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Besonderheiten der Pharmakotherapie beim älteren Hypertoniker

Special features of pharmacotherapy in older hypertensive subjects

  • Schwerpunkt: Hypertonie
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Zusammenfassung

Die Prävalenz der arteriellen Hypertonie liegt in Deutschland im Alter zwischen 65 und 74 Jahren bei 60–80%. Auch bei älteren Menschen besteht eine positive Beziehung zwischen der Blutdruckhöhe und dem Anstieg der Letalität infolge Myokardinfarkt und Schlaganfall. Mit der antihypertensiven Therapie kann die Prognose älterer Hypertoniker deutlich verbessert werden. Bei ihnen hat die Therapie insbesondere für die Prävention von Schlaganfällen eine enorme Bedeutung, die zukünftig aufgrund der demographischen Entwicklung noch weiter zunehmen wird. Ältere Patienten haben ein erhöhtes Risiko, unter der Therapie unerwünschte Arzneimittelwirkungen wie Blutdruckabfälle in Orthostase zu entwickeln. Die individuelle Berücksichtigung von Risikofaktoren für unerwünschte Ereignisse und die Vermeidung von Arzneimittelinteraktionen im Rahmen der Polypharmakotherapie haben eine große Bedeutung bei der Differenzialtherapie mit Antihypertensiva im Alter.

Abstract

The prevalence of arterial hypertension in Germany is 60–80% in individuals between 65 and 74 years of age. In older people there is also a positive correlation between blood pressure level and rise in mortality due to myocardial infarction and stroke. Antihypertensive therapy can considerably improve the prognosis of older hypertensive individuals. Treatment is of enormous importance in these patients, particularly for prevention of strokes, which will continue to increase in the future as a result of demographic trends. Older patients have an elevated risk of developing undesirable drug reactions while under therapy such as a drop in blood pressure in an erect/standing position. Taking into account individual risk factors for unwanted events and avoidance of drug interactions during polypharmacotherapy are important aspects in differential therapy with antihypertensive agents in the elderly.

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  1. Institut für Klinische Pharmakologie und Toxikologie, Charité – Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    R. Kreutz FAHA

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Kreutz, R. Besonderheiten der Pharmakotherapie beim älteren Hypertoniker. Internist 50, 442–454 (2009). https://doi.org/10.1007/s00108-008-2293-7

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