Prophylaxe zerebrovaskulärer Erkrankungen

Zusammenfassung

Angesichts der erwarteten Zunahme von Schlaganfällen aufgrund des künftig höheren Anteils älterer Menschen kommt der Prävention, auch unter gesundheitsökonomischen Aspekten, eine große Bedeutung zu. Die effektivste Form der Primärprävention besteht in der Behandlung von Risikofaktoren, insbesondere der arteriellen Hypertonie. Für die Sekundärprävention sind, neben der Behandlung von Risikofaktoren, vor allem antithrombotisch wirksame Medikamente relevant, wobei deren Indikation sich im Wesentlichen nach dem Pathomechanismus des stattgehabten Schlaganfalls richtet. Darüber hinaus lassen sich Rezidivereignisse durch revaskularisierende Maßnahmen an den hirnversorgenden Arterien vermeiden, vorausgesetzt die Indikation berücksichtigt die auf großen Studien basierende Evidenz.

Summary

Given the rising proportion of elderly in future decades stroke incidence is likely to increase. Due to the enormous socioeconomic impact of stroke, its prevention is a matter of major significance. Primary prevention is primarily focused on and mostly effective through treatment of risk factors, among which hypertension is the most important. Besides risk factor treatment, several antithrombotic regimens are available for secondary prevention and need to be applied according to the underlying pathomechanism of cerebral ischemia. In addition, revascularization of stenosed carotid arteries may prevent further events, provided that they have been indicated appropriately according to the results of large trials.

Key Words

stroke - prevention - risk factors - carotid surgery

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