Zusammenfassung
Die arterielle Hypertonie ist die häufigste innere Erkrankung. Die Behandlung ist durch Senkung der kardiovaskulären Morbidität und Mortalität hoch effektiv. Therapieindikation ist das kardiovaskuläre Gesamtrisiko unter Einbeziehung aller relevanten Risikofaktoren. Zielblutdruck ist <140/90 mmHg, bei gleichzeitigem Diabetes mellitus oder Niereninsuffizienz <130/80 mmHg. Allgemeinmaßnahmen sind je nach Schwere der Hypertonie allein oder adjuvant zur Medikamententherapie sinnvoll. Medikamente der ersten Wahl sind Diuretika, Kalziumantagonisten, ACE-Hemmer, AT1-Blocker und Betablocker. Meist ist eine Kombinationstherapie sinnvoll. Mögliche Behandlungsstrategien sind Stufentherapie, initiale niedrig dosierte Kombinationstherapie und sequenzielle Monotherapie.
Abstract
Arterial hypertension is the most common internal disease. Treatment is highly effective in lowering cardiovascular morbidity and mortality and is indicated based on total cardiovascular risk as assessed by all relevant risk factors. Target blood pressure is <140/90 mmHg, or with concomitant diabetes mellitus or renal insufficiency <130/80 mmHg. Lifestyle modifications are helpful, either alone or as an adjuvant to drug treatment, depending on the severity of the disease. First-line drugs are diuretics, calcium antagonists, ACE inhibitors, AT1 blockers and β blockers. In most cases, combination therapy is appropriate. Possible treatment strategies include stepped care, initial low-dose combination therapy and sequential monotherapy.
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Zidek, W. Behandlung der arteriellen Hypertonie. Internist 48, 613–624 (2007). https://doi.org/10.1007/s00108-007-1839-4
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DOI: https://doi.org/10.1007/s00108-007-1839-4
Schlüsselwörter
- Arterielle Hypertonie
- Kardiovaskuläres Gesamtrisiko
- Antihypertensive Therapie
- Medikamentöse Therapie
- Kombinationstherapie