Herz

, Volume 39, Issue 4, pp 483–494 | Cite as

Risikofaktorenmanagement bei koronarer Herzerkrankung

Was ist evidenzbasiert?
CME Zertifizierte Fortbildung
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Zusammenfassung

Durch eine gezielte Behandlung von Risikofaktoren kann bei Patienten mit koronarer Herzerkrankung (KHK) der weitere Krankheitsverlauf maßgeblich beeinflusst werden. Eine Reduktion von Krankenhauseinweisungen, eine Verbesserung der Lebensqualität und eine Verlängerung der Lebenserwartung durch sekundärprophylaktische Maßnahmen sind gut belegt. Neben einer optimalen medikamentösen Therapie ist hierfür eine oft drastische Veränderung des Lebensstils mit den Schwerpunkten einer konsequenten Nikotinabstinenz, einer gesunden Ernährung und regelmäßiger körperlicher Aktivität notwendig. Daten aus der Versorgungsforschung zeigen, dass diese Ziele nur unzulänglich erreicht werden. Die Umsetzung der bestehenden Behandlungsleitlinien sollte daher mit Nachdruck verfolgt werden. Forschungsbedarf besteht insbesondere hinsichtlich der prognostischen Bedeutung einer Betablockertherapie bei Patienten mit stabiler KHK und erhaltener linksventrikulärer Funktion, der prognostischen Bedeutung einer gezielten Gewichtsreduktion bei KHK-Patienten mit Übergewicht und Adipositas, der Effektivität psychosozialer Interventionen bei unterschiedlichen Patientengruppen und deren Implementierung in die Routineversorgung sowie hinsichtlich der Optimierung von strukturierten Rehabilitationsprogrammen und der Verbesserung der Patienten-Compliance.

Schlüsselwörter

Koronare Herzerkrankung Sekundärprävention Lebensstilveränderung Behandlungsleitlinen Patienten-Compliance 

Risk factor management of coronary heart disease

What is evidence-based?

Abstract

In patients with coronary heart disease the further course of the disease can be substantially influenced by means of a targeted treatment of risk factors. A reduction of hospital referrals, an improvement in quality of life and an extension in life expectation by secondary prophylactic measures have been well documented. In addition to an optimized medicinal therapy, an often drastic change in lifestyle with a focus on a consistent abstinence from nicotine, a healthy diet and regular physical exercise is necessary. Data from healthcare research show that these targets are only insufficiently achieved. The implementation of current guidelines should therefore be rigorously applied. There is a need for research particularly with respect to the prognostic significance of beta blocker therapy for patients with stable coronary heart disease and preserved left ventricular function, the prognostic significance of targeted weight loss for overweight or obese coronary heart disease patients, the effectiveness of psychosocial interventions in the various patient groups and their implementation into routine care. Research is also necessary with respect to optimization of structured rehabilitation programs and improvement in patient compliance.

Keywords

Coronary heart disease Secondary prevention  Lifestyle changes Guidelines Compliance 

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Copyright information

© Urban & Vogel 2014

Authors and Affiliations

  1. 1.Klinik für Innere Medizin/KardiologieUniversität Leipzig – HerzzentrumLeipzigDeutschland

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