Skip to main content
SpringerLink
Log in

Hypertonie — Diätetische Behandlung

  • Conference paper
Nichtmedikamentöse Therapie kardiovaskulärer Risikofaktoren

Part of the book series: Aktuelle Therapieprinzipien in Kardiologie und Angiologie ((THERAPIEPRINZ.))

  • 26 Accesses

Zusammenfassung

Es ist heute kein Problem mehr, einen erhöhten Blutdruck medikamentös zu behandeln. Eine breite Palette gut wirksamer und relativ nebenwirkungsarmer Antihypertensiva steht dazu zur Verfügung. Der Fortschritt in der antihypertensiven Behandlung hat sich in der Abnahme der Schlaganfallrate niedergeschlagen. Vergleichsweise gering ist dagegen der Einfluß auf die kardialen Folgen der Hypertonie. Die Ursachen hierfür sind noch nicht ausreichend geklärt. Es ist derzeit noch nicht abzuschätzen, wie sich das Verhältnis von Nutzen zum Risiko einer jahrzehntelangen (lebenslangen?) medikamentösen Blutdrucksenkung - insbesondere bei der milden Hypertonie - in großem Maßstab darstellen wird. Entsprechende Langzeituntersuchungen liegen bisher nicht vor. Die bisherigen Interventionsstudien konnten den Nutzen einer medikamentösen Therapie bei der milden Hypertonie nicht zweifelsfrei nachweisen. Unter Berücksichtigung dieser Unsicherheiten kommt der nichtmedikamentösen Therapie bei der Primärprophylaxe der Hypertonie und ihrer kardiovaskulären Folgen eine hervorragende Rolle zu. Nichtmedikamentöse Maßnahmen können sehr stark wirksam sein und vielen Patienten Medikamente und Nebenwirkungen vollständig oder z. T. ersparen. Neuere Untersuchungen zeigen auch, daß geringgradige stufenweise Änderungen des Ernährungsverhaltens (Reduktion von Übergewicht, erhöhtem Koch- salz- und Alkoholkonsum), verbunden mit moderater körperlicher Aktivität, die Ausprägung einer manifesten Hypertonie bei prädisponierten Patienten verhindern können [64].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Arkwright PD, Beilin LJ, Vandongen R et al. (1982) The pressor effect of moderate alcohol consumption in man. A search for mechanisms. Circulation 66: 1515–1519

    Google Scholar 

  2. Australian National Health and Medical Research Council Dietary Salt (1989) Study Management Committee: Fall in blood pressure with modest reduction in dietary salt intake in mild hypertension. Lancet 1: 399–402

    Google Scholar 

  3. Basler HD (1987) Hypertonie im Gespräch. MMW 129 /40: 703–705

    Google Scholar 

  4. Basler HD, Brinkmeier U, Buser K, Haehn KD, Mölders-Kober R (1985) Verhaltensänderung adipöser essentieller Hypertoniker - Gruppenbehandlung versus Gesundheitsberatung in der Allgemeinpraxis. Allgemeinmedizin 14: 18–24

    Google Scholar 

  5. Berchtold P, Sims EAH, Horton ES, Berger M (1983) Obesity and hypertension: epidemiology, mechanisms, treatment. Biomed Pharmacother 37: 251–258

    PubMed  CAS  Google Scholar 

  6. Berglund A, Andersson OK, Berglund G, Fagerberg B (1989) Antihypertensive effect of diet compared with drug treatment in obese men with mild hypertension. Br Med J 299: 480–485

    Article  CAS  Google Scholar 

  7. Blaustein MP (1985) How salt causes hypertension: The natriuretic hormone-Na/Ca exchange-hypertension hypothesis. Klin Wochenschr [Suppl III] 63: 62–85

    Article  Google Scholar 

  8. Boegehold MA, Kotchen T (1989) Relative contributions of dietary Na and CI to salt- sensitive hypertension. Hypertension 14: 579–583

    PubMed  CAS  Google Scholar 

  9. Carvalho JJM, Baruzzi RG, Howard PF et al. (1989) Blood pressure in four remote populations in the INTERSALT study. Hypertension 14: 328–346

    Google Scholar 

  10. Dyckner T, Wester PO (1983) Effect of magnesium on blood pressure. Br Med J 286: 1847–1849

    Article  CAS  Google Scholar 

  11. Dyerberg J (1986) Linolenate-derived polyunsaturated fatty acids and prevention of atherosclerosis. Nutr Rev 44: 125–134

