Primär- und Sekundärprävention der KHK

  • Elisabeth von der Lohe


Bedenkt man, dass die kardiovaskulären Erkrankungen weltweit die führende Todesursache des 21. Jahrhunderts sind, wird die Bedeutung sowohl der Primär- als auch der Sekundärprävention der KHK aus gesundheitspolitscher und sozioökonomischer Sicht klar. Die Verhinderung nur eines geringen Prozentsatzes an KHK würde nicht


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Amery A, Birkenhaeger W, Brixxo P et al. (1985) Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly Trial. Lancet 1:1349–1354PubMedCrossRefGoogle Scholar
  2. Antiplatelet Trialists’ Collaboration (1994) Collaborative overview of randomized trials of antiplatelet treatment. Part 1: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet treatment. Br Med J 30:81–106Google Scholar
  3. Arroll B, Beaglehole R (1992) Does physical activity lower blood pressure? A critical review of the clinical trials. J Cl in Epidemiol 45:439–447CrossRefGoogle Scholar
  4. Bittner V, Oparil S (1993) Hypertension in Women. In: Douglas PS (ed) Cardiovascular health and disease in women. Saunders, Philadelphia, vol 63, p 103Google Scholar
  5. Bittner V, Oparil S (1997) Hypertension. In: Julian DG, Wenger NK (eds) Women and heart disease. Dunitz, London, Vol 19, p 311Google Scholar
  6. Blair SN, Kohl HW, Paffenbarger RS et al. (1989) Physieal fitness and all-cause mortality: a prospective study ofhealthy men and women. JAMA 262:2395PubMedCrossRefGoogle Scholar
  7. Blair SN, Kohl HW, Barlow CE (1993) Physical activity, physical fitness, and all-cause mortality in women: do women need to be active? J Am Coll Netr 12:368–371Google Scholar
  8. Blair SN, Kampert JB, Kohl HW et al. (1996) Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 276:205–210PubMedCrossRefGoogle Scholar
  9. Bush TL, Fried LP, Barrett-Connor E et al. (1988) Cholesterollipoproteins, and coronary artery disease in women. Clin Chem 1988;34:B60PubMedGoogle Scholar
  10. Byers T. Hardened fats, hardened arteries. N Engl J Med 337:1544–545Google Scholar
  11. Carlson LA, Rosenhamer G (1988) Reduction of mortality in the Stockholm Ischaemic Heart Disease Secondary Prevention Study combined treatment with clofibrate and nicotinic acid. Acta Med Scand 223:405–418PubMedCrossRefGoogle Scholar
  12. Cauley JA, Cummings SR, Seeley DG (1993) Effect of thiazide therapy on bone mass, fracture and falls. Ann Intern Med 188:666–673Google Scholar
  13. Collins R, Peto R, MacMahon S et al. (1990) Blood pressure, stroke, and coronary heart disease. 2. Short-term reductions in blood pressure: overview of randomized drug trials in the epidemiologie context. Lancet 335:827–838PubMedCrossRefGoogle Scholar
  14. Dahlof B, Lindholm LH, Hansson L et al. (1991) Morbidity and mortality in the Swedish Trial in Older Patients with Hypertension (STOP-Hypertension). Lancet 338:1281–1285PubMedCrossRefGoogle Scholar
  15. DahlofB, Hansson L, Lindholm LH et al. (1993) Swedish Trial in Older Patients with Hypertension (STOP-Hypertension) analyses performed up to 1992. Clin Exper Hypertens 15:925–939CrossRefGoogle Scholar
  16. Darling GM, Johns JA, McCloud PI, Davis SR (1997) Estrogen and progestin compared with simvastatin for hypercholesterolemia in postmenopausal women. N Engl J Med 337:595PubMedCrossRefGoogle Scholar
  17. Davidson MH, Testolin LM, Maki KC et al. (1997) A comparison of estrogen replacement, pravastatin and combined treatment for the management of hypercholesterolemia in postmenopausai women. Arch Intern Med 157:1186PubMedCrossRefGoogle Scholar
  18. Dorr AE, Gunderson K, Schneider JC et al. (1978) Colestipol hydrochloride in hypercholesterolemic patients: effect on serum cholesterol and mortality. J Chron Dis 31:5–14PubMedCrossRefGoogle Scholar
  19. Downs JR, Clearfield M, Weis S et al. (1998) Primary prevention of acute coronary events with lovastatin in men and women with average cholesterollevels. JAMA 279:1615–1622PubMedCrossRefGoogle Scholar
  20. Frantz ID, Dawson EA, Ashman PL et al. (1989) Test of effect oflipid lowering by diet on cardiovascular risk: the Minnesota Coronary Survey.Arteriosclerosis 9(1):129–135PubMedCrossRefGoogle Scholar
