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Hochdruck und Herzinsuffizienz

Hypertension and cardiac failure

  • Schwerpunkt: Herzinsuffizienz
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Zusammenfassung

Die arterielle Hypertonie ist die Hauptursache für Morbidität und Mortalität mit einer weltweiten Prävalenz von etwa 26%. Sie ist das Paradebeispiel einer chronischen Erkrankung mit meist stillem Beginn, schleichendem Verlauf und häufig fatalem Ausgang. Mit zunehmendem Alter nimmt die Inzidenz zu. Die arterielle Hypertonie ist die häufigste Form der Druckbelastung für innere Organe und stellt dadurch einen zentralen kardiovaskulären Risikofaktor dar. Am Herzen treten sowohl vaskuläre als auch myokardiale Manifestationen auf: die stenosierende koronare Makro- und Mikroangiopathie, die konzentrische linksventrikuläre Hypertrophie sowie die perivaskuläre und interstitielle Fibrose. Später resultieren Herzhypertrophie und Herzinsuffizienz. Die arterielle Hypertonie ist eine wesentliche Ursache der koronaren Herzkrankheit, die ihrerseits zu etwa 50% Ursache der Herzinsuffizienz ist und die arterielle Hypertonie ursächlich mitbedingt. So wird der Zusammenhang zwischen arterieller Hypertonie und Herzinsuffizienz deutlich. In dieser Arbeit werden neben Pathophysiologie, klinischer Beschwerdesymptomatik, Diagnostik und therapeutischen Zielen auch medikamentöse Optionen diskutiert.

Abstract

Arterial hypertension is the leading cause of mortality and morbidity with a worldwide prevalence of 26%. Aging increases the incidence of arterial hypertension. Arterial hypertension is the prime example for a chronic disease with asymptomatic beginning, creeping course and fatal outcome. Arterial hypertension is a major cardiovascular risk factor and leads to vascular as well as myocardial manifestations: coronary artery disease, hypertensive microvascular disease, concentric left ventricular hypertrophy as well as perivascular and interstitial fibrosis. In the late stages of the disease, hypertrophy and cardiac failure develop. Arterial hypertension is the leading cause of coronary artery disease and cardiac failure, and coronary artery disease is the cause of heart failure in 50% of cases. Various non-invasive and invasive procedures are available for screening and follow-up. The primary therapeutic target is to reverse cardiac manifestations of arterial hypertension using specific therapeutic algorithms as well as lowering blood pressure. This article covers the pathophysiology of arterial hypertension and cardiac failure, clinical symptoms, diagnostic options and therapeutical goals as well as medicinal options.

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Authors and Affiliations

  1. Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    C.M. Schannwell, M.G. Hennersdorf & B.E. Strauer

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  1. C.M. Schannwell
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  2. M.G. Hennersdorf
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  3. B.E. Strauer
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Correspondence to C.M. Schannwell.

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Schannwell, C., Hennersdorf, M. & Strauer, B. Hochdruck und Herzinsuffizienz. Internist 48, 909–920 (2007). https://doi.org/10.1007/s00108-007-1913-y

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