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Evaluation zur Indikation einer Barorezeptor-Aktivierungstherapie an der Klinik für Nephrologie und Rheumatologie der Universitätsmedizin Göttingen. Eine retrospektive Studie der Jahre 2012 bis 2019.

dc.contributor.advisorKoziolek, Michael Prof. Dr.
dc.contributor.authorKuczera, Tim
dc.date.accessioned2023-04-11T15:48:39Z
dc.date.available2023-05-03T00:50:10Z
dc.date.issued2023-04-11
dc.identifier.urihttp://resolver.sub.uni-goettingen.de/purl?ediss-11858/14614
dc.identifier.urihttp://dx.doi.org/10.53846/goediss-9814
dc.format.extentXXX Seitende
dc.language.isodeude
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject.ddc610de
dc.titleEvaluation 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.typedoctoralThesisde
dc.contributor.refereeKoziolek, Michael Prof. Dr.
dc.date.examination2023-04-25de
dc.description.abstractengUncontrolled 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.coRefereeSchroeter, Marco Prof. Dr.
dc.subject.gerAdhärenzde
dc.subject.gerBarorezeptoraktivierungstherapiede
dc.subject.gertherapieresistente arterielle Hypertoniede
dc.subject.gerunkontrollierte arterielle Hypertoniede
dc.subject.gerantihypertensive Therapiede
dc.subject.engadherencede
dc.subject.engantihypertensive medicationde
dc.subject.engbaroreflex activation therapyde
dc.subject.engresistant hypertensionde
dc.subject.enguncontrolled hypertensionde
dc.identifier.urnurn:nbn:de:gbv:7-ediss-14614-7
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullMedizin (PPN619874732)de
dc.description.embargoed2023-05-03de
dc.identifier.ppn1842150480
dc.notes.confirmationsentConfirmation sent 2023-04-12T06:15:01de


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