Die Behandlung der Hypertonie ist im Sinne der Primärprävention eine hocheffiziente Maßnahme zur Reduktion von kardiovaskulären Ereignissen. Der Therapieerfolg wird in erster Linie durch die erzielte Blutdrucksenkung geprägt. Bei Begleiterkrankungen des Patienten ist die Auswahl der Antihypertensiva kritisch abzuwägen. Denn einige Medikamentengruppen haben neben ihrer blutdrucksenkenden Wirkung auch einen direkten Effekt auf die Prognose der Begleiterkrankung. Diesen Zusatzeffekt gilt es synergistisch mitzuerfassen. Nur so kann die optimale Therapiestrategie für jeden einzelnen Patienten definiert werden. Diese Übersicht beschreibt die möglichen Begleiterkrankungen bei Hypertonie, die einen Einfluss auf die Auswahl von Antihypertensiva haben können. Begleiterkrankungen können aber auch Kontraindikationen für einzelne Medikamente darstellen und sind somit auch unter diesem Aspekt in die differentialtherapeutischen Überlegungen einzubeziehen.
Summary
The treatment of hypertension in the sense of primary prevention is a highly effective measure for the reduction of cardiovascular events. The success of therapy is, in the first instance, determined by the extent to which the elevated blood pressure is lowered. In the presence of concomitant diseases, the choice of antihypertensives must be considered with care, since a number of classes of drugs have a direct impact on the prognosis of comorbidity in addition to their blood pressure-lowering effect. This additional synergistic action must be taken into account. Only in this way is it possible to define an optimal therapeutic strategy for each individual patient. The present overview describes the possible comorbidities accompanying hypertension that may impact on the choice of the appropriate antihypertensive agent. Comorbidities may also represent contraindications for individual drugs, and must thus be taken into account when considering differential therapeutic measures.
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