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Antihypertensive Therapie bei Diabetes mellitus

Leitlinie der österreichischen Diabetesgesellschaft 2012

Antihypertensive therapy in diabetes mellitus

2012 guidelines of the Austrian diabetes association

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Zusammenfassug

Die Blutdrucksenkung ist einer der wichtigsten Maßnahmen um die vaskulären Komplikationen und die Mortalität bei Patienten mit Diabetes mellitus zu senken. Rezente Studien zeigen, dass die optimalen Blutdruckzielwerte zwischen 130–135 mmHg systolisch und 80 mmHg diastolisch liegen dürften. Niedrigere Blutdruckzielwerte (z. B. 120/80 mmHg) können zwar das Risiko für Schlaganfall und diabetische Nephroopathie weiter senken, sind aber mit einer erhöhten Kardiovaskulären Mortalität assoziiert. Sehr niedrige Blutdruckwerte (< 120 mmHg) sollten insbesondere bei Patienten mit koronarer Herzerkrankung oder mit peripherer arterieller Verschlusskrankheit unbedingt vermieden werden. Der Großteil der Patienten mit Diabetes und Hypertonie benötigt eine antihypertensive Kombinationstherapie, wobei ACE-Inhibitoren oder Angiotensin-II Receptor Blocker in der first-line Therapie eingesetzt werden sollen.

Abstract

Blood pressure lowering is one of the most important interventions for reducing the vascular complications and mortality in patients with diabetes mellitus. Recent studies indicate that the optimal blood pressure level might be in the range between 130–135 mmHg systolic and 80 mmHg diastolic. Lower blood pressure levels (e.g. 120/80 mmHg) can further reduce the risk for stroke and diabetic nephropathy, but are associated with increased cardiovascular mortality. In particular very low blood pressure levels (< 120 mmHg) should be avoided in patients with coronary heart disease or peripheral arterial disease. Most patients with diabetes mellitus need antihypertensive combination therapies, whereby ACE-inhibitors or Angiotensin-II receptor antagonists should be first line drugs.

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Authors and Affiliations

  1. 1. Medizinische Abteilung, Krankenanstalt Rudolfstiftung, Wien, Österreich

    Guntram Schernthaner

  2. Abteilung für Innere Medizin und Kardiologie, Landeskrankenhaus Feldkirch, Feldkirch, Österreich

    Heinz Drexel

  3. Klinische Abteilung für Nephrologie, Universitätsklinik für Innere Medizin, Medizinische Universitätsklinik Graz, Graz, Österreich

    Alexander R Rosenkranz

  4. Klinische Abteilung für Angiologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Wien, Österreich

    Gerit-Holger Schernthaner

  5. Klinische Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich

    Bruno Watschinger

Authors
  1. Guntram Schernthaner
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  2. Heinz Drexel
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  3. Alexander R Rosenkranz
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  4. Gerit-Holger Schernthaner
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  5. Bruno Watschinger
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Correspondence to Guntram Schernthaner.

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Schernthaner, G., Drexel, H., Rosenkranz, A. et al. Antihypertensive Therapie bei Diabetes mellitus. Wien Klin Wochenschr 124 (Suppl 2), 23–27 (2012). https://doi.org/10.1007/s00508-012-0270-6

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  • DOI: https://doi.org/10.1007/s00508-012-0270-6

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