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Klin Monbl Augenheilkd 2018; 235(02): 151-156
DOI: 10.1055/s-0044-101260
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Risikofaktoren und Zielwerte in der kardiovaskulären Primär- und Sekundärprävention: Bedeutung für das Glaukom

Risk Factors and Therapeutic Goals for Primary and Secondary Cardiovascular Prevention: Significance for the Glaucoma Patient
Claudia Hacke
1   Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
,
Carl Erb
2   Augenklinik am Wittenbergplatz, Berlin
,
Burkhard Weisser
3   Institut für Sportwissenschaft, Sportmedizin, Christian-Albrechts-Universität, Kiel
› Institutsangaben
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Publikationsverlauf

eingereicht 18. Dezember 2017

akzeptiert 17. Januar 2018

Publikationsdatum:
15. Februar 2018 (online)

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Zusammenfassung

Bluthochdruck, Diabetes mellitus und Fettstoffwechselstörungen gehören zu den wichtigsten kardiovaskulären Risikofaktoren. Gleichzeitig besteht auch ein Zusammenhang mit der Entwicklung und Progression des Glaukoms. In den letzten Jahren wurde eine intensive Diskussion über die optimalen Zielwerte für diese Risikofaktoren geführt. Vor kurzer Zeit haben die amerikanischen Fachgesellschaften 130/80 mmHg als neue Grenze zum Bluthochdruck definiert und auch europäische Richtlinien werden folgen. Die strengeren Grenzwerte erhöhen die Gefahr, dass unter Umständen ein zu starker Blutdruckabfall in der Nacht beim Glaukompatienten erfolgen könnte. Im Gegensatz dazu sollte das LDL-Cholesterin so niedrig wie möglich eingestellt werden („the lower the better“). Differenzierter sind die Zielbereiche beim Diabetes mellitus zu sehen. Für Ältere, also die Hauptgruppe der Glaukompatienten, wird inzwischen eine eher moderate Blutzuckereinstellung mit einem HbA1c-Wert von über 7% empfohlen, um stärkere Unterzuckerungen zu vermeiden. In der vorliegenden Zusammenfassung werden die Bedeutung kardiovaskulärer Risikofaktoren und deren therapeutische Zielbereiche für die Ophthalmologie bei der Therapie von Glaukompatienten dargestellt.

Abstract

Hypertension, diabetes mellitus and dyslipidaemia are among the most important cardiovascular risk factors. In addition, there is an association with the development and progression of glaucoma. During the last years, there has been an intense discussion concerning optimal treatment goals for these risk factors. Recently, the American Heart Association has defined a blood pressure greater than 130/80 mmHg as hypertension and the European guidelines will follow this definition. These lower blood pressure limits increase the risk for a too strict blood pressure treatment with night values, which might be too low for glaucoma patients. In contrast, the treatment goals for LDL cholesterol should be as low as possible (“the lower the better”). There is a more differentiated picture concerning treatment goals for diabetes mellitus. For elderly patients, which is the main group of the glaucoma patients, a less intense blood sugar reduction is currently recommended with an HbA1c value of above 7%. The present paper summarizes the significance of cardiovascular risk factors and the respective treatment goals for the therapy of patients with glaucoma.

Schlüsselwörter

Hypertonie - Diabetes mellitus - Fettstoffwechselstörungen - Glaukom

Key words

hypertension - diabetes mellitus - dyslipidaemia - glaucoma
 

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