[Cardiovascular prevention and rehabilitation].
The distinction between primary and secondary prevention has been abandoned in favor of cardiovascular prevention, mandating individual risk assessment. First, the individual cardiovascular risk of a person is determined by index diseases like myocardial infarction, peripheral arterial disease or other, or, if absent, by a score consisting of a number of conventional risk factors. According to current guidelines, cardiovascular prevention is indicated, as soon as the risk for fatal cardiovascular disease is > or = 5 %, equivalent to a risk for a major cardiovascular event of > or = 20 %. Non-pharmaceutical approaches are: refraining from smoking, mediterranean diet with fatty fish, physical activity and normal body weight. Blood pressure and diabetes mellitus are optimized. In addition, the following agents are used: platelet inhibitors, beta-blockers, ACE-inhibitors, statins and omega-3 fatty acids. A number of structural problems add to individual factors impeding optimal implementation of cardiovascular prevention in Germany.
von Schacky
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Medizinische Klinik und Poliklinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität München. Clemens.vonSchacky@med.uni-muenchen.de
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D001161:Arteriosclerosis / Q000453:epidemiology / Q000517:prevention & control / Q000534:rehabilitation; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D015444:Exercise; D005247:Feeding Behavior; D005858:Germany; D006293:Health Promotion / Q000639:trends*; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D008019:Life Style; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control / Q000534:rehabilitation; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors