[Primary and secondary prevention of the acute coronary syndrome].
Coronary heart disease and the acute coronary syndrome are the leading causes of death in Germany. In prospective observational studies conventional risk factors such as smoking, arterial hypertension, hypercholesterolaemia, and diabetes can explain over 80% of cardiovascular diseases. Therefore, cardiovascular diseases are potentially preventable. The basis of a rational primary prevention is a thorough estimation of the global vascular risk. The application of risk scores allows an estimation of a person's global vascular risk. Furthermore, the estimation of an individual global vascular risk enables to identify patients who profit from an additional medical treatment to control blood pressure, lipids, and platelet aggregation. Besides general preventive measures, strict guidelines for secondary prevention are pre-eminent for patients with known coronary heart disease, documented arteriosclerosis in other vascular regions or known diabetes. Patients with an acute coronary syndrome are at an increased risk. Therefore, guidelines for these patients are very strict. In general, the following applies to primary and secondary prevention of the acute coronary syndrome: Change in lifestyle and strict risk factor control improve the quality of life and prognosis when followed consequently.
Weingärtner
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Klinik und Poliklinik Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar.
Laufs
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