[Antihypertensive therapy in arterial occlusive disease].
Patients with hypertension requiring therapy frequently present with concurrent peripheral vascular disease (PVD). This situation must be taken into account for an optimum antihypertensive treatment. In general, in patients with PVD only a cautious and gradual lowering of the blood pressure is recommended, since the decrease in poststenotic perfusion pressure may accentuate the symptoms of occlusive disease. In intermittent claudication--the most frequent manifestation of occlusive disease beta--receptor blockers today are no longer considered to be contraindicated. In the presence of critical ischemia of the legs (pain at rest and/or necroses) beta blockers should only be given with extreme caution. The agents of choice are calcium antagonists, ACE -inhibitors as well as alpha blockers and some newer vasodilating substances (e.g. Carvedilol). Conventional diuretics show disadvantages. An slightly elevated blood pressure in critical leg ischemia helps to improve the poststenotic perfusion of the affected limb. Antihypertensive treatment should not be instituted in patients whose systolic blood pressure is lower than 160 mmHg.
Abt. für Kardiologie, Angiologie und Pulmologie, Medizinische Universitätsklinik Heidelberg.
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Diehm
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000188:drug therapy*; D000075202:Contraindications; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D014655:Vascular Resistance / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents
Antihypertensive Therapie bei arterieller Verschlusskrankheit.