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Angiotensin II AT1-Rezeptorantagonisten pp 77–102Cite as

Behandlung der Hypertonie mit AT1-Rezeptorantagonisten

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Zusammenfassung

Unkonstrollierte persistierende Blutdruckerhöhungen stellen einen der wichtigsten unabhängigen Hauptrisikofaktoren für zerebrovaskuläre Schädigungen, kardiale Komplikationen und fortgeschrittene Nierenerkrankung dar. Eine adäquate medikamentöse Behandlung des Bluthochdrucks führte zu einer deutlichen Reduktion der kardiovaskulären Mortalität und Morbidität [14, 30]. Neue Ergebnisse der Framingham-Studien von mittlerweile über 20 Jahre „follow-up“ weisen darauf hin, daß eine Langzeitbehandlung mit Andhypertensiva noch viel mehr gegen kardiovaskuläre Morbidität und Mortalität schützt, als es frühere Ergebnisse aus klinischen Untersuchungen haben vermuten lassen [36]. Die höchste Gesamtüberlebenszeit war bei Männern mit einem systolischen Blutdruck von weniger als 134 mg unter antihypertensiver Behandlung assoziiert, bei Frauen von weniger als 149 mg systolisch und für beide Geschlechter mit einem diastolischen Blutdruck von weniger als 95 mg [6]. Die Hypertension-Optimal-Treatment (HOT)-Studie hat weiterhin gezeigt, daß eine Blutdrucksenkung unter 90 mg diastolisch möglich und sicher ist und daß der optimale Blutdruck unter Behandlung mit der geringsten kardiovaskulären Morbidität bei 139/83 mg liegt [31]. Eine Metaanalyse von 14 randomisierten klinischen Studien konnte eine 42%ige Reduktion der Inzidenz für Schlaganfälle bei einer Abnahme des diastolischen Blutdrucks von 5–6 mg feststellen [14]. Die Abnahme der Schlaganfallsrate war in einem vergleichbaren Umfang übereinstimmend in Langzeit- beobachtungsstudien festgestellt worden, in denen bei einer entsprechenden Blutdruckabnahme eine 35–40%ige Abnahme der Schlaganfallereignisse zu verzeichnen war. Zusammenfassend unterstreichen die dargestellten Ergebnisse die Notwendigkeit, eine antihypertensive Therapie konsequent durchzuführen.

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Authors and Affiliations

  1. Medizinische Klinik 4, Klinikum Süd, Universität Erlangen-Nürnberg, Breslauer Straße 201, 90471, Nürnberg, Germany

    Prof. Dr. med. Roland E. Schmieder

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  1. Prof. Dr. med. Roland E. Schmieder
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  2. J. K. Rockstroh
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  1. Institut für experimentelle und klinische Pharmakologie und Toxikologie, Med. Universität zu Lübeck, Ratzeburger Allee 160, D-23538, Lübeck, Deutschland

    Peter Dominiak

  2. Institut für Pharmakologie, Klinikum der Christian-Albrechts-Universität zu Kiel, Hospitalstraße 4, D-24105, Kiel, Deutschland

    Thomas Unger

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Schmieder, R.E., Rockstroh, J.K. (1999). Behandlung der Hypertonie mit AT1-Rezeptorantagonisten. In: Dominiak, P., Unger, T. (eds) Angiotensin II AT1-Rezeptorantagonisten. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-93705-7_3

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