    Article  PubMed  CAS  Google Scholar 

  12. Eaton SB, Konner M (1985) Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med 312: 283–289

    Article  PubMed  CAS  Google Scholar 

  13. Falkner B, Harvey K (1990) Effect of chronic sodium loading on cardiovascular response in young blacks and whites. Hypertension 15: 36–43

    PubMed  CAS  Google Scholar 

  14. Frisancho AR, Leonard WR, Bollettino LA (1984) Blood pressure in blacks and whites and its relationship to dietary sodium and potassium intake. J Chronic Dis 37: 515–519

    Article  PubMed  CAS  Google Scholar 

  15. Froment A, Milon H, Gravier C (1979) Relationship of sodium intake and arterial hypertension. Contribution of geographical epidemiology. Rev Epidemiol Sante Publique 27: 437–454

    PubMed  CAS  Google Scholar 

  16. Gleibermann L (1973) Blood pressure and dietary salt in human populations. Ecol Food Nutr 2: 143–156

    Article  Google Scholar 

  17. Grim CE, Luft FC, Miller JZ et al. (1980) Racial differences in blood pressure in Evans County/GA: relationship to sodium and potassium intake and plasma renin activity. J Chronic Dis 33: 87–94

    Article  PubMed  CAS  Google Scholar 

  18. Grobbee DE, Hofman A (1986) Does sodium restriction lower blood pressure? Br Med J 293: 27–29

    Article  CAS  Google Scholar 

  19. Grobbee DE, Waal-Manning HJ (1990) The role of calcium supplementation in the treatment of hypertension. Current evidence. Drugs 39: 7–18

    Article  PubMed  CAS  Google Scholar 

  20. Havlik RJ, Hubert HB, Fabsitz RR, Feinleib M (1983) Weight and hypertension. Ann Intern Med 98 (5 pt2): 855–859

    PubMed  CAS  Google Scholar 

  21. Heagerty AM, Ollerenshaw JD, Robertson DI et al. (1986) Influence of dietary linolenic acid on leukocyte sodium transport and blood pressure. Br Med J 293: 295–297

    Article  CAS  Google Scholar 

  22. Himms-Hagen J (1984) Thermogenesis in brown adipose tissue as an energy buffer. N Engl J Med 311: 1549–1558

    Article  PubMed  CAS  Google Scholar 

  23. Iacono JM, Dougherty RM, Puska P (1982) Reduction of blood pressure associated with dietary polyunsaturated fat. Hypertension [Suppl III] 4: 34–42

    CAS  Google Scholar 

  24. Imura O, Kijima T, Kikuchi K et al. (1981) Studies on the hypotensive effect of high potassium intake in patients with essential hypertension. Clin Sci [Suppl 7] 61: 77s–80s

    Google Scholar 

  25. Intersalt Cooperative Research Group (1988) An international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Br Med J 297: 319–328

    Article  Google Scholar 

  26. Kaplan NM, Carnegie A, Raskin P et al. (1985) Potassium supplementation in hypertensive patients with diuretic-induced hypokalemia. N Engl J Med 312: 746–749

    Article  PubMed  CAS  Google Scholar 

  27. Kawasaki T, Delea CS, Bartter FC, Smith H (1978) The effect of high-sodium and low- sodium intakes on blood pressure and other related variables in human subjects with idiopathic hypertension. Am J Med 64: 193

    Article  PubMed  CAS  Google Scholar 

  28. Kempner W (1948) Treatment of hypertensive vascular disease with rice diet. Am J Med 4: 545

    Article  PubMed  CAS  Google Scholar 

  29. Khaw KT, Barrett-Connor E (1987) Dietary potassium and stroke-associated mortality: a 12 year prospective population study. N Engl J Med 316: 235–240

    Article  PubMed  CAS  Google Scholar 

  30. Khaw KT, Thom S (1982) Randomised double-blind cross-over trial of potassium on blood pressure in normal subjects. Lancet 11: 1127–1129

    Article  Google Scholar 

  31. Knapp HR, Garret AP (1989) The antihypertensive effects of fish oil. N Engl J Med 320: 1037–1043

    Article  PubMed  CAS  Google Scholar 

  32. Krishna GP, Miller E, Kapoor S (1989) Increased blood pressure during potassium depletion in normotensive men. N Engl J Med 320: 1177–1182