  21. Fuster V, Pearson TA (1996) 27th Bethesda Conference: matching the intensity of risk factor management with the hazard for coronary disease events. J Am Coll Cardiol 27:957–1047CrossRefGoogle Scholar
  22. Gaziano JM, Manson JE, Ridker PM (2001) Primary and Secondary Prevention of Coronary Heart Disease. In Braunwald E, Zipes DP, Libby P (eds) Heart disease. Saunders, Philadelphia, vol. 32, pp 1040–1065Google Scholar
  23. Gaziano JM, Buring JE, Breslow JL et al. (1993) Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 329:1829–1834PubMedCrossRefGoogle Scholar
  24. Groups of Physicians of the Newcastle upon Tyne Region (1971) Trial of clofibrate in the treatment of ischemic heart disease. BMJ 4:767–775CrossRefGoogle Scholar
  25. Gueyffier F, Boutitie F, Boissei JP et al. (1997) Effects of antihypertensive drug treatment on cardiovascular outcomes in women and men: a metaanalysis of individual patient data from randomized, controlled trials. Ann Intern Med 126:761–776PubMedGoogle Scholar
  26. Hammond EC, Garfinkel L (1975) Aspirin and coronary artery disease: findings of a prospective study. Br Med J 2:269–271PubMedCrossRefGoogle Scholar
  27. Haskell WL, Alderman EL, Fair JM et al. (1994) Effects of intensive multiple risk factor reduction on coronary artherosclerosis and clinical cardiac events in men and women with coronary artery disease. Circulation 89:975–990PubMedCrossRefGoogle Scholar
  28. Hennekens CH, Buring JE, Manson JE et al. (1996) Lack of effect oflong-term supplementation with beta-carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 334:1145–1149PubMedCrossRefGoogle Scholar
  29. Hu FB, Stampfer MJ, Manson JE et al. (1997) Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 337:1491PubMedCrossRefGoogle Scholar
  30. ISIS-2 (Second International Study of Infarct SurvivaI) Collaborative Group (1988) Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet 11:349–360Google Scholar
  31. Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (1997) The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med 157:2413–2446CrossRefGoogle Scholar
  32. Jones G, Nguyen T, Sambrook PN, Eismann JA (1995) Thiazide diuretics and fractures: can meta-analysis help? J Bone Mineral Res 10:106–111Google Scholar
  33. Klatsky A, Friedman G, Armstrong M (1986) The relationship between alcoholic beverage use and other traits to blood pressure: a new Kaiser Permanente study. Circulation 73:628–636PubMedCrossRefGoogle Scholar
  34. Kushi LF, Folsom AR, Prineas RJ et al. (1996) Dietary antioxidant vitamins and death from coronary artery disease in postmenopausal women. N Engl J Med 18:1156–1162CrossRefGoogle Scholar
  35. LaCroix AZ, Wienpahl J, White LR et al. (1990) Thiazide diuretic agents and the incidence of hip fracture. N Engl J Med 322:286–290PubMedCrossRefGoogle Scholar
  36. LaCroix AZ, Leveille SG, Hecht JA et al. (1996) Does walking decrease the risk of cardiovascular disease hospitalizations and death in older adults? J Am Geriatr Soc 44:113–120PubMedGoogle Scholar
  37. Lewis SJ, Mitchell JS, East C et al. (1996) Women in CARE have earlier and greater response to pravastatin on coronary events after myocardial infarction in patients with average cholesterollevels. Circulation 94(8) Suppl.I:69Google Scholar
  38. Lichtenstein AH (1997) Trans-fatty acids, plasma lipid levels, and risk of developing cardiovascular disease: a statement for health care professionals from the American Heart Association. Circulation 95:2588–2590PubMedCrossRefGoogle Scholar
  39. Lindblad U, Rastarn L, Ryden L et al. (1994) Control of blood press ure and risk of first myocardial infarction: the Skaraborg hypertension project. BMJ 308:681–686PubMedCrossRefGoogle Scholar
  40. Manson JE, Gaziano JM, Speisberg A et al. (1995) A secondary prevention trial of antioxidant vitamins and cardiovascular disease in women: rationale, design, and methods. Am J Epidemiol 5:255–260CrossRefGoogle Scholar
  41. Manson JE, Stampfer MJ, Willet WC et al. (1995) Physical activity and incidence of coronary heart disease and stroke in women. Circulation 91:927Google Scholar
  42. Manson JE, Rich-Edwards JW, Colditz JA et al. (1996) The role of walking in the prevention of cardiovascular disease in women. Circulation 94(Suppl):S339Google Scholar
