Download PDF
Dtsch Med Wochenschr 2021; 146(12): 787-792
DOI: 10.1055/a-1221-6985
Dossier

Schlaganfallprävention durch Lifestyle-Modifikation

Lifestyle changes for stroke prevention
Alexander H. Nave
,
Matthias Endres
› Further Information
Also available at
    Permissions and Reprints

In der Prävention des ischämischen Schlaganfalls gilt es vor allem die klassischen kardiovaskulären Risikofaktoren zu reduzieren und zu behandeln: u. a. Bluthochdruck, Hypercholesterinämie und Diabetes mellitus. Wie bei anderen verbreiteten Volkskrankheiten hilft ein gesunder Lebensstil dabei, Risikofaktoren zu kontrollieren und das Schlaganfallrisiko zu senken – oft sogar effektiver als Medikamente.

Abstract

Changes of lifestyle have a substantial effect on stroke prevention, especially in high-risk patients. Maintaining a healthier lifestyle can have greater effects than most pharmacological therapies of cardiovascular prevention. For example, increasing the amount of physical activity, adopting a healthy diet, limiting alcohol consumption and quitting smoking are associated with a 70 % decrease in stroke risk. Despite the abundance of observational data and meta-analyses assessing the association of different lifestyle changes and stroke risk, the literature frequently lacks evidence from randomized controlled clinical trial. This article will provide an overview of various forms of lifestyle changes and summarize their potential to modify the risk of stroke.

Schlüsselwörter

Schlaganfall - Prävention - Lebensstil - Risikofaktoren - Ernährung - körperliche Aktivität - Schlaf

Key words

stroke - prevention - lifestyle - risk factors - diet - physical activity - sleep