    Article  PubMed  CAS  Google Scholar 

  33. Kromann N, Green A (1980) Epidemiological studies in the Upernarvik district, Greenland: incidence of some chronic diseases 1950–1974. Acta Med Scand 208: 401–406

    Article  PubMed  CAS  Google Scholar 

  34. Kurtz TW, Morris RC (1989) Chloride as a determinant of salt-sensitivity. In: Rettig R, Ganten D, Luft FC (eds) Salt and hypertension. Springer, Berlin Heidelberg New York Tokyo, pp 211–217

    Chapter  Google Scholar 

  35. Kurtz TW, Al-Bander HA, Morris RC (1987) “Salt-sensitive” essential hypertension in men. N Engl J Med 317:1043–1048

    Article  PubMed  CAS  Google Scholar 

  36. Labhart A (1986) Alte und neue Aspekte der Fettsucht. Schweiz Med Wochenschr 116: 758–762

    PubMed  CAS  Google Scholar 

  37. Lian C (1915) L’alcolism cause de hypertension arteriale. Bull Acad Med (Paris) 74: 525–528

    Google Scholar 

  38. Lim P, Jacob E (1972) Magnesium deficiency in patients on longterm diuretic therapy for heart failure. Br Med J 3: 620–622

    Article  PubMed  CAS  Google Scholar 

  39. MacCarron DA, Morris C (1985) Blood pressure response to oral calcium in persons with mild to moderate hypertension: a randomized, double-blind, placebo-controlled, crossover trial. Ann Intern Med 103: 825–831

    Google Scholar 

  40. MacGregor GA (1989) Alteration of sodium and potassium intake in the treatment of hypertension. In: Rettig R, Ganten D, Luft FC (eds) Salt and hypertension. Springer, Berlin Heidelberg New York Tokyo, pp 300–308

    Chapter  Google Scholar 

  41. MacGregor GA et al. (1987) Moderate sodium restriction with angiotensin converting enzyme inhibitor in essential hypertension: a double blind study. Br Med J 294: 531–534

    Article  CAS  Google Scholar 

  42. MacGregor GA, Sagnella GA, Markandu ND, Singer DRJ, Cappuccio FP (1989) Double- blind study of three sodium intakes and long-term effects of sodium restriction in essential hypertension. Lancet 11: 1244–1247

    Article  Google Scholar 

  43. Middeke M, Beck B (1989) Erfolgreiche ambulante Gewichtsreduktion bei mittelschwerer Hypertonie. Z Allg Med 65: 598–601

    Google Scholar 

  44. Middeke M, Weisweiler P, Schwandt P, Holzgreve H (1987) Serum lipoproteins during antihypertensive therapy with betablockers and diuretics: A controlled long-term comparative trial. Clin Cardiol 10: 94–98

    Article  PubMed  CAS  Google Scholar 

  45. Middeke M, Völker K, Pospisil E (1989) Bluthochdruck senken ohne Medikamente. TRIAS (Thieme, Hippokrates, Enke ), Stuttgart

    Google Scholar 

  46. Middeke M, Richter OW, Schwandt P, Beck B, Holzgreve H (1990) Normalization of lipid metabolism after withdrawal from antihypertensive long-term therapy with betablockers and diuretics. Arteriosclerosis 10: 145–147

    Article  PubMed  CAS  Google Scholar 

  47. Morgan T (1982) The effect of potassium and bicarbonate ions on the rise in blood pressure caused by sodium chloride. Clin Sci 63: 407S–409S

    Google Scholar 

  48. Norris PG, Jones CJ, Weston MJ (1986) Effect of dietary supplementation with fish oil on systolic blood pressure in mild essential hypertension. Br Med J 293: 104–105

    Article  CAS  Google Scholar 

  49. Oberman A et al. (1990) Pharmacologic and nutritional treatment of mild hypertension: Changes in cardiovascular risk status. Ann Intern Med 112: 89–95

    PubMed  CAS  Google Scholar 

  50. Ophir O, Peer G, Galid J et al. (1983) Low blood pressure in vegetarians: the possible role of potassium. Am J Clin Nutr 37: 755–762

    PubMed  CAS  Google Scholar 

  51. Page LB, Damon A, Moellering RC (1974) Antecedents of cardiovascular disease in six Solomon Islands societies. Circulation 49: 1132–1146

    PubMed  CAS  Google Scholar 

  52. Perman ES (1958) The effect of ethyl alcohol on the secretion from adrenal medulla in man. Acta Physiol Scand 44: 241

