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Epidemiologie von Gefäßerkrankungen und Versorgung von Gefäßpatienten

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Zusammenfassung

Die Global Burden of Disease Study 2010 (Krishnamurthi et al. 2013) schätzte, dass im Jahr 2010 weltweit 11.569.538 ischämische Schlaganfälle beobachtet wurden, davon 63 % in Ländern mit geringem oder mittlerem Einkommen. An hämorrhagischen Schlaganfällen wurden weltweit 5.324.997 Ereignisse gesehen, davon 80 % in Ländern mit geringem und mittlerem Einkommen. Ischämische Schlaganfälle, die unter anderem durch arteriosklerotische Läsionen der extrakraniellen Gefäße (wie die Karotisstenose) bedingt sind, machten demnach 68,5 % aller Schlaganfälle aus. Am ischämischen Schlaganfall starben 2.835.419 Personen (57 % in Ländern niedrigen und mittleren Einkommens), am hämorrhagischen Schlaganfall 3.038.763 Personen (84 % in Ländern niedrigen und mittleren Einkommens). Im Jahr 2010 reichte die altersstandardisierte Inzidenz des ischämischen Schlaganfalls pro 100.000 Personenjahre von 51,88 in Qatar bis 433,97 in Litauen, die Inzidenz des hämorrhagischen Schlaganfalls von 14,55 in Qatar bis 159,81 in China. Die altersstandardisierten Sterblichkeitsraten pro 100.000 Personenjahre bewegten sich beim ischämischen Schlaganfall von 9,17 (Qatar) bis 137,70 (Russland), beim hämorrhagischen Schlaganfall von 9,64 (USA) bis 210,56 (Mongolei). Für Deutschland nannten die Autoren eine altersstandardisierte Inzidenz des ischämischen Schlaganfalls pro 100.000 Personenjahre von 141,66 und eine Sterblichkeit von 21,11, die Vergleichszahlen für den hämorrhagischen Schlaganfall waren 49,55 und 11,53. In den letzten zwei Jahrzehnten ist in Ländern mit hohem Einkommen wie bei uns die Inzidenz des ischämischen Schlaganfalls signifikant um 13 % zurückgegangen, die Sterblichkeit sogar um 37 %. Der Rückgang bei der Inzidenz hämorrhagischer Schlaganfälle machte 19 % und der ihrer Sterblichkeit 38 % aus. Der Rückgang der Schlaganfallinzidenz ist auf eine Modifikation der Risikofaktoren zurückzuführen, von denen die drei wichtigsten sind: Hoher Blutdruck, Tabakkonsum (einschließlich Passivrauchen) und Alkoholgenuss. Weitere beeinflussbare Risikofaktoren stellen hoher Kochsalzverbrauch, geringer Früchtekonsum und körperliche Inaktivität dar (Feigin et al. 2015).

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© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2020

Authors and Affiliations

  1. 1.ehem. Wissenschaftlich Medizinischer DirektorKreiskliniken Altötting-BurghausenBurghausenDeutschland
  2. 2.Klinik und Poliklinik für GefäßmedizinUniversitätsklinikum Hamburg-Eppendorf (UKE)HamburgDeutschland

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