Zusammenfassung
Der Zusammenhang zwischen Alkoholkonsum und der Ätiologie und Prognose von kardiovaskulären Erkrankungen ist seit vielen Jahren im Fokus des Interesses sowie Gegenstand kontroverser Diskussionen. Dies trifft in besonderer Weise auf die Herzinsuffizienz zu, die durch koronare Herzkrankheit (KHK), Bluthochdruck, Herzklappenerkrankungen oder Kardiomyopathien hervorgerufen sein kann. Akute Effekte hoher Dosen von Alkohol können zu Einschränkungen der kardialen Kontraktionskraft mit Rhythmusstörungen („Holiday-Heart-Syndrom“), transitorischen ischämischen Attacken und in seltenen Fällen zum plötzlichen Herztod führen. Zu den chronischen Effekten hoher Dosen von Alkohol zählen insbesondere ventrikuläre Dysfunktion, chronische Rhythmusstörungen, alkoholische Kardiomyopathie und KHK. Leichter bis moderater Alkoholkonsum hingegen kann das Risiko für KHK und ischämischen Schlaganfall reduzieren. Alkoholkonsum ist allerdings, auch in moderaten bis kleinen Mengen, mit einem erhöhten Risiko für Vorhofflimmern assoziiert. Bei Frauen treten die ungünstigeren Alkoholwirkungen bereits bei wesentlich niedrigen akut oder chronisch konsumierten Mengen auf als bei Männern. Bei Senioren ebenso wie bei Jüngeren zeigte sich, dass ein moderater Alkoholkonsum mit einem niedrigeren Risiko für eine Herzinsuffizienz assoziiert ist.
Abstract
The association between alcohol consumption and the etiology and prognosis of cardiovascular diseases has been the focus of attention and also the subject of controversial discussions for many years. This is particularly true for heart failure, which can be induced by coronary artery disease (CAD), arterial hypertension, atrial and ventricular arrhythmias and cardiomyopathies. Acute effects of high doses of alcohol can lead to impairment of the cardiac contraction strength with rhythm disturbances (holiday heart syndrome), transient ischemic attacks and in rare cases to sudden cardiac death. The chronic effects of high alcohol consumption include in particular, ventricular dysfunction, chronic rhythm disturbances, alcoholic cardiomyopathy and CAD. In contrast, light to moderate consumption of alcohol is associated with a reduced risk of CAD and ischemic stroke; however, even moderate alcohol drinking is associated with a greater risk for atrial fibrillation. The unfavorable effects of alcohol occur at much lower levels of acute or chronic consumption in women than in men. In the elderly just as in young people, a moderate alcohol consumption is associated with a lower risk of heart failure.
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Pankuweit, S. Alkoholkonsum bei Frauen und Senioren. Herz 41, 494–497 (2016). https://doi.org/10.1007/s00059-016-4462-0
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DOI: https://doi.org/10.1007/s00059-016-4462-0