treat hypertension (RADIANCE-HTN SOLO): a multicentre, international, single-blind, randomised, sham-controlled trial. Lancet 391(10137):2335–2345. https://doi.org/10.1016/S0140-6736(18)31082-1
Azizi M, Sanghvi K, Saxena M et al (2021) Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE-HTN TRIO): a randomised, multicentre, single-blind, sham-controlled trial. Lancet. https://doi.org/10.1016/s0140-6736(21)00788-1
Böhm M, Schumacher H, Teo KK et al (2017) Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials. Lancet 389(10085):2226–2237. https://doi.org/10.1016/S0140-6736(17)30754-7
Ettehad D, Emdin CA, Kiran A et al (2016) Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 387(10022):957–967. https://doi.org/10.1016/S0140-6736(15)01225-8
Forouzanfar MH, Afshin A, Alexander LT et al (2016) Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 388(10053):1659–1724. https://doi.org/10.1016/S0140-6736(16)31679-8
Forouzanfar MH, Liu P, Roth GA et al (2017) Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990–2015. JAMA 317(2):165–182. https://doi.org/10.1001/jama.2016.19043
Kandzari DE, Böhm M, Mahfoud F et al (2018) Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. Lancet 391(10137):2346–2355. https://doi.org/10.1016/S0140-6736(18)30951-6
Kario K, Hoshide S, Mizuno H et al (2020) Nighttime blood pressure phenotype and cardiovascular prognosis: practitioner-based nationwide JAMP study. Circulation 142(19):1810–1820. https://doi.org/10.1161/CIRCULATIONAHA.120.049730
Kotseva K, De Backer G, De Bacquer D et al (2019) Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry. Eur J Prev Cardiol 26(8):824–835. https://doi.org/10.1177/2047487318825350
Mancia G, Fagard R, Narkiewicz K et al (2013) The task force for the management of arterial hypertension of the european society of hypertension (esh) and of the european society of cardiology (esc). J Hypertens 31(7):1281–1357. https://doi.org/10.1097/01.hjh.0000431740.32696.cc
Multiple risk factor intervention trial (1982) Risk factor changes and mortality results. Multiple Risk Factor Intervention Trial Research Group. https://pubmed.ncbi.nlm.nih.gov/7050440/. Zugegriffen am 29.06.2021
Sundström J, Arima H, Woodward M et al (2014) Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data. Lancet 384(9943):591–598. https://doi.org/10.1016/S0140-6736(14)61212-5
Townsend RR, Mahfoud F, Kandzari DE et al (2017) Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial. Lancet 390(10108):2160–2170. https://doi.org/10.1016/S0140-6736(17)32281-X
Whelton PK, Carey RM, Aronow WS et al (2018) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical practice guidelines. Hypertension 71(6):E13–E115. https://doi.org/10.1161/HYP.0000000000000065
Williams B, Mancia G, Spiering W et al (2018) 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 39(33):3021–3104. https://doi.org/10.1093/eurheartj/ehy339
Zhou B, Danaei G, Stevens GA et al (2019) Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. Lancet 394(10199):639–651. https://doi.org/10.1016/S0140-6736(19)31145-6
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this entry
Cite this entry
Emrich, I., Kulenthiran, S., Mahfoud, F. (2022). Kardiovaskulärer Risikofaktor Hypertonie. In: Marx, N., Erdmann, E. (eds) Klinische Kardiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62939-0_8-1
Download citation
DOI: https://doi.org/10.1007/978-3-662-62939-0_8-1
Received:
Accepted:
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-62939-0
Online ISBN: 978-3-662-62939-0
eBook Packages: Springer Referenz Medizin