Nicht rein hormonell bedingt - Prämature Atherosklerose bei Männern - Was ist die Ursache?

Zusammenfassung

Die koronare Herzerkrankung (KHK) ist die Haupttodesursache bei Männern wie bei Frauen. Männer entwickeln sie aufgrund einer prämaturen Atherosklerose jedoch zehn Jahre früher als Frauen. Dies verkürzt die Lebenserwartung des Mannes um rund sechs Jahre. Bei gleichem Blutdruckwert oder Cholesterinwert haben jüngere und mittelalte Männer ein doppelt so hohes kardiovaskuläres Risiko wie Frauen - oder das gleiche Risiko wie um zehn Jahre ältere Frauen. Demnach ist das männliche Geschlecht neben dem Alter ein eigenständiger wesentlicher Risikofaktor. Die geschlechtsspezifische Hormonsituation (Sexualhormone) kann jedoch die beschriebene Geschlechterdifferenz bei atherosklerotischen Folgeerkrankungen nicht erklären. Die bisherige Datenlage erlaubt zurzeit keine definitive Erklärung der prämaturen Atherosklerose beim Mann.

Summary

Coronary artery disease (CAD) is the leading cause of death in men and women. But, compared to women men develop heart disease about ten years earlier, leading to an average life expectancy six years less than in women. What is the cause? The cause is premature atherosclerosis in men. Compared to women the same value of blood pressure or cholesterol results in a doubling of cardiovascular risk in men - or in the same risk as ten year older women - having the same risk factor value. Thus, besides age the most important cardiovascular risk factor is male sex, an irreversible one. But, the gender difference in coronary artery disease cannot be explained on the basis of endogenous sex hormone exposure. Till today, current evidence does not allow any definitive explanation of the premature atherosclerosis in men.

Key Words

premature atherosclerosis - gender gap - male cardiovascular risk

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1 National Cholesterol Education Program

2 PROspective CArdiovascular Münster Studie

3 Lipid Research Clinics Coronary Primary Prevention Trial

Anschrift des Verfassers