Therapieziele bei der Hypertoniebehandlung

Rainer Düsing

doi:10.1055/s-0043-107269

DMW - Deutsche Medizinische Wochenschrift, Table of Contents

Dtsch Med Wochenschr 2017; 142(19): 1420-1429
DOI: 10.1055/s-0043-107269

Dossier

Therapieziele bei der Hypertoniebehandlung

Treatment Targets in Hypertension

Rainer Düsing

Abstract

The optimal target blood pressure (BP) in the treatment of hypertensive patients remains controversial. Recently, the systolic blood pressure trial (SPRINT) has proposed that a target systolic blood pressure of < 120 mmHg provides prognostic benefit in elderly hypertensive patients at high cardiovascular risk. The results of SPRINT contrast with several other intervention trials which have investigated the effect of intense BP lowering (Secondary Prevention of Small Subcortical Strokes [SPS3], Action to Control Cardiovascular Risk in Diabetes [ACCORD], Heart Outcomes Prevention Evaluation [HOPE]-3). The differences in outcomes in SPRINT vs. other intervention trials are, to a large extend, due to an "unobserved" BP measurement procedure utilized in the SPRINT trial. Thus, a BP goal of < 120 mmHg, at least by conventional BP measurement, remains unproven. Independent of SPRINT the controversial evidence with respect to BP targets calls for further studies and, possibly, for more individualized treatment goals.

Arterielle Hypertonie gilt als wichtigster kardiovaskulärer Risikofaktor. Im folgenden Beitrag wird die Frage des optimalen Zielblutdrucks näher beleuchtet und aufgezeigt, wie Alter, Ausgangsblutdruck sowie verschiedene Blutdruckmessverfahren Einfluss auf eine wirksame Therapie nehmen können. Außerdem wird erläutert, ob eine zu starke Blutdrucksenkung das Risiko kardiovaskulärer Komplikationen sogar erhöhen kann.

Schlüsselwörter

Hypertonie - Interventionsstudien - J-Kurve - Leitlinien - Systolic Blood Pressure Intervention Trial (SPRINT) - Zielblutdruck

Key words

hypertension - intervention trials - j-curve - guidelines - systolic blood pressure intervention trial (SPRINT) - target blood pressure

Full Text

References

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