![\"\"](\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Blutdruck.jpg?resize=300%2C200\")
Ganz aktuell finden wir die neusten Empfehlungen zur Definition einer arteriellen Hypertonie aus den USA von verschiedenen Fachgesellschaften (ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA). Eine \u00dcbersicht zu den US-amerikanischen Empfehlungen finden sich hier:<\/p>\n
\n2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults.\u00a0A Report of the American College of Cardiology\/ American Heart Association Task Force on Clinical Practice Guidelines.\u00a0(PDF<\/a>)\u00a0<\/strong><\/p>\n<\/blockquote>\n
\nIn einer Leitlinien-Synopsis werden die Hauptempfehlungen zusammengefasst:<\/p>\n
Cifu AS et al.\u00a0Prevention, Detection, Evaluation, and Management\u00a0of High Blood Pressure in Adults.\u00a0JAMA Published Online November 20, 2017 (Link<\/a>)<\/strong><\/p><\/blockquote>\n
\nDiagnosis<\/strong><\/p>\n
\na. Blood pressure should be categorized as normal\u00a0(<120\/80mmHg), elevated (120-129\/<80mmHg), stage 1\u00a0hypertension (130-139\/80-89mmHg), or stage 2\u00a0hypertension (140\/90mmHg) (strong recommendation;\u00a0moderate-quality evidence).<\/p>\n
b. Out-of-office blood pressure measurements are recommended to\u00a0confirm the diagnosis of hypertension and for titration\u00a0of blood pressure-lowering medication in conjunction with\u00a0telehealth counseling or clinical interventions\u00a0(strong recommendation; high-quality evidence).<\/p>\n<\/blockquote>\n
2. Initiating therapy<\/strong><\/p>\n
\na. Many nonpharmacologic interventions that are effective\u00a0in lowering blood pressure \u00a0are recommended for people with\u00a0elevated blood pressure or hypertension (strong recommendation;\u00a0high-quality evidence).<\/p>\n
b. Blood pressure\u2013lowering medication is recommended\u00a0for patients with clinical cardiovascular disease or an estimated 10-year\u00a0atherosclerotic cardiovascular disease risk of 10% or higher who\u00a0have a systolic blood pressure of 130 mmHg or higher or a\u00a0diastolic blood pressure of 80 mmHg or higher (strong\u00a0recommendation; high-quality evidence [for systolic blood pressure] and\u00a0expert opinion [for diastolic blood pressure]).<\/p>\n
c. For patients with no history of cardiovascular disease\u00a0and an atherosclerotic cardiovascular disease\u00a0risk of\u00a0less than 10%, blood pressure-lowering medication is recommended\u00a0for patients who have an systolic blood pressure of 140 mmHg or higher or\u00a0a diastolic blood pressure of 90 mmHg or higher (strong recommendation;\u00a0low-quality evidence).<\/p>\n<\/blockquote>\n
3. Management<\/strong><\/p>\n
\na. In patients with cardiovascular disease\u00a0or atherosclerotic cardiovascular disease\u00a0event risk of 10% or\u00a0higher, a blood pressure target of less than 130\/80mmHg is\u00a0recommended (strong recommendation;\u00a0moderate-quality evidence [for systolic blood pressure] and expert\u00a0opinion [for diastolic blood pressure]). A blood pressure target of less than 130\/80 mmHg\u00a0may also be reasonable in low-risk patients (weak\u00a0recommendation; moderate-quality evidence [for systolic blood pressure]\u00a0and expert opinion [for diastolic blood pressure]).<\/p>\n
b. In patients warranting pharmacotherapy, thiazide\u00a0diuretics, calcium channel blockers, and\u00a0angiotensin-converting enzyme inhibitors\u00a0or angiotensin II receptor blockers are\u00a0recommendedas first-lineagents (strong recommendation;\u00a0high-quality evidence).<\/p>\n
c. Patients with stage 2 hypertension and an average blood pressure of\u00a0more than 20\/10mmHg above their blood pressure target should\u00a0begin therapy with 2 first-line agents of different classes\u00a0(strong recommendation; expert opinion).<\/p>\n<\/blockquote>\n
\nKritische Worte wurden auch umgehend publiziert, z.B. in diesem Artikel des deutschen \u00c4rzteblatts: PDF<\/strong><\/a>
\nHier wird beispielsweise ausgef\u00fchrt: „In den USA hingegen steigt die Zahl der Hochdruckpatienten auf \u201eeinen Streich\u201c von etwa 72 auf 103 Millionen.“<\/em><\/p>\n
