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Antihypertonika

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Arzneiverordnungs-Report 2003

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Zusammenfassung

Die arterielle Hypertonie (Blutdruckwerte von ≥140/≥90mmHg bei wiederholten Messungen) kommt in Deutschland bei über 50% der 35-64jährigen vor (Wolf-Maier et al. 2003) und begünstigt das Auftreten von Apoplexie, Demenz, Herzinfarkt, Herzinsuffizienz, Nierenversagen und peripherer arterieller Verschlußkrankheit. Bei mittelschwerer und schwerer Hypertonie ist der günstige Effekt einer konsequenten Arzneitherapie auf die Lebenserwartung des Hochdruckpatienten durch zahlreiche Studien belegt. Bei einem diastolischen Blutdruck zwischen 90 und 99 mmHg im mittleren Alter, der in über 75% aller Fälle mit Hypertonie vorliegt, ist der Nutzen einer antihypertensiven Therapie zwar ebenfalls nachgewiesen, er ist aber deutlich geringer. Bei 65-70jährigen steigt die Prävalenz der Hypertonie weiter an, vor allem wenn die häufig vorkommende isolierte systolische Hypertonie (systolisch über 160, diastolisch unter 90 mmHg) mit berücksichtigt wird. Kontrollierte Studien haben gezeigt, daß eine antihypertensive Therapie auch im Alter die kardiovaskuläre Morbidität und Mortalität senkt. Selbst bei isolierter systolischer Hypertonie wird im Alter vor allem die Rate von Schlaganfällen vermindert (Übersicht bei Thijs et al. 1992, Anlauf 1994, Staessen et al. 1997).

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Literatur

  • Anlauf M. (1994): Hypertonie im Alter. MMV Medizin Verlag, München.

    Google Scholar 

  • Anlauf M., Hense H.-W. (2003): Echte und vermeintliche Sparpotenziale in der Hochdrucktherapie—Neues aus dem Zauberhut. Dtsch. Med. Wschr. 128:1557–1559.

    Article  PubMed  CAS  Google Scholar 

  • Anlauf M., Tholl U., Hirche H.,Weber F. (2001): A silent revolution in blood pressure measurement? Some late remarks in regards to the HOT study. J. Hum. Hypertension. 15: 649–651.

    Article  CAS  Google Scholar 

  • Arzneimittelkommission der Deutschen Ärzteschaft (2003): Empfehlungen zur Therapie der arteriellen Hypertonie. 2. Auflage AVP (in Vorbereitung).

    Google Scholar 

  • Barmer Information (2003): Pressekonferenz der Barmer „Mehr Qualität statt weniger Leistung“ 23.April 2003.

    Google Scholar 

  • Black H.R., Elliott W.J., Grandits G., Grambsch R, Lucente T., White W. B. et al. for the CONVINCE Research Group (2003): Principal Results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) Trial. JAMA 289: 2073–2082.

    Article  PubMed  CAS  Google Scholar 

  • Bock K.D., Anlauf M. (1984): Die Qual der Wahl—das Dilemma der Hochdrucktherapie. Münch. Med. Wochenschr. 16: 477–479.

    Google Scholar 

  • Deutsche Hochdruckliga (2001): Leitlinien für die Prävention, Erkennung, Diagnostik und Therapie der arteriellen Hypertonie. Dtsch. Med. Wschr. 126(Suppl.4): S201–S238.

    Google Scholar 

  • Chobanian A.V., Bakris G.L., Black H.R., Cushman WC. et al. (2003): The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA 289: 2560–2571.

    Article  PubMed  CAS  Google Scholar 

  • Dickerson J.E.C., Hingorani A.D., Ashby M.J., Palmer CR., Brown M.J. (1999): Optimisation of antihypertensive treatment by crossover rotation of four major classes. Lancet 353: 2008–2013.

    Article  PubMed  CAS  Google Scholar 

  • Guidelines Committee (2003): 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J.Hypertens. 21: 1011–1053.

    Article  Google Scholar 

  • Hansson L., Zanchetti A., Carruthers S.G., Dahlöf B., Elmfeldt D. et al. (1998): Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 351: 1755–62.

    Article  PubMed  CAS  Google Scholar 

  • Jackson PR., Ramsay L.E. (2002): The United States JNC VI and British Hypertension Society Guideline. The International WHO/ISH Guideline. First-line treatment for hypertension. Eur. Heart J. 23: 179–182.

    Article  PubMed  CAS  Google Scholar 

  • Luft EC. (2001): Recent clinical trial highlights in hypertension. Curr. Hypertens. Rep. 3: 133–138.

    Article  PubMed  CAS  Google Scholar 

  • Medical Research Council Working Party (1985): MRC trial of treatment of mild hypertension. Brit Med. J. 291: 97–104.

