Hacke Claudia, Erb Carl, Weisser Burkhard
Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
Augenklinik am Wittenbergplatz, Berlin.
Klin Monbl Augenheilkd. 2018 Feb;235(2):151-156. doi: 10.1055/s-0044-101260. Epub 2018 Feb 15.
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 HbA 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.
高血压、糖尿病和血脂异常是最重要的心血管危险因素。此外,它们与青光眼的发生和发展也存在关联。在过去几年里,关于这些危险因素的最佳治疗目标展开了激烈讨论。最近,美国心脏协会将血压高于130/80 mmHg定义为高血压,欧洲指南也将遵循这一定义。这些更低的血压限值增加了夜间血压治疗过于严格的风险,而这对青光眼患者来说可能过低。相比之下,低密度脂蛋白胆固醇的治疗目标应尽可能低(“越低越好”)。糖尿病的治疗目标则更为复杂。对于青光眼患者的主要群体老年患者,目前建议进行强度较低的血糖降低治疗,糖化血红蛋白值高于7%。本文总结了心血管危险因素的重要性以及青光眼患者治疗的相应治疗目标。