\nNews-Papers.eu auf TWITTER<\/a>\u00a0 \u00a0\u00a0Follow news-papers.eu<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"
Ganz aktuell finden wir die neusten Empfehlungen zur Definition einer arteriellen Hypertonie aus den USA von verschiedenen Fachgesellschaften (ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA). Eine \u00dcbersicht zu den US-amerikanischen Empfehlungen finden sich hier: 2017 Guideline […]<\/p>\n","protected":false},"author":2,"featured_media":6403,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"__cvm_playback_settings":[],"__cvm_video_id":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false},"categories":[1079],"tags":[1266],"class_list":["post-6402","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kardiovaskulaerer-notfall","tag-hypertension"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Blutdruck-e1511700462767.jpg?fit=300%2C200","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-1Fg","jetpack-related-posts":[{"id":12394,"url":"http:\/\/news-papers.eu\/?p=12394","url_meta":{"origin":6402,"position":0},"title":"Neue Empfehlungen zum „Physiological Difficult Airway“ – Teil 4","author":"Michael Bernhard","date":"Oktober 30, 2020","format":false,"excerpt":"Schauen wir heute doch noch mal etwas genauer in die neuen Empfehlungen zum Vorgehen f\u00fcr den \"physiologisch schwierigen Atemweg\": Kornas RL et al. Evaluation and Management of the Physiologically\u00a0Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesthesia Analgesia 2020, online Zum Thema \"RV-Versagen\" finden sich folgende detaillierten Empfehlungen:\u00a0 Angesichts\u2026","rel":"","context":"In "Atemwegsmanagement"","block_context":{"text":"Atemwegsmanagement","link":"http:\/\/news-papers.eu\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/07\/TEE2-300x169.jpeg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":15764,"url":"http:\/\/news-papers.eu\/?p=15764","url_meta":{"origin":6402,"position":1},"title":"symptomloser Hypertonus keine Indikation f\u00fcr Notaufnahme","author":"Bj\u00f6rn Hossfeld","date":"Juli 25, 2022","format":false,"excerpt":"Die Arbeitsgemeinschaft der in Bayern t\u00e4tigen Not\u00e4rzte (agbn) e.V. schreibt heute auf Ihrer Homepage, dass Patienten mit Hypertonus nicht zwingend in einer Notaufnahme vorgestellt werden m\u00fcssen, sondern in die haus\u00e4rztliche Versorgung weitergeleitet werden k\u00f6nnen. Hypertonie sei inzwischen eine h\u00e4ufige Indikation f\u00fcr die Entsendung von Not\u00e4rzt*innen. In vielen F\u00e4llen seien Patient*innen\u2026","rel":"","context":"In "Herz-Kreislauf"","block_context":{"text":"Herz-Kreislauf","link":"http:\/\/news-papers.eu\/?cat=8"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2022\/07\/radike-Helm-Patient-03.jpg?fit=1200%2C800&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2022\/07\/radike-Helm-Patient-03.jpg?fit=1200%2C800&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2022\/07\/radike-Helm-Patient-03.jpg?fit=1200%2C800&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2022\/07\/radike-Helm-Patient-03.jpg?fit=1200%2C800&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2022\/07\/radike-Helm-Patient-03.jpg?fit=1200%2C800&resize=1050%2C600 3x"},"classes":[]},{"id":2122,"url":"http:\/\/news-papers.eu\/?p=2122","url_meta":{"origin":6402,"position":2},"title":"Monitoring: Empfehlungen zum h\u00e4modynamischen Monitoring – Teil 2","author":"Michael Bernhard","date":"September 24, 2016","format":false,"excerpt":"Die Arbeitsgruppe kardiovaskul\u00e4re Intensiv- und Notfallmedizin der Deutschen Gesellschaft f\u00fcr Kardiologie hat Empfehlungen zum kardiovaskul\u00e4ren Monitoring publiziert: Janssens U, et al. Empfehlungen zum\u00a0h\u00e4modynamischen Monitoring\u00a0in der internistischen\u00a0Intensivmedizin.\u00a0Kardiologe 2016 \u00b7 10:149\u2013169 Die wesentlichen Empfehlungen im \u00dcberblick: Basismonitoring Grundkomponente des Monitorings ist die klinische Einsch\u00e4tzung durch den erfahrenen kardiovaskul\u00e4ren Intensivmediziner. Basis- oder Standardmonitoring\u2026","rel":"","context":"In "Herz-Kreislauf"","block_context":{"text":"Herz-Kreislauf","link":"http:\/\/news-papers.eu\/?cat=8"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/IMG_0819.jpg?fit=1200%2C675&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/IMG_0819.jpg?fit=1200%2C675&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/IMG_0819.jpg?fit=1200%2C675&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/IMG_0819.jpg?fit=1200%2C675&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/09\/IMG_0819.jpg?fit=1200%2C675&resize=1050%2C600 3x"},"classes":[]},{"id":6219,"url":"http:\/\/news-papers.eu\/?p=6219","url_meta":{"origin":6402,"position":3},"title":"Risiko: „Energydrinks\u201c","author":"Michael Bernhard","date":"November 13, 2017","format":false,"excerpt":"Ein Beitrag von PD Dr. J\u00fcrgen Knapp, Bern\/Schweiz: In den letzten Jahren mehren sich die Pressemeldungen \u00fcber Herzkreislaufstillst\u00e4nde, die vermeintlich in Zusammenhang mit dem \u00fcberm\u00e4\u00dfigen Konsum von Energydrinks gebracht werden bzw. wurden. Spiegel.de MDR.de In einer systematischen Literaturrecherche wurde nun der Frage nachgegangen, welche notfallmedizinisch relevanten Krankheitsbilder auf den (teils\u2026","rel":"","context":"In "Intoxikationen"","block_context":{"text":"Intoxikationen","link":"http:\/\/news-papers.eu\/?cat=14"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/07\/Dose2-300x225.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":8908,"url":"http:\/\/news-papers.eu\/?p=8908","url_meta":{"origin":6402,"position":4},"title":"Umfrage zu Vergiftungsf\u00e4llen mit neuen psychoaktiven Substanzen","author":"Bj\u00f6rn Hossfeld","date":"Februar 5, 2019","format":false,"excerpt":"Neue psychoaktive Substanzen (NPS; Synonym: \u201eLegal\u2010Highs\u201c) finden vor allem unter Jugendlichen eine zunehmende Verbreitung. Diese Designerdrogen werden als abgepackte Fertigprodukte, z.B. als sog. Badesalze oder Kr\u00e4utermischungen angeboten, was den eigentlichen Konsumzweck verschleiern soll. Laut einer j\u00e4hrlich in Frankfurt\/Main durchgefu\u0308hrten Befragung haben 6 % der 15\u2010 bis 18\u2010J\u00e4hrigen mindestens einmal im\u2026","rel":"","context":"In "Intoxikationen"","block_context":{"text":"Intoxikationen","link":"http:\/\/news-papers.eu\/?cat=14"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/02\/Legal-highs-104x300.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":6624,"url":"http:\/\/news-papers.eu\/?p=6624","url_meta":{"origin":6402,"position":5},"title":"Hypertensiver Notfall – und jetzt ?","author":"Michael Bernhard","date":"Januar 6, 2018","format":false,"excerpt":"T\u00e4glich werden Notfallmediziner allerorts mit dem hypertensiven Notfall konfrontiert. Sozusagen ein h\u00e4ufig auftretender Notfall. Aber was machen? Prof. Gerd B\u00f6nner aus Freiburg hat hierzu eine exzellente \u00dcbersicht publiziert: B\u00f6nner G. Der hypertensive Notfall. DMW 2017; 142: 1437-1445 Unterschieden werden: 1.Krisenhafter Blutdruckanstieg\/Hypertensive Krise bedrohliche Symptome bei einer unkomplizierten Hypertonie unspezifischen Symptome:\u2026","rel":"","context":"In "Kardiovaskul\u00e4rer Notfall"","block_context":{"text":"Kardiovaskul\u00e4rer Notfall","link":"http:\/\/news-papers.eu\/?cat=1079"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Blutdruck-300x200.jpg?resize=350%2C200","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/6402","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6402"}],"version-history":[{"count":9,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/6402\/revisions"}],"predecessor-version":[{"id":6446,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/6402\/revisions\/6446"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/6403"}],"wp:attachment":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6402"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6402"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6402"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}