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Kardiovaskuläre Prävention und regelmäßige körperliche Aktivität

Bewegung und Training als wahre „polypill“

Cardiovascular prevention and regular physical exercise

Activity and training as the true “polypill”

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Zusammenfassung

Präventionsleitlinien bedürfen einer regelmäßigen Überarbeitung und Aktualisierung. Gerade zum Thema Bewegung und körperlicher Aktivität sind in den letzten Jahren zahlreiche neue Studien mit praktischer Bedeutung publiziert worden. Diese betreffen die Evidenz der körperlichen Aktivität, das Indikationsspektrum wie auch die Trainingsempfehlungen nach der FITT-Regel: Frequenz, Intensität, Zeit der Trainingseinheit („time“) und Art der Aktivität („type“). Bedeutsam ist, dass bereits mit moderater körperlicher Aktivität, so auch mit vermehrter Bewegung im Alltag (z. B. 10.000 Schritte am Tag) ein präventiver Trainingseffekt erreicht werden kann. Ein derzeit noch unzureichend gelöstes Problem ist die wirksame Motivation zu körperlicher Aktivität. Das Rezept für Bewegung ist dafür ein wichtiger Ansatz. Das ergänzende Beratungsgespräch mit der Trainingsempfehlung setzt sportmedizinische Kenntnisse der Ärzte in Klinik und Praxis voraus. Im niedergelassenen Bereich fehlt die angemessene Vergütung. Bevölkerungsbezogene Interventionen, neu in der Leitlinie, sind dringend erforderlich. Die zuständigen Einrichtungen sind hier gefordert. Die aktuelle ESC-Leitlinie bringt eine Fülle von neuen Ergebnissen und Präventionsmöglichkeiten. Diese sind aber ergänzungsbedürftig, insbesondere im Hinblick auf den sehr wichtigen Risikofaktor der körperlichen Inaktivität, des Bewegungsmangels und der sitzenden Lebensweise in allen Altersgruppen.

Abstract

Guidelines for cardiovascular prevention need to be regularly revised and updated. With respect to physical activity and exercise, many studies with practical relevance have been published in recent years. They are concerned with the evidence of physical activity for prevention of many diseases and the spectrum of indications for applying physical activity for prevention, therapy and rehabilitation. Training recommendations have been developed for the prevention of various diseases according to the FITT rule, which stands for frequency, intensity, time (of session) and type of sports followed by a progression in the amount of training. Recent publications show that moderate exercise with an increase in regular activity (e.g. 10,000 steps per day) is a sufficient approach for risk reduction in many diseases. An as yet unresolved problem is the best approach for effective motivation for physical exercise. The prescription of exercise is an important approach for improving the motivation for physical activity; however, prescribing exercise needs basic knowledge in sports physiology and proper training recommendations. Furthermore, population-based interventions for physical activity are urgently needed to implement more physical activity in the daily routine. The current ESC guidelines provide a great deal of new information to be implemented in the prevention in primary care; however, with regard to physical activity, more comprehensive biological data of physical activity should be presented in order to improve physician’s knowledge, thus enhancing the fight against inactivity and sedentary lifestyles as one of the most significant risk factors.

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Authors and Affiliations

  1. Bermesgasse 32b, 42897, Remscheid, Deutschland

    H. Löllgen

  2. Institut für Sportmedizin und Österreichisches Zentrum für Sportwissenschaften, Auf der Schmelz 6, Wien, A-1150, Österreich

    N. Bachl

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Correspondence to H. Löllgen.

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H. Löllgen ist Cardiology Consultant für ESA. N. Bachl gibt an, dass kein Interessenkonflikt besteht.

Diese Arbeit enthält keine Inhalte zu tierexperimentellen Studien sowie keine von den Autoren durchgeführten Studien an Menschen.

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Löllgen, H., Bachl, N. Kardiovaskuläre Prävention und regelmäßige körperliche Aktivität. Herz 41, 664–670 (2016). https://doi.org/10.1007/s00059-016-4506-5

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