Update kardiovaskuläre Risikofaktoren

Mit neueren Therapien lassen sich kardiovaskuläre Risikofaktoren zielgerichtet einstellen. Dazu muss jedoch das individuelle kardiovaskuläre Risiko bekannt sein, was nur möglich ist, wenn man die wichtigsten kardiovaskulären Risikofaktoren kennt, mit der Berechnung des Gesamtrisikos vertraut ist und mögliche individuelle Behandlungsstrategien erstellen kann.

Kernaussagen

• Zur Erfassung des individuellen kardiovaskulären Risikos sollten validierte Risikorechner (ESC SCORE, Framingham u. a.) verwendet werden. Dies sollte jedoch nicht zur unkritischen Umsetzung führen, sondern immer die individuellen Eigenheiten des Patienten berücksichtigen.

• Biomarker (u. a. hsCRP) zur weiteren Risikoeinschätzung haben noch keinen Eingang in den klinischen Alltag gefunden.

• Neben LDL-Cholesterin sind weitere Lipidfaktoren wie z. B. Triglyzeride und Lipoprotein(a) in die individuelle Risikoabschätzung mit einzubeziehen.

• Die neuesten Empfehlungen der ESC zur arteriellen Hypertonie behalten die Hypertoniegrenze bei 140/90 mmHg.

• Der Nutzen von ASS ist vor allem in der Sekundärprophylaxe kardiovaskulärer Erkrankungen belegt.

Schlüsselwörter

kardiovaskuläres Risiko - Lipide - Hypertonie - koronare Herzerkrankung

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