Subscribe to RSS
DOI: 10.1055/s-0034-1387394
Geschlechterunterschiede in der kardiovaskulären Prävention
Sex and gender differences in cardiovascular preventionPublication History
17 June 2014
28 August 2014
Publication Date:
25 November 2014 (online)
Zusammenfassung
Erkrankungen des Herz-Kreislaufsystems stellen die häufigsten Todesursachen für Frauen und Männer in Deutschland und weltweit dar. Viele dieser Erkrankungen könnten durch adäquate Präventionsmaßnahmen vermieden werden. Risikofaktoren für kardiovaskuläre Erkrankungen betreffen zwar beide Geschlechter, dennoch sind Frauen, die rauchen, an Diabetes erkrankt sind oder übergewichtig sind, mehr gefährdet als Männer mit denselben Risikofaktoren. Diese Gewichtung wird weder in der Praxis ausreichend umgesetzt, noch findet sie aktuell Einzug in geläufige Risiko-Scores. Aktuelle Erkenntnisse aus der Forschung und Anregungen für die Praxis werden im folgenden Übersichtsartikel präsentiert.
Abstract
Cardiovascular diseases represent the first cause of mortality in Germany and worldwide. Many of these diseases could be avoided with adequate prevention measures. Risk factors for cardiovascular diseases affect both women and men, yet women who smoke, suffer from diabetes or are overweight develop cardiovascular conditions more frequently than men with the same risk factors. This relative risk increase is not incorporated into current practice, neither is it considered in common risk scores. In the following review we present data from current studies and suggestions for clinical practice.
-
Literatur
- 1 American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2012; 35 (Suppl. 01) S64-71
- 2 Appel LJ, Moore TJ, Obarzanek E et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336: 1117-1124
- 3 Blair SN, Kohl 3rd HW, Paffenbarger Jr RS et al. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA 1989; 262: 2395-2401
- 4 Bundesamt S. Todesursachen in Deutschland. . Fachserie 12, Reihe 4, Statistisches Bundesamt Wiesbaden, 2013
- 5 Busch MA, Maske UE, Ryl L et al. [Prevalence of depressive symptoms and diagnosed depression among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 733-739
- 6 Busch MA, Schienkiewitz A, Nowossadeck E et al. [Prevalence of stroke in adults aged 40 to 79 years in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 656-660
- 7 Bushnell C, McCullough LD, Awad IA et al. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45: 1545-1588
- 8 Canto JG, Rogers WJ, Goldberg RJ et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA 2012; 307: 813-822
- 9 Culic V, Miric D, Jukic I. Acute myocardial infarction: differing preinfarction and clinical features according to infarct site and gender. Int J Cardiol 2003; 90: 189-196
- 10 D'Agostino Sr RB, Vasan RS, Pencina MJ et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008; 117: 743-753
- 11 Gillum RF. The association of body fat distribution with hypertension, hypertensive heart disease, coronary heart disease, diabetes and cardiovascular risk factors in men and women aged 18-79 years. J Chronic Dis 1987; 40: 421-428
- 12 Go AS, Hylek EM, Phillips KA et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001; 285: 2370-2375
- 13 Gosswald A, Schienkiewitz A, Nowossadeck E et al. [Prevalence of myocardial infarction and coronary heart disease in adults aged 40-79 years in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 650-655
- 14 Heidemann C, Du Y, Rathmann W et al. Prävalenz und zeitliche Entwicklung des bekannten Diabetes mellitus. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsbl 2013; 56: 668-677
- 15 Hu FB, Grodstein F, Hennekens CH et al. Age at natural menopause and risk of cardiovascular disease. Arch Intern Med 1999; 159: 1061-1066
- 16 Hubert HB, Feinleib M, McNamara PM et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67: 968-977
- 17 Huxley RR, Woodward M. Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies. Lancet 2011; 378: 1297-1305
- 18 Keil U, Fitzgerald A, Gohlke H et al. Risikoabschätzung tödlicher Herz-Kreislauf-Erkrankungen: Die neuen SCORE-Deutschland-Tabellen für die Primärprävention. Dtsch Ärtebl 2005; 105: A-1808 / B-1526 / C-1441
- 19 Löwel H. Koronare Herzerkrankung und akuter Myokardinfarkt. In: Robert-Koch-Institut Gesundheitsberichterstattung des Bundes. 2006
- 20 Marjoribanks J, Farquhar C, Roberts H et al. Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev 2012; 7 CD004143
- 21 Mosca L, Benjamin EJ, Berra K et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women – 2011 update: a guideline from the american heart association. Circulation 2011; 123: 1243-1262
- 22 O'Donnell MJ, Xavier D, Liu L et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010; 376: 112-123
- 23 Oertelt-Prigione S. Immunology and the menstrual cycle. Autoimmun Rev 2012; 11: A486-492
- 24 Oertelt-Prigione S, Regitz-Zagrosek V. Gender aspects in cardiovascular pharmacology. J Cardiovasc Transl Res 2009; 2: 258-266
- 25 Payne S. 'Smoke like a man, die like a man'?: a review of the relationship between gender, sex and lung cancer. Soc Sci Med 2001; 53: 1067-1080
- 26 Pines A. Guidelines and recommendations on hormone therapy in the menopause. J Midlife Health 2010; 1: 41-42
- 27 Ronda G, Van Assema P, Brug J. Stages of change, psychological factors and awareness of physical activity levels in The Netherlands. Health Promot Int 2001; 16: 305-314
- 28 Scott CA, Bewley S, Rudd A et al. Incidence, risk factors, management, and outcomes of stroke in pregnancy. Obstet Gynecol 2012; 120: 318-324
- 29 Stang A, Stang M. An inter-state comparison of cardiovascular risk in Germany – towards an explanation of high ischemic heart disease mortality in Saxony-Anhalt. Dtsch Ärtebl Int 2014; 111: 530-536
- 30 Statistisches Bundesamt. Mortalitätsstatistiken nach ICD10, 1998-2012. (Stand 18.08.14)
- 31 Stone NJ, Robinson JG, Lichtenstein AH et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: 2889-2934
- 32 Thefeld W. Verbreitung der Herz-Kreislauf-Risikofaktoren Hypercholesterinämie, Übergewicht, Hypertonie und Rauchen in der Bevölkerung. Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2000; 43: 415-423
- 33 Tucker JM, Welk GJ, Beyler NK. Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans. Am J Prev Med 2011; 40: 454-461
- 34 Wong ND, Thakral G, Franklin SS et al. Preventing heart disease by controlling hypertension: impact of hypertensive subtype, stage, age, and sex. Am Heart J 2003; 145: 888-895
- 35 Yusuf S, Hawken S, Ounpuu S et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364: 937-952