Lebensstiländerungen zur Prävention koronarer Herzkrankheit

BACKGROUND: In developed countries arteriosclerosis is responsible for the majority of all deaths. With growing prosperity the life expectancy is increasing, and cardiovascular disease is becoming the primary cause of premature death. Most complications of arteriosclerosis occur unexpectedly. Because of the severe morbidity and high mortality prevention is the only true solution. CHANGES OF LIFESTYLE: Unhealthy nutrition, physical inactivity, overweight and smoking have been identified as the primary causes of arteriosclerotic vascular disease. Central obesity is responsible for the risk factors characterizing the metabolic syndrome. This is the result of inappropriate caloric intake and expenditure. In addition, the nutrients themselves can bear harmful consequences either indirectly by deteriorating risk factors like lipid parameters or by affecting directly the vessel wall. This can add to the deleterious effects of smoking. Evidently saturated fat is the single most decisive nutrient for atherosclerotic vascular disease. Cholesterol and trans fatty acids act additive, while unsaturated fatty acids appear to be beneficial. However, total fat intake is an important determinant of the energy supply, which again influences body weight and composite. Physical activity can counteract, but appears to be beneficial by several additional ways. Quitting smoking is highly effective already within few years. Together with physical activity and healthy nutrition more than 80% of all cardiovascular events can be prevented. CONCLUSION: Preventive medicine needs to focus on lifestyle changes because they are feasible and highly effective. A nutrition low in total fat primarily by avoiding saturated and trans fatty acids, but rich in carbohydrates and fiber is recommended. Daily physical activity in any preferred way should be encouraged, and quitting smoking needs to be strongly emphasized.     

Kardiovaskuläre Prävention in Peri- und Postmenopause – Herz und Kreislauf gesund erhalten

Gynäkologische Endokrinologie - Kardiovaskuläre Erkrankungen haben neben Krebs wesentlichen Anteil an Morbidität und Mortalität im höheren Alter der Frau jenseits der...     

Behavioral Health Risk Factors and Motivation to Change among Cardiovascular General Hospital Patients Aged 50 to 79 Years

Little is known about the (co-)occurrence of smoking, alcohol at-risk drinking, physical inactivity and overweight, and the motivation to change these behavioral health risk factors (HRFs) in older general hospital patients with cardiovascular disease. Between October and December 2016, all consecutively admitted patients aged 50 to 79 years were proactively recruited on 3 cardiology wards and asked to participate in a survey on HRFs and behavior change motivation. Of the eligible patients, 80.4% participated in the survey (n = 328). The mean age was 66.5 years (standard deviation 9.0), and 65.5% were male. At least 1 HRF was present in 91.8% (n = 280), at least 2 HRFs in 54.4% (n = 166), and 3 or 4 HRFs in 12.1% (n = 37) of participants. The proportion of older adults who contemplated or were changing or planning to change their behavior to meet health behavior recommendations ranged between 66.0% (smoking) and 93.2% (alcohol consumption). The results indicate a notable co-occurrence of behavioral HRFs in older patients with cardiovascular disease. The majority of older adults were at least considering changing the respective behavior. To prevent and treat diseases efficiently, hospitalization may be a suitable moment for systematic multiple HRF screening and intervention.     

The association between coffee consumption and periodontitis: a cross-sectional study of a northern German population

Clinical Oral Investigations - Positive and negative influences on oral health are attributed to coffee consumption. The aim of the current study is to evaluate the association between coffee...     

A homocysteine metabolism-related dietary pattern and the risk of coronary heart disease in two independent German study populations

A biomarker profile of high folate and vitamin B-12 and low plasma homocysteine concentrations reduces the risk of coronary heart disease (CHD) and may be linked to diet. The objectives of the present study were to identify a food pattern related to these biomarkers and to examine its association with CHD risk. Dietary patterns related to biomarker plasma concentrations were constructed from data obtained in the Coronary Risk Factors for Atherosclerosis in Women (CORA) Study (200 cases; 255 controls) using the reduced rank regression statistical method. Risks for CHD with relation to the identified pattern were estimated in the CORA study and in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study with 157 cases of incident myocardial infarction among 26,795 participants. In these 2 German study populations, whole-grain bread, fresh fruit, olive oil, mushrooms, cruciferous vegetables, wine, and nuts contributed the most positively and fried potatoes the most negatively to a dietary pattern that was directly associated with both plasma folate and vitamin B-12 concentrations, but inversely with plasma homocysteine. Multivariate-adjusted relative risks for CHD across increasing quintiles of the food pattern score were 1.0, 0.55, 0.52, 0.58, 0.39 (P for trend = 0.05) in the case-control sample and 1.0, 0.95, 0.75, 0.56, 0.72 (P for trend = 0.041) in the prospective study. The combination of a high intake of whole-grain bread, fresh fruit, olive oil, mushrooms, cruciferous vegetables, wine, and nuts with a low intake of fried potatoes was associated with a favorable biomarker profile of homocysteine metabolism and reduced risk of CHD.     

Cholesterinsenkung zur kardiovaskulären Prävention

Women have a very high morbidity and mortality due to cardiovascular and cerebrovascular diseases of atherosclerotic origin. Non-high-density lipoprotein (HDL) cholesterol, as the atherogenic component of plasma cholesterol, plays a central role in the pathogenesis. Its reduction lowers the risk of cardiovascular disease independent of clinically evident risk factors. For this reason, cholesterol reduction is a universally effective preventive measure. Modification of nutrition and when necessary statins, are effective and inexpensive. According to evidence from studies between and within populations, genetic variants and interventional trials, non-HDL cholesterol should be kept within a range of 100–150 mg/dl throughout life, equivalent to an LDL cholesterol of 70–120 mg/dl depending on the individual risk. Starting prevention early in life bears a decisive advantage. On development of arteriosclerosis, non-HDL and LDL cholesterol need to be reduced to 80 and 50 mg/dl, respectively. Lowering cholesterol is a simple, effective and economic measure to prevent cardiovascular diseases, which are the most serious health burden among women.