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Therapie und Prävention mit Kalziumantagonisten pp 7–16Cite as

Wirkungsmechanismen von Kalziumantagonisten bei Hypertonie

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Zusammenfassung

Die etablierte arterielle Hypertonie ist hämodynamisch durch einen erhöhten systemischen Gefäßwiderstand charakterisiert. Dieser wird durch strukturelle Unterschiede zwischen den Gefäßen von normotensiven und hypertensiven Personen (15) verursacht, zum anderen aber auch durch funktioneile Komponenten wie z.B. eine Erhöhung der über den Sympathikus vermittelten Vasokonstriktion (1, 5, 25). Weil die freie intrazelluläre Kalziumkonzentration der letzte gemeinsame Weg aller vasokonstriktiven Mechanismen ist (6), wurde vermutet, daß ein Defekt im Kationenhaushalt der glatten Muskelzelle zu einer erhöhten freien zytosolischen Kalziumkonzentration und damit zu einer erhöhten Spannungsentwicklung und einem gesteigerten systemischen Gefäßwiderstand (4) bei der Hypertonie führen könnte. Eine Reduktion der freien intrazellulären Kalziumkonzentration sollte deshalb zu einer Erschlaffung der glatten Gefäßmuskulatur und damit zu Vasodilatation und Blutdruckabfall führen. Kalziumantagonisten vermindern die intrazelluläre Kalziumkonzentrationen hauptsächlich durch eine Reduktion des trans-membranösen langsamen Kalziumeinstromes, der während der Membrandepolari-sierung (13) auftritt, so daß theoretisch ein Sinken des Blutdrucks erwartet werden kann. Eine antihypertensive Wirkung von Kalziumantagonisten wurde schon vor mehr als 20 Jahren beobachtet (21), aber erst in den letzten Jahren wurden diese detaillierter untersucht.

Unterstützt durch Schweizerische Nationalfonds, Nr. 3.924.083

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Authors and Affiliations

  1. Departement für Innere Medizin, Abt. für Kardiologie, Kantonsspital, CH-4031, Basel, Schweiz

    Priv.-Doz. Dr. W. Kiowski & F. R. Bühler

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  1. Priv.-Doz. Dr. W. Kiowski
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  2. F. R. Bühler
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F. Bender A. Fleckenstein

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© 1988 Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt

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Kiowski, W., Bühler, F.R. (1988). Wirkungsmechanismen von Kalziumantagonisten bei Hypertonie. In: Bender, F., Fleckenstein, A. (eds) Therapie und Prävention mit Kalziumantagonisten. Steinkopff. https://doi.org/10.1007/978-3-642-85362-3_2

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  • DOI: https://doi.org/10.1007/978-3-642-85362-3_2

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-85363-0

  • Online ISBN: 978-3-642-85362-3

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