dc.contributor.advisor | Koziolek, Michael Prof. Dr. | |
dc.contributor.author | Kuczera, Tim | |
dc.date.accessioned | 2023-04-11T15:48:39Z | |
dc.date.available | 2023-05-03T00:50:10Z | |
dc.date.issued | 2023-04-11 | |
dc.identifier.uri | http://resolver.sub.uni-goettingen.de/purl?ediss-11858/14614 | |
dc.identifier.uri | http://dx.doi.org/10.53846/goediss-9814 | |
dc.format.extent | XXX Seiten | de |
dc.language.iso | deu | de |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject.ddc | 610 | de |
dc.title | Evaluation zur Indikation einer Barorezeptor-Aktivierungstherapie an der Klinik für Nephrologie und Rheumatologie der Universitätsmedizin Göttingen. Eine retrospektive Studie der Jahre 2012 bis 2019. | de |
dc.type | doctoralThesis | de |
dc.contributor.referee | Koziolek, Michael Prof. Dr. | |
dc.date.examination | 2023-04-25 | de |
dc.description.abstracteng | Uncontrolled hypertension is a main risk factor for cardiovascular morbidity. Baroreflex activation therapy (BAT) is an effective therapy option addressing true resistant hypertension. We evaluated patients' eligibility for BAT in a staged assessment as well as adherence to antihypertensive drug therapy. Therefore, we analyzed files of 345 patients, attending the hypertension clinic at University Medicine Göttingen. Additionally, gas chromatographic-mass spectrometric urine analyses of selected individuals were performed evaluating their adherence. Most common cause for a revoked BAT recommendation was blood pressure (BP) control by drug adjustment (54.2%). Second leading cause was presence of secondary hypertension (31.6%). Patients to whom BAT was recommended (59 (17.1%)) were significantly more often male (67.8% vs. 43.3%, P = .0063), had a higher body mass index (31.8 ± 5.8 vs. 30.0 ± 5.7 kg/m², P = .0436), a higher systolic office (168.7 ± 24.7 vs. 147.7 ± 24.1 mmHg, P < .0001), and 24h ambulatory BP (155.0 ± 14.6 vs. 144.4 ± 16.8 mmHg, P = .0031), took more antihypertensive drugs (5.8 ± 1.3 vs. 4.4 ± 1.4, P < .0001), and suffered more often from numerous concomitant diseases. Eventually, 27 (7.8%) received a BAT system. In the toxicological analysis of 75 patients, mean adherence was 75.1%. 16 patients (21.3%) showed non-adherence. Thus, only a small number of patients eventually received a BAT system, as treatable reasons for apparently resistant hypertension could be identified frequently. This study is-to our knowledge-the first report of a staged assessment of patients' suitability for BAT and underlines the need for a careful examination and indication. Non-adherence was proven to be a relevant issue concerning apparently resistant hypertension and therefore non-eligibility for interventional antihypertensive therapy. | de |
dc.contributor.coReferee | Schroeter, Marco Prof. Dr. | |
dc.subject.ger | Adhärenz | de |
dc.subject.ger | Barorezeptoraktivierungstherapie | de |
dc.subject.ger | therapieresistente arterielle Hypertonie | de |
dc.subject.ger | unkontrollierte arterielle Hypertonie | de |
dc.subject.ger | antihypertensive Therapie | de |
dc.subject.eng | adherence | de |
dc.subject.eng | antihypertensive medication | de |
dc.subject.eng | baroreflex activation therapy | de |
dc.subject.eng | resistant hypertension | de |
dc.subject.eng | uncontrolled hypertension | de |
dc.identifier.urn | urn:nbn:de:gbv:7-ediss-14614-7 | |
dc.affiliation.institute | Medizinische Fakultät | de |
dc.subject.gokfull | Medizin (PPN619874732) | de |
dc.description.embargoed | 2023-05-03 | de |
dc.identifier.ppn | 1842150480 | |
dc.notes.confirmationsent | Confirmation sent 2023-04-12T06:15:01 | de |