  43. Manson JE, Hu FB, Rich-Edwards JW et al. (1999) A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. N Engl J Med 341:650PubMedCrossRefGoogle Scholar
  44. Manson JE, Stampfer MJ, Colditz GA et al. (1994) A prospective study of aspirin use and primary prevention of cardiovascular disease in women. JAMA 266:521–527CrossRefGoogle Scholar
  45. May GS, Eberlein KA, Furberg CD et al. (1982) Secondary prevention after myocardial infarction: a review of the long-term trials. Prog Cardiovasc Dis 24:331–362PubMedCrossRefGoogle Scholar
  46. Miettinen M, Turpeinen 0, Karvonen MJ et al. (1972) Effect of cholesterollowering diet on mortality from coronary heart disease and other causes: a twelve year clinical trial in men and women. Lancet 11:835–838CrossRefGoogle Scholar
  47. Moore RD, Levine DM, Southard J et al. (1990) Alcohol consumption and blood pressure in the 1982 Maryland Hypertension Survey. Am J Hypertens 3:1–7PubMedGoogle Scholar
  48. O’Connor GT, Buring GE, Yusaf S et al. (1989) An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation 80:234–244PubMedCrossRefGoogle Scholar
  49. O’Toole ML (1993) Exercise and physical activity. In: Douglas PS (ed) Cardiovascular health and disease in women. Saunders, Philadelphia, p 253Google Scholar
  50. Ornish DM, Scherwitz LW, Brown SE et al. (1990) Can lifestyle changes reverse artherosclerosis? Lancet 336:129–133PubMedCrossRefGoogle Scholar
  51. Paganini-Hil A, Chao A, Ross RK, Henderson BE (1989) Aspirin use and chronic diseases: a cohort of the elderly. Br Med J 299:1247–1250CrossRefGoogle Scholar
  52. Reaven PD, Barrett-Connor E, Edelstein S (1991) Relation between leisuretime physical activity and blood pressure in older women. Circulation 83:559–565PubMedCrossRefGoogle Scholar
  53. Research Committee of the Scottish Society of Physicians (1971) Ischemic heart disease: a secondary prevention trial using clofibrate. BMJ 4:775–784CrossRefGoogle Scholar
  54. Sacks FM, Pfeffer MA, Moye et al. (1996) The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 335:1001–1009PubMedCrossRefGoogle Scholar
  55. Scandinavian Simvastatin Survival Study Group (1994) Randomized trial of cholesterollowering in 4.444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4 S). Lancet 344:1383–389Google Scholar
  56. Schuler G, Hambrecht R, Schlierf G et al. (1992) Regular physical exercise and low-fat diet: effects on progression of coronary artery disease. Circulation 86:1–11PubMedCrossRefGoogle Scholar
  57. SHEP Cooperative Research Group (1991) Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 265:3255–3264CrossRefGoogle Scholar
  58. Smith SC, Blair SN, Criqui MH et al. (1992) Preventing heart attack and death in patients with coronary disease. Circulation 86:1–11CrossRefGoogle Scholar
  59. Stampfer MJ, Colditz GA, Willett WC et al. (1988) A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med 319:267–273PubMedCrossRefGoogle Scholar
  60. Stampfer MJ, Hennekens CH, Manson JE et al. (1993) Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 328:1444–1449PubMedCrossRefGoogle Scholar
  61. Summary of the Second Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II) (1993) Expert Panel on Detection, Evaluation and treatment of high blood cholesterol in adults. JAMA 269:3015CrossRefGoogle Scholar
  62. Ueshima H, Ozawa H, Baba S et al. (1992) Alcohol drinking and high blood pressure: data from a 1980 national cardiovascular survey of Japan. J Clin Epidemiol 45:667–673PubMedCrossRefGoogle Scholar
  63. West of Scotland Coronary Prevention Study Group (1998) Influence of pravastatin and plasma lipids on clinical events in the West of Scotland Coronary Prevention Study (WOSCOPS). Circulation 97:1440–1445CrossRefGoogle Scholar
  64. Witteman JCM, Willette WC, Stampfer MJ et al. (1990) Relation of moderate alcohol consumption and risk of systemic hypertension in women. Am J Cardiol 65:633–637PubMedCrossRefGoogle Scholar
  65. Women’s Health Study Research Group (1992) The Women’s Health Study: rationale and background. J Myocardial Ischemia4:30–40Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2002

Authors and Affiliations

  • Elisabeth von der Lohe
    • 1
  1. 1.Wishard Health ServicesKrannert Institute of CardiologyIndianapolisUSA

Personalised recommendations