Blutdruckbehandlung im Akutstadium des Schlaganfalls

Zusammenfassung

Die Ergebnisse bisheriger Studien zur Blutdrucktherapie bei akutem Schlaganfall erlauben wenige allgemeingültige Therapieempfehlungen. Es sollte versucht werden, ein konstantes Blutdruckniveau ohne große Schwankungen zu erreichen. Eine antihypertensive Therapie im Akutstadium des Schlaganfalls sollte nur bei stark erhöhten Werten eingeleitet werden. Hohe Blutdruckwerte werden bei Patienten mit ischämischem Schlaganfall toleriert, sofern keine Thrombolyse in Betracht kommt. Sollte diese angestrebt werden, muss der Blutdruck schnell auf einen Zielbereich von zumindest < 180 mmHg abgesenkt werden. Im Falle intrazerebraler Blutung scheint eine Blutdruckabsenkung von Vorteil zu sein. Die ESO empfiehlt eine Absenkung auf < 140 mmHg systolisch innerhalb einer Stunde, nach Empfehlungen der ESH und der EUSI jedoch nicht mehr als 20 %.

Abstract

The results of previous studies on blood pressure in acute stroke therapy allow a few generally valid therapeutic recommendations. Efforts should be made to achieve a constant blood pressure level without major fluctuations. An antihypertensive therapy in the acute stage of stroke should be initiated only at highly elevated values. High blood pressure levels can be tolerated in patients with ischemic stroke unless thrombolytic comes into consideration. Should this be desired, the blood pressure must be quickly lowered to a target range of at least < 180 mmHg. In the case of intracerebral hemorrhage a blood pressure reduction appears to be beneficial. The ESO recommends a reduction to < 140 mmHg systolic within one hour, according to recommendations of the ESH and the EUSI but not more than 20 %.

Schlüsselwörter

Schlaganfall - Bluthochdruck - antihypertensive Therapie

Keywords

stroke - high blood pressure - antihypertensive therapy

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