    Article  PubMed  CAS  Google Scholar 

  53. Reisin E, Abel R, Modan M, Silverberg DS, Eliahou HE, Modam B (1978) Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients. N Engl J Med 298: 1–6

    Article  PubMed  CAS  Google Scholar 

  54. Romsos DR (1983) Low sympathetic nervous system activity in the brown tissue of obese mice. In: Controversies in obesity. Praeger, London New York (Endocrinology and metabolism series, vol 5, pp 122–129 )

    Google Scholar 

  55. Ruppert M, Diehl J, Kolloch R, Kraft K, Overlack A, Stumpe KO (1990) Dietary sodium restriction increases serum total and LDL-cholesterol in salt-sensitive and salt-resistant normotensive adults. (13th Scientific Meeting of the International Society of Hypertension, Montreal, Canada, June 1990, abstract IA. 6, p 1 )

    Google Scholar 

  56. Ruskin A (1956) Introduction. In: Classics in arterial hypertension. Thomas, Springfield/IL, p xi

    Google Scholar 

  57. Saunders JB, Beevers DG, Paton A (1981) Alcohol-induced hypertension. Lancet 11: 653–656

    Article  Google Scholar 

  58. Savdie E, Grosslight GM, Adena MA (1984) Relation of alcohol and cigarette consumption to blood pressure and serum creatinine levels. J Chronic Dis 37: 617–623

    Article  PubMed  CAS  Google Scholar 

  59. Sharma AM, Arntz HR, Kribben A, Schattenfroh S, Distler A (1990) Dietary sodium restriction: Adverse effect on plasma lipids. Klin Wochenschr 68: 664–668

    Article  PubMed  CAS  Google Scholar 

  60. Shore AC, Markandu ND, MacGregor GA (1987) Sodium loading in patients with essential hypertension. Proc Am Soc Hypertens 2: 78

    Google Scholar 

  61. Sims EAH (1982) Mechanisms of hypertension in the overweight. Hypertension 4/III: 43

    Google Scholar 

  62. Singer P, Wirth M, Voigt S et al. (1985) Blood pressure- and lipid-lowering effect of mackerel and herring diet in patients with mild essential hypertension. Atherosclerosis 56: 223–235

    Article  PubMed  CAS  Google Scholar 

  63. Stamler R et al. (1987) Nutrional therapy for high blood pressure. Final report of a four-year randomized controlled trial - the hypertension control program. JAMA 257: 1484–1491

    Article  PubMed  CAS  Google Scholar 

  64. Stamler R et al. (1989) Primary prevention of hypertension by nutritional-hygienic means. JAMA 262: 1801–1807

    Article  PubMed  CAS  Google Scholar 

  65. Steiner A, Oertel R, Bättig B et al. (1989) Effect of fish oil on blood pressure and serum lipids in hypertension and hyperlipidemia. J Hypertens [Suppl 3] 7: 73

    Google Scholar 

  66. Stitt FW, Crawford MD, Clayton DG et al. (1973) Clinical and biochemical indicators of cardiovascular disease among men living in hard and soft water areas. Lancet I: 12–126

    Google Scholar 

  67. Svetkey LP, Yarger WE, Feussner JR et al. (1987) Double-blind, placebo-controlled trial of potassium trial of potassium chloride in the treatment of mild hypertension. Hypertension 9: 444–450

    PubMed  CAS  Google Scholar 

  68. Wechsler JG, Ditschuneit H (1987) Bluthochdruck und Übergewicht. MMW 129 /48: 882–884

    Google Scholar 

  69. Geleijnse JM, Grobbee DE, Hofman A (1990) Sodium and potassium intake and blood pressure change in childhood. Br Med J 300: 8990–9002

    Article  Google Scholar 

Download references

Authors
  1. M. Middeke
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Medizinische Poliklinik der Universität München, Pettenkoferstraße 8a, D-8000, München 2, Germany

    M. Middeke

  2. Klinik II und Poliklinik für Innere Medizin der Universität Köln, Klinikum Köln-Merheim, Ostmerheimer Straße 200, D-5000, Köln 91, Germany

    Gerd Bönner

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Middeke, M. (1991). Hypertonie — Diätetische Behandlung. In: Middeke, M., Bönner, G. (eds) Nichtmedikamentöse Therapie kardiovaskulärer Risikofaktoren. Aktuelle Therapieprinzipien in Kardiologie und Angiologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-75412-8_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-75412-8_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-52134-1

  • Online ISBN: 978-3-642-75412-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation