Skip to main content

Schlaganfall – Prävalenz, Bedeutung und Implikationen für die Prävention und Gesundheitsförderung

  • Living reference work entry
  • First Online:
Book cover Prävention und Gesundheitsförderung

Part of the book series: Springer Reference Pflege – Therapie – Gesundheit ((SRPTG))

  • 505 Accesses

Zusammenfassung

In Deutschland treten 262.000 Schlaganfälle pro Jahr auf. Das Alter ist einer der wichtigsten nicht modifizierbaren Risikofaktoren, so dass allein durch die demografische Entwicklung mit einer weiteren Zunahme zu rechnen ist. Lebensstil-Risikofaktoren wie Nikotinkonsum, Übergewicht und körperliche Inaktivität bieten neben klassischen Faktoren wie arterielle Hypertonie und Diabetes mellitus optimale Ansatzpunkte für die Primärprävention. Durch das Nichtraucherschutzgesetz konnte in Deutschland eine Abnahme des Nikotinkonsums und bereits eine Reduktion kardiovaskulärer Ereignisse beobachtet werden. Einer Zunahme des Körpergewichtes in der Gesamtbevölkerung könnte mit Hilfe einer verbesserten Gesundheitserziehung (körperliche Aktivität, Ernährung) und Lebensmittelkennzeichnung begegnet werden. In der medikamentösen Primärprophylaxe hat der Einsatz von ASS aufgrund von Blutungsnebenwirkungen an Stellenwert verloren, während der Einsatz von Statinen patientenindividuell diskutiert wird.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Literatur

  • Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE 3rd (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24:35–41

    Article  PubMed  Google Scholar 

  • Amarenco P, Bogousslavsky J, Caplan LR, Donnan GA, Wolf ME, Hennerici MG (2013) The ASCOD phenotyping of ischemic stroke (updated ASCO phenotyping). Cerebrovasc Dis 36:1–5

    Article  PubMed  CAS  Google Scholar 

  • ASCEND Study Collaborative Group, Bowman L, Mafham M, Wallendszus K, Stevens W, Buck G, Barton J, Murphy K, Aung T, Haynes R et al (2018) Effects of aspirin for primary prevention in persons with diabetes mellitus. N Engl J Med 379:1529–1539

    Article  Google Scholar 

  • Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, Kirby A, Sourjina T, Peto R, Collins R et al (2005) Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 366:1267–1278

    Article  PubMed  CAS  Google Scholar 

  • Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, Peto R, Barnes EH, Keech A et al (2010) Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 376:1670–1681

    Article  PubMed  CAS  Google Scholar 

  • Berger K, Schulte H, Stogbauer F, Assmann G (1998) Incidence and risk factors for stroke in an occupational cohort: the PROCAM Study. Prospective Cardiovascular Muenster Study. Stroke 29:1562–1566

    Article  PubMed  CAS  Google Scholar 

  • Cappuccio FP, Markandu ND, Carney C, Sagnella GA, MacGregor GA (1997) Double-blind randomised trial of modest salt restriction in older people. Lancet 350:850–854

    Article  PubMed  CAS  Google Scholar 

  • Castilla-Guerra L, Fernandez-Moreno MDC, Leon-Jimenez D, Carmona-Nimo E (2018) Antidiabetic drugs and stroke risk. Current evidence. Eur J Intern Med 48:1–5

    Article  PubMed  CAS  Google Scholar 

  • Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO, Hennekens CH (1990) Blood pressure, stroke, and coronary heart disease. Part 2, short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet 335:827–838

    Article  PubMed  CAS  Google Scholar 

  • Deutsches Ärzteblatt. https://www.aerzteblatt.de/nachrichten/95718/Nahrungsergaenzungsmittel-sind-Verkaufsrenner. Zugegriffen am 28.04.2019

  • Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, Lee IM, Lichtenstein AH, Loria CM, Millen BE et al (2014) 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63:2960–2984

    Article  PubMed  Google Scholar 

  • Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, Gomez-Gracia E, Ruiz-Gutierrez V, Fiol M, Lapetra J et al (2018) Primary prevention of cardiovascular disease with a mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med 378:e34

    Article  CAS  PubMed  Google Scholar 

  • Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, Mensah GA, Norrving B, Shiue I, Ng M et al (2016) Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol 15:913–924

    Article  PubMed  Google Scholar 

  • Foerch C, Misselwitz B, Sitzer M, Steinmetz H, Neumann-Haefelin T (2008) Die Schlaganfallzahlen bis zum Jahr 2050. Dtsch Ärztebl 105:467–473

