Neue Bluthochdruck-Leitlinien - Handlungsbedarf für Hausärzte?

Zusammenfassung

Neue US-amerikanische und europäische Leitlinien zur Hypertonie weisen neben einem erwartungsgemäß hohen Grad an Übereinstimmung etliche Differenzen auf, die sich im Wesentlichen beziehen auf:
- Blutdruckdefinitionen
- unterschiedliche Therapieempfehlungen zur „First-Line”-Therapie und
- Therapie mit Kombinationspräparaten.
Bei einer Hypertonie-Prävalenz von wenigstens knapp 30 % bei deutschen Erwachsenen sind verschiedene Therapiemaßnahmen zu bündeln, um so einen der Hauptrisikofaktoren für die erhöhte kardio- und zerebrovaskuläre Mortalität positiv zu beeinflussen. Von allen Leitlinien wird die Bedeutung von Lebensstiländerungen (Nikotinkarenz, Gewichtsreduktion, etc.) betont; neu ist die Empfehlung von Kombinationspräparaten zur Verbesserung der Compliance bereits zu Beginn einer medikamentösen Bluthochdruck-Therapie.

Abstract

Apart from an expected high degree of agreement, recently published European and American hypertension guidelines show some relevant differences in:
- blood pressure definitions
- different therapeutic recommendations regarding the first- line therapy and
- combination therapy.
With a prevalence of hypertension of at least 30 % among German adults, public health and medical initiatives need to be focused on this major risk factor for cardio- and cerebrovascular mortality. Apart from evidence-based pharmacotherapy and combination preparations for better compliance, strategies should concentrate on life-style changes with proven effectiveness (smoking cessation, weight reduction, etc).

Leitlinien - Hypertonie - Schwellenwerte - „First-line”-Therapie - Kombinationstherapie

Guidelines - hypertension - thresholds - first-line therapy - combination therapy

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