Karl C. Mayer, Facharzt für Neurologie, Psychiatrie und Facharzt für Psychotherapeutische Medizin, Psychoanalyse

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International Society of Hypertension (WHO-ISH) 1999 neu definierten Richtlinien für die Einteilung des Hypertonus

Kategorie Systolisch (mmHg) Diastolisch (mmHg)
Optimaler Blutdruck < 120 < 80
Normaler Blutdruck < 130 < 85
Hochnormaler Blutdruck 130–139 85–89
Stufe 1: leichte Hypertonie 140–159 90–99
grenzwertig leichte Hypertonie 140–149 90–94
Stufe 2: mittelgradige Hypertonie 160–179 100–109
Stufe 3: hochgradige Hypertonie 180   110
isolierte systolische Hypertonie (ISH) 140 < 90
grenzwertige ISH 140–149 < 90
     

 

Schweizer Bluthochdruckinformation Bloodpressure.com Diabetic and Hypertensive Nephropathy Research Center Mayo Clinic Hypertonus

Indikation 

Therapie

A. Gesicherte zusätzliche Wirkungen/Indikationen

 AVP-Sonderheft Therapieempfehlungen Antihypertensiva 1. Auflage, August 1998 ARZNEIMITTELKOMMISSION DER DEUTSCHEN ÄRZTESCHAFT 

Diabetes mellitus mit Proteinurie

ACE-Hemmer

Herzinsuffizienz  

ACE-Hemmer, Diuretika

Isolierte systolische Hypertonie (ältere Patienten

 Diuretika (bevorzugt), Calciumantagonisten, (langwirkende Dihydropyridine)

 

 

Z. n. Myokardinfarkt

Betarezeptorenblocker (ohne ISA), ACE-Hemmer, (bei systolischer Dysfunktion)

 

 

B. Günstige Wirkungen möglich

 

Angina pectoris

Betarezeptorenblocker, Calciumantagonisten, (Dihydropyridine bei instabiler Angina pectoris kontraindiziert)

 

 

Vorhoftachykardie und -flimmern  

Betarezeptorenblocker, Clonidin, Calciumantagonisten (Nicht-Dihydropyridine)

 

 

Diabetes mellitus,

niedrig dosierte Betarezeptorenblocker, Alpharezeptorenblocker

Hyperlipidämie   

Alpharezeptorenblocker

Migräne

Betarezeptorenblocker (ohne ISA)

Benigne Prostatahyperplasie

Alpharezeptorenblocker

Niereninsuffizienz     (Cave: renovaskuläre Hypertonie und Kreatinin ³ 3 mg/dl)

ACE-Hemmer

 

 

C. Nachteilige Wirkungen möglich

 

Obstruktive Ventilationsstörungen    

Betarezeptorenblocker

Diabetes mellitus (nichtselektive)

Betarezeptorenblocker, hochdosierte Diuretika, Calciumantagonisten

 

 

Gicht

Diuretika

Herzinsuffizienz

Calciumantagonisten

AV-Überleitungsstörungen

Betarezeptorenblocker, Calciumantagonisten (Nicht-Dihydropyridine)

Periphere arterielle Verschlußkrankheit 

(nichtselektive) Betarezeptorenblocker

Niereninsuffizienz Kaliumsparende Mittel,

Thiazide nicht bei Kreatinin > 2mg/dl

Nierenarterienstenose

ACE-Hemmer, AT 1 –Rezeptorenblocker

 

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