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Prämature Atherosklerose

Risikofaktor männliches Geschlecht

Premature atherosclerosis

Male sex as a risk factor

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Zusammenfassung

Die koronare Herzerkrankung (KHK) ist bei Männern und Frauen die Haupttodesursache. Männer entwickeln aufgrund einer prämaturen Atherosklerose die KHK jedoch 10 Jahre früher. Dies verkürzt die Lebenserwartung des Mannes um etwa 6 Jahre. Jüngere und mittelalte Männer haben bei gleichem Blutdruck- oder Cholesterinwert ein doppelt so hohes kardiovaskuläres Risiko wie Frauen bzw. das gleiche Risiko wie 10 Jahre ältere Frauen. Das männliche Geschlecht ist neben dem Alter ein nicht beeinflussbarer wesentlicher Risikofaktor. Diese Geschlechterdifferenz bei atherosklerotischen Folgeerkrankungen, die sich erst im Alter >75 Jahre ausgleicht, kann über die unterschiedlichen Sexualhormone nicht erklärt werden. Die bisherige Datenlage erlaubt derzeit keine definitive Erklärung der prämaturen Atherosklerose beim Mann. Parallel zur KHK haben Männer auch häufiger und in früherem Alter eine periphere arterielle Verschlusskrankheit (pAVK) oder auch abdominelle und thorakale Aortenaneurysmen.

Abstract

Coronary heart disease (CAD) is the leading cause of death in men and women. However, men develop heart disease about 10 years earlier, which reduces their average life expectancy by about 6 years. The cause is the high incidence of premature atherosclerosis in men. In fairly young and middle-aged men with the same blood pressure or cholesterol levels as women cardiovascular risk is double that in women the same age, or the same as in women 10 years older but with the same risk factor profile otherwise. This means that like age, male sex is a cardiovascular risk factor that noone can do anything about. The sex difference does not even out until after the age of 75 years and cannot be explained on the basis of the different sex hormones. The data currently available do not allow any definitive explanation for the premature atherosclerosis seen in men. In parallel with CAD, men also suffer more frequently and earlier in life than women from peripheral arterial disease and aortic aneurysms.

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Strödter, D. Prämature Atherosklerose. Gefässchirurgie 12, 401–412 (2007). https://doi.org/10.1007/s00772-007-0548-6

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