    Google Scholar 

  • Gaziano JM, Brotons C, Coppolecchia R, Cricelli C, Darius H, Gorelick PB, Howard G, Pearson TA, Rothwell PM, Ruilope LM et al (2018) Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. Lancet 392:1036–1046

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Goldstein LB, Adams R, Becker K, Furberg CD, Gorelick PB, Hademenos G, Hill M, Howard G, Howard VJ, Jacobs B et al (2001) Primary prevention of ischemic stroke: a statement for healthcare professionals from the Stroke Council of the American Heart Association. Circulation 103:163–182

    Article  PubMed  CAS  Google Scholar 

  • Gorelick PB, Farooq MU, Min J (2015) Population-based approaches for reducing stroke risk. Expert Rev Cardiovasc Ther 13:49–56

    Article  PubMed  CAS  Google Scholar 

  • Hart RG, Pearce LA, Aguilar MI (2007) Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 146:857–867

    Article  PubMed  Google Scholar 

  • He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Goldbourt U, Greenland P (2004) Fish consumption and incidence of stroke: a meta-analysis of cohort studies. Stroke 35:1538–1542

    Article  PubMed  Google Scholar 

  • Heller DJ, Coxson PG, Penko J, Pletcher MJ, Goldman L, Odden MC, Kazi DS, Bibbins-Domingo K (2017) Evaluating the impact and cost-effectiveness of statin use guidelines for primary prevention of coronary heart disease and stroke. Circulation 136:1087–1098

    Article  PubMed  PubMed Central  Google Scholar 

  • Heuschmann PU, Busse O, Wagner M, Endres M, Villringer A (2010) Frequency and care of stroke in Germany. Aktuel Neurol 37:333–340

    Article  Google Scholar 

  • Howard VJ, McDonnell MN (2015) Physical activity in primary stroke prevention: just do it! Stroke 46:1735–1739

    Article  PubMed  Google Scholar 

  • Hughes JR, Stead LF, Lancaster T (2007) Antidepressants for smoking cessation. Cochrane Database Syst Rev (1):CD000031

    Google Scholar 

  • Jenkins DJA, Spence JD, Giovannucci EL, Kim YI, Josse R, Vieth R, Blanco Mejia S, Viguiliouk E, Nishi S, Sahye-Pudaruth S et al (2018) Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 71:2570–2584

    Article  PubMed  CAS  Google Scholar 

  • Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J et al (2016) 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37:2893–2962

    Article  PubMed  Google Scholar 

  • Lee IM, Hennekens CH, Berger K, Buring JE, Manson JE (1999) Exercise and risk of stroke in male physicians. Stroke 30:1–6

    Article  PubMed  CAS  Google Scholar 

  • Li J, Siegrist J (2012) Physical activity and risk of cardiovascular disease – a meta-analysis of prospective cohort studies. Int J Environ Res Public Health 9:391–407

    Article  PubMed  PubMed Central  Google Scholar 

  • Lip GY, Skjoth F, Nielsen PB, Larsen TB (2015) Non-valvular atrial fibrillation patients with none or one additional risk factor of the CHA2DS2-VASc score. A comprehensive net clinical benefit analysis for warfarin, aspirin, or no therapy. Thromb Haemost 114:826–834

    Article  PubMed  Google Scholar 

  • Markidan J, Cole JW, Cronin CA, Merino JG, Phipps MS, Wozniak MA, Kittner SJ (2018) Smoking and risk of ischemic stroke in young men. Stroke 49:1276–1278

    Article  PubMed  PubMed Central  Google Scholar 

  • Mayer F, Stahrenberg R, Groschel K, Mostardt S, Biermann J, Edelmann F, Liman J, Wasem J, Goehler A, Wachter R et al (2013) Cost-effectiveness of 7-day-Holter monitoring alone or in combination with transthoracic echocardiography in patients with cerebral ischemia. Clin Res Cardiol 102:875–884

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • McNeil JJ, Wolfe R, Woods RL, Tonkin AM, Donnan GA, Nelson MR, Reid CM, Lockery JE, Kirpach B, Storey E et al (2018) Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. N Engl J Med 379:1509–1518

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Mora S, Cook N, Buring JE, Ridker PM, Lee IM (2007) Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation 116:2110–2118

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • O’Donnell CJ, Ridker PM, Glynn RJ, Berger K, Ajani U, Manson JE, Hennekens CH (1997) Hypertension and borderline isolated systolic hypertension increase risks of cardiovascular disease and mortality in male physicians. Circulation 95:1132–1137

