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Pathophysiologie der Hypertonie

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Pathophysiology of hypertension

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Zusammenfassung

Die Pathophysiologie der essenziellen arteriellen Hypertonie lässt auch im Jahr 2015 viele Fragen offen. In diversen Bereichen der Medizin wurden mithilfe neuer molekularer „Omics“-Techniken erhebliche wissenschaftliche Fortschritte erzielt, die dann in neue diagnostische und therapeutische Verfahren einfließen konnten. Im Bereich der Hypertonieforschung wurden diese Methoden im Rahmen sehr großer Kohorten eingesetzt, haben jedoch weniger als erwartet zum pathophysiologischen Verständnis oder klinischen Management beigetragen. Die in der vorliegenden Arbeit diskutierten Befunde zur pathophysiologischen Bedeutung von Baroreflexmechanismen, natriuretischen Peptiden und osmotisch inaktiver Natriumspeicherung haben eine Gemeinsamkeit: Alle beruhen auf Beobachtungen kleiner, sorgfältig durchgeführter systemphysiologischer Untersuchungen, deren Resultate oft nicht im Einklang mit der Lehrbuchmeinung stehen. Dennoch haben diese Befunde neue Forschungsfelder eröffnet und werden mit großer Wahrscheinlichkeit Eingang in die Klinik finden.

Abstract

In the year 2015, many questions regarding the pathophysiology of essential arterial hypertension remain unresolved. Substantial scientific progress has been made in various medical areas aided by novel molecular“omics” techniques. The findings could then be implemented in diagnostic and therapeutic procedures. In the field of hypertension research such methods have been applied in very large cohorts but have contributed less to pathophysiological understanding and clinical management than expected. The findings on the pathophysiological importance of baroreflex mechanisms, natriuretic peptides and osmotically inactive sodium storage discussed in this article all have something in common: all are based on small, carefully conducted human physiological investigations and often challenge current textbook knowledge. Nevertheless, these findings have opened up new research fields and are likely to affect clinical care.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Jordan: Beratertätigkeit für Novartis, Boehringer, Riemser, Orexigen und Vivus. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Institut für Klinische Pharmakologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    J. Jordan

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Jordan, J. Pathophysiologie der Hypertonie. Internist 56, 219–223 (2015). https://doi.org/10.1007/s00108-014-3572-0

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