Publication History

Article published online:
15 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 O’Donnell MJ, Chin SL, Rangarajan S. et al Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet 2016; 388: 761-775
    CrossrefPubMedSearch in Google Scholar
  • 2 Larsson SC, Akesson A, Wolk A. Primary prevention of stroke by a healthy lifestyle in a high-risk group. Neurology 2015; 84: 2224-2228
    CrossrefPubMedSearch in Google Scholar
  • 3 Lakka TA, Venäläinen JM, Rauramaa R. et al Relation of leisure-time physical activity and cardiorespiratory fitness to the risk of acute myocardial infarction. N Engl J Med 1994; 330: 1549-1554
    CrossrefPubMedSearch in Google Scholar
  • 4 Lee CD, Folsom AR, Blair SN. Physical activity and stroke risk: A meta-analysis. Stroke 2003; 34: 2475-2481
    CrossrefPubMedSearch in Google Scholar
  • 5 Arnett DK, Blumenthal RS, Albert MA. et al 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2019; 140 (11) e596-e646
    CrossrefPubMedSearch in Google Scholar
  • 6 Mubanga M, Byberg L, Egenvall A. et al Dog ownership and survival after a major cardiovascular event: A register-based prospective study. Circ Cardiovasc Qual Outcomes 2019; 12: 1-9
    CrossrefPubMedSearch in Google Scholar
  • 7 Levine GN, Allen K, Braun LT. et al Pet ownership and cardiovascular risk: A scientific statement from the American Heart Association. Circulation 2013; 127: 2353-2363
    CrossrefPubMedSearch in Google Scholar
  • 8 Schmidt W, Endres M, Dimeo F. et al Train the vessel, gain the brain: physical activity and vessel function and the impact on stroke prevention and outcome in cerebrovascular disease. Cerebrovasc Dis 2013; 35: 303-312
    CrossrefPubMedSearch in Google Scholar
  • 9 Billinger SA, Arena R, Bernhardt J. et al Physical Activity and Exercise Recommendations for Stroke Survivors. Stroke 2014; 45: 2532-2553
    CrossrefPubMedSearch in Google Scholar
  • 10 Saunders DH, Sanderson M, Hayes S. et al Physical fitness training for stroke patients. Cochrane database Syst Rev 2020; 3: CD003316
    CrossrefPubMedSearch in Google Scholar
  • 11 Nave AH, Rackoll T, Grittner U. et al Physical Fitness Training in Patients with Subacute Stroke (PHYS-STROKE): multicentre, randomised controlled, endpoint blinded trial. BMJ 2019; 366: l5101
    CrossrefPubMedSearch in Google Scholar
  • 12 Winter Y, Rohrmann S, Linseisen J. et al Contribution of obesity and abdominal fat mass to risk of stroke and transient ischemic attacks. Stroke 2008; 39: 3145-3151
    CrossrefPubMedSearch in Google Scholar
  • 13 Tong TYN, Appleby PN, Key TJ. et al The associations of major foods and fibre with risks of ischaemic and haemorrhagic stroke: A prospective study of 418 329 participants in the EPIC cohort across nine European countries. Eur Heart J 2020; 41: 2632-2640
    CrossrefPubMedSearch in Google Scholar
  • 14 Estruch R, Ros E, Salas-Salvadó J. et al Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013; 368: 1279-1290
    CrossrefPubMedSearch in Google Scholar
  • 15 Chen GC, Neelakantan N, Martín-Calvo N. et al Adherence to the Mediterranean diet and risk of stroke and stroke subtypes. Eur J Epidemiol 2019; 34: 337-349
    CrossrefPubMedSearch in Google Scholar
  • 16 Hansen CP, Overvad K, Kyrø C. et al Adherence to a Healthy Nordic Diet and Risk of Stroke: A Danish Cohort Study. Stroke 2017; 48: 259-264
    CrossrefPubMedSearch in Google Scholar
  • 17 Larsson SC. Dietary approaches for stroke prevention. Stroke 2017; 48: 2905-2911
    CrossrefPubMedSearch in Google Scholar
  • 18 Appel LJ, Moore TJ, Obarzanek E. et al A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure. N Engl J Med 1997; 336: 1117-1124
    CrossrefPubMedSearch in Google Scholar
  • 19 Abdelhamid AS, Brown TJ, Brainard JS. et al Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev 2020; 3 (02) CD003177
    Search in Google Scholar
  • 20 Khan SU, Khan MU, Riaz H. et al Effects of nutritional supplements and dietary interventions on cardiovascular outcomes. Ann Intern Med 2019; 171: 190-198
    CrossrefPubMedSearch in Google Scholar
  • 21 Mons U, Müezzinler A, Gellert C. et al Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: Meta-analysis of Individual participant data from prospective cohort studies of the CHANCES consortium. BMJ 2015; 350: 1-12
    CrossrefPubMedSearch in Google Scholar
  • 22 Ding N, Sang Y, Chen J. et al Cigarette Smoking, Smoking Cessation, and Long-Term Risk of 3 Major Atherosclerotic Diseases. J Am Coll Cardiol 2019; 74: 498-507
    CrossrefPubMedSearch in Google Scholar
  • 23 Wannamethee SG, Shaper AG, Whincup PH. et al Smoking cessation and the risk of stroke in middle-aged men. J Am Med Assoc 1995; 274: 155-160
    CrossrefPubMedSearch in Google Scholar
  • 24 Larsson SC, Wallin A, Wolk A. et al Differing association of alcohol consumption with different stroke types: A systematic review and meta-analysis. BMC Med 2016; 14 (01) 178
    CrossrefPubMedSearch in Google Scholar
  • 25 Millwood IY, Walters RG, Mei XW. et al Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China. Lancet 2019; 393: 1831-1842
    CrossrefPubMedSearch in Google Scholar
  • 26 Mader FM, Schwenke R. Leitlinie Schlaganfall 2020. Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin e. V. (DEGAM). AWMF-Registernummer 053–011.
    PubMed
  • 27 Ding M, Bhupathiraju SN, Satija A. et al Long-term coffee consumption and risk of cardiovascular disease: A systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation 2014; 129: 643-659
    CrossrefPubMedSearch in Google Scholar
  • 28 Qian Y, Ye D, Huang H. et al Coffee Consumption and Risk of Stroke: A Mendelian Randomization Study. Ann Neurol 2020; 87: 525-532
    CrossrefPubMedSearch in Google Scholar
  • 29 Ren S, Newby D, Li SC. et al Effect of the adult pneumococcal polysaccharide vaccine on cardiovascular disease: a systematic review and meta-analysis. Open Hear 2015; 2: e000247
    CrossrefPubMedSearch in Google Scholar
  • 30 Lee KR, Bae JH, Hwang IC. et al Effect of Influenza Vaccination on Risk of Stroke: A Systematic Review and Meta-Analysis. Neuroepidemiology 2017; 48: 103-110
    CrossrefPubMedSearch in Google Scholar
  • 31 Yang Q, George MG, Chang A. et al Effect of herpes zoster vaccine and antiviral treatment on risk of ischemic stroke. Neurology 2020; 95: e708-e717
    CrossrefPubMedSearch in Google Scholar
  • 32 Vyas MV, Garg AX, Iansavichus AV. et al Shift work and vascular events: Systematic review and meta-analysis. BMJ 2012; 345: 1-11
    CrossrefPubMedSearch in Google Scholar
  • 33 Khot SP, Morgenstern LB. Sleep and Stroke. Stroke 2019; 50: 1612-1617
    CrossrefPubMedSearch in Google Scholar
  • 34 Phua CS, Jayaram L, Wijeratne T. Relationship between sleep duration and risk factors for stroke. Front Neurol 2017; 8: 1-6
    CrossrefPubMedSearch in Google Scholar
  • 35 Titova OE, Michaëlsson K, Larsson SC. Sleep Duration and Stroke: Prospective Cohort Study and Mendelian Randomization Analysis. Stroke 2020; 51 (11) 3279-3285
    CrossrefPubMedSearch in Google Scholar
  • 36 Zhou L, Yu K, Yang L. et al Sleep duration, midday napping, and sleep quality and incident stroke: The Dongfeng-Tongji cohort. Neurology 2020; 94: e345-e356
    CrossrefPubMedSearch in Google Scholar
  • 37 Yamada T, Hara K, Shojima N. et al Daytime Napping and the Risk of Cardiovascular Disease and All-Cause Mortality: A Prospective Study and Dose-Response Meta-Analysis. Sleep 2015; 38: 1945-1953
    CrossrefPubMedSearch in Google Scholar
  • 38 Rosengren A, Hawken S, Ôunpuu S. et al Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): Case-control study. Lancet 2004; 364: 953-962
    CrossrefPubMedSearch in Google Scholar
  • 39 Castillo-Richmond A, Schneider RH, Alexander CN. et al Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke 2000; 31: 568-573
    CrossrefPubMedSearch in Google Scholar
  • 40 Levine GN, Lange RA, Bairey-Merz CN. et al Meditation and Cardiovascular Risk Reduction. J Am Heart Assoc 2017; 6: 57-60
    CrossrefPubMedSearch in Google Scholar