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Erschienen in: Herz 1/2020

10.12.2019 | Koronare Herzerkrankung | Schwerpunkt

Primärprävention der koronaren Herzkrankheit

Evidenzbasierte medikamentöse Therapie

verfasst von: Franziska Mühleck, Ulrich Laufs

Erschienen in: Herz | Ausgabe 1/2020

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Zusammenfassung

Die koronare Herzkrankheit (KHK) ist die häufigste Ursache für Morbidität und Mortalität weltweit. Eine wirksame Prävention der KHK ist durch Lebensstilmaßnahmen und eine medikamentöse Therapie der kardiovaskulären Risikofaktoren möglich. Der Ausgangspunkt der Prävention ist die Bestimmung des individuellen kardiovaskulären Risikos. Evidenz für eine Reduktion von KHK-Ereignissen besteht für die Therapie einer arteriellen Hypertonie mit ACE(„angiotensin-converting enzyme“)-Hemmern, Angiotensinrezeptorblockern (ARB) und Kalziumantagonisten, für die Therapie der Hypercholesterinämie mit Statinen, Ezetimib und PCSK9(Proproteinkonvertase Subtilisin/Kexin Typ 9)-Hemmern und bei Therapie des Diabetes mellitus Typ 2 für Metformin, SGLT2(„sodium-glucose linked transporter 2“)-Hemmer und GLP(„glucagon-like peptide“)-1-Agonisten. Kein günstiges Nutzen-Risiko-Verhältnis für Menschen mit niedrigem Risiko (im Unterschied zur Datenlage in der Sekundärprävention) besteht für Acetylsalicylsäure. Ebenso liegt kein Wirksamkeitsbeleg für eine Primärprävention mit Betablockern, DPP(Dipeptidylpeptidase)-4-Hemmer, Glitazone, Sulfonylharnstoffe oder Insulin vor. Dies gilt gleichermaßen für eine medikamentöse Adipositastherapie, jegliche Substitution von Vitamin- oder Hormonpräparaten und Omega-3-Fettsäuren.
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Metadaten
Titel
Primärprävention der koronaren Herzkrankheit
Evidenzbasierte medikamentöse Therapie
verfasst von
Franziska Mühleck
Ulrich Laufs
Publikationsdatum
10.12.2019
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 1/2020
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-019-04873-3

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