    Article  Google Scholar 

  • Messerli F.H., Grossman E., Goldbourt U. (1998): Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA 279: 1903–1907.

    Article  PubMed  CAS  Google Scholar 

  • Middeke M., Anlauf M., Baumgart P., Franz A., Krönig B., Schrader J., Schulte K.-L. (1998): Ambulante 24h-Blutdruckmessung. (ABDM). DMW 123: 1426–1430.

    Google Scholar 

  • Neal B., MacMahon S., Chapman N. for the Blood Pressure Lowering Treatment Trialists’ Collaboration (2000): Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Lancet 356: 1955–1964.

    Article  PubMed  CAS  Google Scholar 

  • Neaton J.D., Grimm R.H., Prineas R.J., Stamler J., Grandits G.A., for the Treatment of Mild Hypertension Study Research Group (1993): Treatment of Mild Hypertension Study Final Results. JAMA 270: 713–724.

    Article  PubMed  CAS  Google Scholar 

  • Pahor M., Psaty B.M., Alderman M.H., Applegate W. B., Williamson J.D., Cavazzini C, Furberg CD. (2000): Health outcomes associated with calcium antagonists compared with other first-line antihypertensive therapies: a meta-analysis of randomised controlled trials. Lancet 356: 1942–1943.

    Article  Google Scholar 

  • Piller L. B., Davis B.R., Cutler J.A., Cushman W.C., Wright J.T. Jr., Williamson J.D. et al. (2002): Validation of heart failure events in the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Participants Assigned to Doxazosin and Chlorthalidone. Curr. Control Trials Cardiovasc. Med. 3:10–19.

    Article  PubMed  Google Scholar 

  • Pitt B., Byington R.P., Furberg CD., Hunninghake D. B., Mancini G. B., Miller M.E., Riley W. for the PREVENT Investigators (2000): Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. Circulation 102: 1503–1510.

    Article  PubMed  CAS  Google Scholar 

  • Psaty B.M., Lumley T., Furberg CD., Schellenbaum G., Pahor M., Alderman M.H., Weiss N.S. (2003): Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA 289: 2534–2544.

    Article  PubMed  CAS  Google Scholar 

  • Staessen J.A., Fagard R., Thijs L., Celis H., Arabidze G.G. et al. (1997): Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet 350: 757–764

    Article  PubMed  CAS  Google Scholar 

  • The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group (2000): Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). JAMA 283: 1967–1975.

    Article  Google Scholar 

  • The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group (2002): Major outcomes in hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 288: 2981–2997.

    Article  Google Scholar 

  • Thijs L., Fagard R., Lijnen P., Staessen J.A., Van Hoof R., Amery A. (1992): A meta-analysis of outcome trials in elderly hypertensives. J. Hypertension 10:1103–1109.

    Article  CAS  Google Scholar 

  • WHO/ISH (1999): Guidelines for the Management of Hypertension. J. Hypertension 17:151–183.

    Google Scholar 

  • Wing L.M.H., Reid M.C, Ryan P., Beilin L.J. et al. for the Second Australian National Blood Pressure Study Group (2003): A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly. N. Engl. J. Med. 348: 583–592.

    Article  PubMed  CAS  Google Scholar 

  • Wolf-Maier K., Cooper R.S., Banegas J.R., Giampaoli S., Hense H.W. et al. (2003): Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 289: 2363–2369.

    Article  PubMed  Google Scholar 

  • Wolk R. (2000): Anti-arrhythmic properties of moxonidine—implications for the MOXCON study. Int. J. Cardiol. 12: 89–92.

    Article  Google Scholar 

  • Zhu Q.M., Lesnick J.D., Jasper J.R., MacLennan S.J., Dillon M.P., Eglen R.M., Blue D.R. Jr. (1999): Cardiovascular effects of rilmenidine, moxonidine and Clonidine in conscious wild-type and D79N alpha2A-adrenoceptor transgenic mice. Br. J. Pharmacol. 126:1522–1530.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Manfred Anlauf
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Editors and Affiliations

  1. Pharmakologisches Institut der Universitat Heidelberg, Im Neuenheimer Feld 366, 69120, Heidelberg, Germany

    Ulrich Schwabe

  2. Bachstraße 29, 50858, Köln

    Dieter Paffrath

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© 2004 Springer-Verlag Berlin Heidelberg

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Anlauf, M. (2004). Antihypertonika. In: Schwabe, U., Paffrath, D. (eds) Arzneiverordnungs-Report 2003. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18512-0_13

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  • DOI: https://doi.org/10.1007/978-3-642-18512-0_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-40188-9

  • Online ISBN: 978-3-642-18512-0

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