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Hypertonie-Update

Aktuelle Handlungsempfehlungen für die Praxis
  • J. MenneEmail author
  • B. M. W. Schmidt
CME
  • 45 Downloads

Zusammenfassung

Der Hypertonus ist weiterhin die Erkrankung, die zu den meisten vermeidbaren Todesfällen und zur größten Zunahme an behinderungsadjustierten Lebensjahren („disability-adjusted life years“, DALY) führt. Aus diesem Grunde sind die aktuellen von der European Society of Hypertension (ESH) und der European Society of Cardiology (ESC) gemeinsam veröffentlichten Leitlinien von großer praktischer Bedeutung. In diesen Leitlinien gibt es zwei besonders wichtige Änderungen: Erstens wird jetzt bei fast allen Patienten unter 65 Jahren ein systolischer Blutdruck von 120–129 mm Hg angestrebt. Zweitens wird die Kombinationstherapie anstatt einer Monotherapie als initiale Medikamententherapie empfohlen. Weitere wichtige Empfehlungen der Leitlinie werden im Text dargestellt. Auch haben neue Analysen ergeben, dass die langfristige Therapie mit Hydrochlorothiazid (HCT) zu einem bis zu 7‑ bis 8‑fach erhöhten Risiko für das Auftreten eines Plattenepithelkarzinoms der Haut führt. Therapiealternativen werden benannt.

Schlüsselwörter

Antihypertensiva Blutdruck Kombinationstherapie Leitlinie Hydrochlorothiazid 

Hypertension update

Current recommendations for action in practice

Abstract

Hypertension continues to be the disease that leads to the most preventable deaths and the largest increase in disability-adjusted life years (DALY). For this reason, the current guidelines jointly published by the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) are of great practical importance. There are two particularly important changes in these guidelines. Firstly, a systolic blood pressure of 120–129 mm Hg is targeted for almost all patients under the age of 65 years. Secondly, it is now recommended that combination therapy instead of monotherapy should be used as the initial drug treatment. Many more recommendations from the guidelines are highlighted in the text. New analyses have also shown that long-term treatment with hydrochlorothiazide (HCT) leads to a 7–8-fold increased risk of squamous cell carcinoma of the skin. Treatment alternatives are named.

Keywords

Antihypertensive agents Blood pressure Combination therapy Guidelines Hydrochlorothiazide 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Menne und B.M.W. Schmidt geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik für Nieren- und HochdruckerkrankungenMedizinische Hochschule HannoverHannoverDeutschland

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