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Hochdruck und Herz

Hypertension and heart

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Zusammenfassung

Die arterielle Hypertonie, die mit einer hohen Dunkelziffer behaftet ist, führt in einem hohen Prozentsatz zu Endorganschäden. Neben Niere, Gefäßen und Gehirn nimmt hier das Herz eine zentrale Rolle ein. Wesentliche Folgen der Hypertonie am Herzen sind Mikroangiopathie, interstitielle Fibrose und Linksherzhypertrophie. Gerade die Linksherzhypertrophie ist anfangs ein Kompensationsmechnismus. Hat sie sich einmal entwickelt, stellt sie aber auch einen wesentlichen eigenständigen Risikofaktor für die kardiovaskuläre Mortalität dar. Damit einhergehend entwickelt sich früh eine diastolische, bei länger dauernder Hypertonie auch eine systolische Funktionsstörung. Klinische Folgen sind Angina pectoris, Dyspnoe und Herzrhythmusstörungen (v. a. atriale Arrhythmien bzw. Vorhofflimmern). Bei eingeschränkter systolischer Funktion treten auch vermehrt ventrikuläre Tachyarrhythmien auf, das Risiko des plötzlichen Herztods ist deutlich erhöht. Die antihypertensive Therapie kann zu einer Hypertrophieregression führen, damit einhergehend verbessert sich auch die Klinik und die Prognose der Patienten.

Abstract

Arterial hypertension often leads to diseases of kidneys, vessels and brain. Besides these end organ damages the changes of the heart are of important role. Substantial consequences of hypertension are microangiopathy, interstitial fibrosis and left ventricular hypertrophy. Hence, as an early stage diastolic dysfunction results. Due to longer persistent hypertension also systolic dysfunction develops. Clinically, patients suffer from angina pectoris, dyspnoea and cardiac arrhythmias (i.e. atrial arrhythmia, atrial fibrillation). The left ventricular hypertrophy also is associated with an increased risk of malignant ventricular arrhythmias. The risk of sudden cardiac death is raised as well, in particular in patients with dilated heart and reduced left ventricular ejection fraction. Well controlled antihypertensive therapy could lead to a regression of left ventricular hypertrophy. Hence, disorders and prognosis of the patients could be improved.

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Authors and Affiliations

  1. Medizinische Klinik I, Klinikum Am Gesundbrunnen, SLK-Kliniken Heilbronn GmbH , Am Gesundbrunnen 20–26, 74078, Heilbronn, Deutschland

    M. Hennersdorf

  2. Klinik für Kardiologie und Angiologie, Evangelisches Krankenhaus, Oberhausen, Deutschland

    C.M. Schannwell

  3. Klinik für Kardiologie und Elektrotherapie, Klinikum Karlsburg, Karlsburg, Deutschland

    W. Motz

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  1. M. Hennersdorf
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  2. C.M. Schannwell
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  3. W. Motz
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Correspondence to M. Hennersdorf.

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Hennersdorf, M., Schannwell, C. & Motz, W. Hochdruck und Herz. Internist 51, 815–825 (2010). https://doi.org/10.1007/s00108-009-2556-y

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