    Article  PubMed  Google Scholar 

  • O’Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, Rao-Melacini P, Zhang X, Pais P, Agapay S et al (2016) Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet 388:761–775

    Article  PubMed  Google Scholar 

  • Persson J, Levin LA, Holmegaard L, Redfors P, Svensson M, Jood K, Jern C, Blomstrand C, Forsberg-Warleby G (2017) Long-term cost of spouses’ informal support for dependent midlife stroke survivors. Brain Behav 7:e00716

    Article  PubMed  PubMed Central  Google Scholar 

  • Qureshi AI, Suri MF, Kirmani JF, Divani AA (2005) Cigarette smoking among spouses: another risk factor for stroke in women. Stroke 36:e74–e76

    Article  PubMed  CAS  Google Scholar 

  • Ridker PM, Cook NR, Lee IM, Gordon D, Gaziano JM, Manson JE, Hennekens CH, Buring JE (2005) A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 352:1293–1304

    Article  PubMed  CAS  Google Scholar 

  • Ringelstein EB, Knecht S (2006) Blood pressure reduction to lower the risk of stroke. Dtsch Med Wochenschr 131(Suppl 5):S135–S138

    Article  PubMed  Google Scholar 

  • Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, Elkind MS, George MG, Hamdan AD, Higashida RT et al (2013) An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44:2064–2089

    Article  PubMed  Google Scholar 

  • Sargent JD, Demidenko E, Malenka DJ, Li Z, Gohlke H, Hanewinkel R (2012) Smoking restrictions and hospitalization for acute coronary events in Germany. Clin Res Cardiol 101:227–235

    Article  PubMed  PubMed Central  Google Scholar 

  • Sharma AM, Wittchen HU, Kirch W, Pittrow D, Ritz E, Goke B, Lehnert H, Tschope D, Krause P, Hofler M et al (2004) High prevalence and poor control of hypertension in primary care: cross-sectional study. J Hypertens 22:479–486

    Article  PubMed  CAS  Google Scholar 

  • Shiroma EJ, Lee IM (2010) Physical activity and cardiovascular health: lessons learned from epidemiological studies across age, gender, and race/ethnicity. Circulation 122:743–752

    Article  PubMed  Google Scholar 

  • Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM et al (2014) 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 129:S1–S45

    Article  PubMed  Google Scholar 

  • Turner RC, Cull CA, Frighi V, Holman RR (1999) Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA 281:2005–2012

    Article  PubMed  CAS  Google Scholar 

  • Tyagi S, Koh GC, Nan L, Tan KB, Hoenig H, Matchar DB, Yoong J, Finkelstein EA, Lee KE, Venketasubramanian N et al (2018) Healthcare utilization and cost trajectories post-stroke: role of caregiver and stroke factors. BMC Health Serv Res 18:881

    Article  PubMed  PubMed Central  Google Scholar 

  • Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A et al (2018) 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J 39:3021–3104

    Article  PubMed  Google Scholar 

  • Wilson PW, Hoeg JM, D’Agostino RB, Silbershatz H, Belanger AM, Poehlmann H, O’Leary D, Wolf PA (1997) Cumulative effects of high cholesterol levels, high blood pressure, and cigarette smoking on carotid stenosis. N Engl J Med 337:516–522

    Article  PubMed  CAS  Google Scholar 

  • Wolf PA, Benjamin EJ, Belanger AJ, Kannel WB, Levy D, D’Agostino RB (1996) Secular trends in the prevalence of atrial fibrillation: the Framingham Study. Am Heart J 131:790–795

    Article  PubMed  CAS  Google Scholar 

  • Yong JH, Thavorn K, Hoch JS, Mamdani M, Thorpe KE, Dorian P, Sharma M, Laupacis A, Gladstone DJ, Committee ES (2016) Potential cost-effectiveness of ambulatory cardiac rhythm monitoring after cryptogenic stroke. Stroke 47:2380–2385

    Article  PubMed  Google Scholar 

  • Zunker P, Schick A, Buschmann HC, Georgiadis D, Nabavi DG, Edelmann M, Ringelstein EB (1996) Hyperinsulinism and cerebral microangiopathy. Stroke 27:219–223

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Klaus Gröschel .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Uphaus, T., Gröschel, K. (2019). Schlaganfall – Prävalenz, Bedeutung und Implikationen für die Prävention und Gesundheitsförderung. In: Tiemann, M., Mohokum, M. (eds) Prävention und Gesundheitsförderung. Springer Reference Pflege – Therapie – Gesundheit . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55793-8_43-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-55793-8_43-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-55793-8

  • Online ISBN: 978-3-662-55793-8

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics