14:57, 26 August 2018
They waited a long time for them: the new guidelines for the treatment of high blood pressure were presented at the Cardiologists Congress in Munich.
They basically continue to provide blood pressure from a limit of 140/90 mmHg must be treated. However, higher limits are accepted in older patients.
Avoid side effects
As stated by the Chairman of the Cardiology Society (ÖKG), Andrea Podczeck-Schweighofer, up to 160 mmHg can sometimes be tolerated "in order to prevent unwanted side effects due to intensive drug treatment".
Only in certain cases should medication in the range of normal blood pressure in the upper range (130 to 139 to 85 to 89 mmHg) be treated. "That is, if there is a high risk of cardiovascular disease due to a previous illness," said Podczeck-Schweighofer.
than treatment goal As before, a reduction in principle applies below 140/90 mmHgwith well-tolerated therapy, 130 mmHg should be sought as a systolic value.
For patients under 65 years must aim for a target value of 120-129 mmHg. A goal under 120 mmHg is in no patient group appropriate, because the risks "outweigh the potential benefits.
4 million more American patients receive medication
The new European guidelines for hypertension were awaited with great interest because the treatment needs in the US were reduced last year.
Accordingly, a hypertension of 130/80 mmHg is given. Patients with blood pressure above 130/80 mmHg are expected to require medication in the new US guidelines if they have additional risk factors.
Other patients should be treated with general measures. "But still, according to new US guidelines in the US alone, about four million people need medication treatment, which would not be a 140/90 mmHg threshold," noted Podczeck-Schweighofer.
Two active ingredients from the beginning
A new recommendation in the recently published blood pressure guideline is a treatment recommendation: according to this, a majority of high-pressure patients must be treated with two different substances from the start.
Up to now, it has been recommended to first start with a medication and only combine it with a second or third medication if necessary.
Must have hypertension with a combination of three hypotensive substances should not be reduced sufficiently, should also be diuretic being added.
"Changes in lifestyle are also recommended in the new guideline for all patients," says Podczeck-Schweighofer. These include:
- a reduction in salt consumption,
- healthy food,
- regular physical training,
- Exemption of nicotine and
- aim for normal weight.
To the previous recommendation to consume only moderate alcohol, now comes the explicit indication that the so-called coma or binge drinking ("binge drinking") should be avoided.
Hypertension and cancer
With regard to hypertension and cancer, it is noted that a temporary discontinuation of cancer treatment may be considered when very high blood pressure levels are not controllable, even with combination treatment.
Also new is a recommendation about hypertension and physical exertion in the high mountains. Therefore, patients with high blood pressure should refrain from falling asleep Heights of more than 4,000 meters above sea level to go.
Hypertension is not only an important risk factor for strokes, but also increases the risk of heart failure, atrial fibrillation, renal insufficiency, peripheral obstructive disease or dementia.