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Zeitschrift für Gerontologie und Geriatrie

, Volume 51, Issue 7, pp 822–835 | Cite as

Arterielle Hypertonie im Alter mit dem Fokus 80+

  • Dhayana Dallmeier
  • Michael D. Denkinger
CME
  • 257 Downloads

Zusammenfassung

Ein unbehandelter Bluthochdruck erhöht auch im Alter das Risiko für Folgeerkrankungen, v. a. für Schlaganfälle, koronare Herzerkrankung, Myokardinfarkt und Herzinsuffizienz, und ist leitliniengerecht zu therapieren. Als systolische Blutdruckzielwerte werden für leicht gebrechliche bis zu 80-Jährige 130–139 mm Hg (in der Praxis gemessen) angestrebt. Dies gilt gemäß den aktuellen europäischen Leitlinien auch für über 80-Jährige, allerdings mit Therapiebeginn beim systolischen Wert >160 mm Hg. Körperlich eingeschränkte, sehr gebrechliche Ältere erhalten altersunabhängig eine individuell angepasste Therapie; die Autoren empfehlen systolische Zielwerte <150 mm Hg, ohne 130/70 mm Hg zu unterschreiten. Schlechte Verträglichkeit erfordert ggf. die Therapieanpassung. Antihypertensiva sind unter Polypharmazieaspekten auszuwählen. Der arterielle Hypertonus im Alter kann in vielen Fällen unter Berücksichtigung von Multimorbidität und Medikamenteninteraktionen leitliniengerecht therapiert werden.

Schlüsselwörter

Blutdruck Blutdruckbestimmung Frailty Körperliche Funktion Behinderung 

Arterial hypertension in old age with the focus on 80+

Abstract

Untreated high blood pressure in old age increases the risk of secondary diseases, especially stroke, coronary heart disease, myocardial infarction and heart failure and should be treated according to the guidelines. For slightly frail people up to the age of 80 years, a systolic blood pressure of 130–139 mm Hg (measured in the doctors surgery) should be the aim. According to the current European guidelines the same values are recommended for those over the age of 80 years but treatment should start at a systolic blood pressure of ≥160 mm Hg. In physically disabled and very frail older people an individually tailored approach is recommended, regardless of age. The authors recommend a target systolic value <150 mm Hg but not below 130/70 mm Hg. In the event of poor tolerance the treatment should be adapted further as necessary. Antihypertensive medication should be selected under the aspects of polypharmacy. In many cases arterial hypertension in old age can be treated in accordance with the guidelines, taking multimorbidity and the interaction of medications into consideration.

Keywords

Blood pressure Blood pressure determination Frailty Physical function Disability 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

D. Dallmeier und M.D. Denkinger geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Geriatrie der Universität UlmAGAPLESION Bethesda KlinikUlmDeutschland
  2. 2.Geriatrisches Zentrum Ulm/Alb-DonauUlmDeutschland

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