Wiener klinische Wochenschrift

, Volume 124, Supplement 2, pp 23–27 | Cite as

Antihypertensive Therapie bei Diabetes mellitus

Leitlinie der österreichischen Diabetesgesellschaft 2012
  • Guntram Schernthaner
  • Heinz Drexel
  • Alexander R Rosenkranz
  • Gerit-Holger Schernthaner
  • Bruno Watschinger
leitlinien für die praxis

Zusammenfassug

Die Blutdrucksenkung ist einer der wichtigsten Maßnahmen um die vaskulären Komplikationen und die Mortalität bei Patienten mit Diabetes mellitus zu senken. Rezente Studien zeigen, dass die optimalen Blutdruckzielwerte zwischen 130–135 mmHg systolisch und 80 mmHg diastolisch liegen dürften. Niedrigere Blutdruckzielwerte (z. B. 120/80 mmHg) können zwar das Risiko für Schlaganfall und diabetische Nephroopathie weiter senken, sind aber mit einer erhöhten Kardiovaskulären Mortalität assoziiert. Sehr niedrige Blutdruckwerte (< 120 mmHg) sollten insbesondere bei Patienten mit koronarer Herzerkrankung oder mit peripherer arterieller Verschlusskrankheit unbedingt vermieden werden. Der Großteil der Patienten mit Diabetes und Hypertonie benötigt eine antihypertensive Kombinationstherapie, wobei ACE-Inhibitoren oder Angiotensin-II Receptor Blocker in der first-line Therapie eingesetzt werden sollen.

Schlüsselwörter

Diabetes mellitus Blutdrucksenkung Antihypertensive Therapie 

Antihypertensive therapy in diabetes mellitus

2012 guidelines of the Austrian diabetes association

Abstract

Blood pressure lowering is one of the most important interventions for reducing the vascular complications and mortality in patients with diabetes mellitus. Recent studies indicate that the optimal blood pressure level might be in the range between 130–135 mmHg systolic and 80 mmHg diastolic. Lower blood pressure levels (e.g. 120/80 mmHg) can further reduce the risk for stroke and diabetic nephropathy, but are associated with increased cardiovascular mortality. In particular very low blood pressure levels (< 120 mmHg) should be avoided in patients with coronary heart disease or peripheral arterial disease. Most patients with diabetes mellitus need antihypertensive combination therapies, whereby ACE-inhibitors or Angiotensin-II receptor antagonists should be first line drugs.

Keywords

Diabetes mellitus Blood pressure lowering Antihypertensive therapy Myocardial infarction Stroke Diabetic nephropathy 

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Copyright information

© Springer-Verlag Wien 2012

Authors and Affiliations

  • Guntram Schernthaner
    • 1
  • Heinz Drexel
    • 2
  • Alexander R Rosenkranz
    • 3
  • Gerit-Holger Schernthaner
    • 4
  • Bruno Watschinger
    • 5
  1. 1.1. Medizinische AbteilungKrankenanstalt RudolfstiftungWienÖsterreich
  2. 2.Abteilung für Innere Medizin und KardiologieLandeskrankenhaus FeldkirchFeldkirchÖsterreich
  3. 3.Klinische Abteilung für Nephrologie, Universitätsklinik für Innere MedizinMedizinische Universitätsklinik GrazGrazÖsterreich
  4. 4.Klinische Abteilung für Angiologie, Universitätsklinik für Innere Medizin IIMedizinische Universität WienWienÖsterreich
  5. 5.Klinische Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin IIIMedizinische Universität WienWienÖsterreich

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