Skip to main content

2017 | OriginalPaper | Buchkapitel

4. Risikofaktoren eines Schlaganfalls

verfasst von : M. Nückel

Erschienen in: Pflegewissen Stroke Unit

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die Risikofaktoren des Schlaganfalls setzen sich aus den „klassischen“, auch für die koronare Herzkrankheit geltenden vaskulären Risikofaktoren zusammen. Sie können in nicht veränderbare Faktoren auf der einen Seite und beeinflussbare Faktoren auf der anderen Seite unterteilt werden. Die modifizierbaren Risikofaktoren können medikamentös oder durch interventionelle Gefäßeingriffe und/oder nicht medikamentös vor allem durch Änderung des Lebensstils behandelt werden. Daneben gibt es prädisponierende Erkrankungen (z. B. Vorhofflimmern), die mit einem erhöhten Schlaganfallrisiko einhergehen. Die INTERSTROKE-Studie konnte zeigen, dass fünf Risikofaktoren (Hypertonie, abdominale Adipositas, Bewegungsmangel, Rauchen und Ernährungsfehler) insgesamt 83,4 % des Schlaganfallrisikos in der untersuchten Population erklären können. Dieses Kapitel gibt einen Überblick über die einzelnen Faktoren und Erkrankungen, die einen Einfluss auf das Schlaganfallrisiko haben.
Literatur
Zurück zum Zitat Albert CM, Cook NR, Gaziano JM, Zaharris E, MacFadyen J, Danielson E, Buring JE, Manson JE (2008) Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. JAMA 299:2027–2036CrossRef Albert CM, Cook NR, Gaziano JM, Zaharris E, MacFadyen J, Danielson E, Buring JE, Manson JE (2008) Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. JAMA 299:2027–2036CrossRef
Zurück zum Zitat Amarenco P, Labreuche J (2009) Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. Lancet Neurol 8:453–463CrossRef Amarenco P, Labreuche J (2009) Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. Lancet Neurol 8:453–463CrossRef
Zurück zum Zitat Bacigaluppi M, Hermann DM (2010) Hypercholesterinämie, Hyperhomozysteinämie und Atherosklerose. In: Hermann DM, Steiner T, Diener HC (Hrsg) Vaskuläre Neurologie. Thieme, Stuttgart, S 36–44 Bacigaluppi M, Hermann DM (2010) Hypercholesterinämie, Hyperhomozysteinämie und Atherosklerose. In: Hermann DM, Steiner T, Diener HC (Hrsg) Vaskuläre Neurologie. Thieme, Stuttgart, S 36–44
Zurück zum Zitat Baillargeon JP, McClish DK, Essah PA, Nestler JE (2005) Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. J Clin Endocrinol Metab 90:3863–3870CrossRef Baillargeon JP, McClish DK, Essah PA, Nestler JE (2005) Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. J Clin Endocrinol Metab 90:3863–3870CrossRef
Zurück zum Zitat Bushnell CD (2008) Stroke in woman: Risk and prevention throughout the lifespan. Neurol Clin 26:1161–1171CrossRef Bushnell CD (2008) Stroke in woman: Risk and prevention throughout the lifespan. Neurol Clin 26:1161–1171CrossRef
Zurück zum Zitat Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Le Heuzey JY, Kay GN, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann S (2006) ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation). Eur Heart J 27:1979–2030 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Le Heuzey JY, Kay GN, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann S (2006) ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation). Eur Heart J 27:1979–2030
Zurück zum Zitat Gabriel SR, Carmona L, Roque M, Sánchez GL, Bonfill X (2005) Hormone replacement therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev: CD002229 Gabriel SR, Carmona L, Roque M, Sánchez GL, Bonfill X (2005) Hormone replacement therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev: CD002229
Zurück zum Zitat Gaede P, Lund-Andersen H, Parving HH, Pedersen O (2008) Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med 358:580–591CrossRef Gaede P, Lund-Andersen H, Parving HH, Pedersen O (2008) Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med 358:580–591CrossRef
Zurück zum Zitat Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, Creager MA, Culebras A, Eckel RH, Hart RG, Hinchey JA, Howard VJ, Jauch EC, Levine SR, Meschia JF, Moore WS, Nixon JV, Pearson TA (2011) Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42:517–584CrossRef Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, Creager MA, Culebras A, Eckel RH, Hart RG, Hinchey JA, Howard VJ, Jauch EC, Levine SR, Meschia JF, Moore WS, Nixon JV, Pearson TA (2011) Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42:517–584CrossRef
Zurück zum Zitat Grodstein F, Manson JE, Stampfer MJ, Rexrode K (2008) Postmenopausal hormone therapy and stroke: role of time since menopause and age at initiation of hormone therapy. Arch Intern Med 168:861–866CrossRef Grodstein F, Manson JE, Stampfer MJ, Rexrode K (2008) Postmenopausal hormone therapy and stroke: role of time since menopause and age at initiation of hormone therapy. Arch Intern Med 168:861–866CrossRef
Zurück zum Zitat Hackam DG (2015) Cannabis and stroke: Systematic appraisal of case reports. Stroke 46: 852–856CrossRef Hackam DG (2015) Cannabis and stroke: Systematic appraisal of case reports. Stroke 46: 852–856CrossRef
Zurück zum Zitat Haratz S, Tanne D (2011) Diabetes, hyperglycemia and the management of cerebrovascular disease. Curr Opin Neurol 24:81–88CrossRef Haratz S, Tanne D (2011) Diabetes, hyperglycemia and the management of cerebrovascular disease. Curr Opin Neurol 24:81–88CrossRef
Zurück zum Zitat Heeringa J, van der Kuip DA, Hofman A, Kors JA, van Herpen G, Stricker BH, Stijnen T, Lip GY, Witteman JC (2006) Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 27:949–953CrossRef Heeringa J, van der Kuip DA, Hofman A, Kors JA, van Herpen G, Stricker BH, Stijnen T, Lip GY, Witteman JC (2006) Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 27:949–953CrossRef
Zurück zum Zitat Kruit MC, van Buchem MA, Hofman PA, Bakkers JT, Terwindt GM, Ferrari MD, Launer LJ (2004) Migraine as a risk factor for subclinical brain lesions. JAMA 291:427–434CrossRef Kruit MC, van Buchem MA, Hofman PA, Bakkers JT, Terwindt GM, Ferrari MD, Launer LJ (2004) Migraine as a risk factor for subclinical brain lesions. JAMA 291:427–434CrossRef
Zurück zum Zitat Kurth T, Gaziano JM, Berger K, Kase CS, Rexrode KM, Cook NR, Buring JE, Manson JE (2002) Body mass index and the risk of stroke in men. Arch Int Med 162:2557–2562CrossRef Kurth T, Gaziano JM, Berger K, Kase CS, Rexrode KM, Cook NR, Buring JE, Manson JE (2002) Body mass index and the risk of stroke in men. Arch Int Med 162:2557–2562CrossRef
Zurück zum Zitat Kurth T, Gaziano JM, Rexrode KM, Kase CS, Cook NR, Manson JE, Buring JE (2005) Prospective study of body mass index and risk of stroke in apparently healthy women. Circulation 111:1992–1998CrossRef Kurth T, Gaziano JM, Rexrode KM, Kase CS, Cook NR, Manson JE, Buring JE (2005) Prospective study of body mass index and risk of stroke in apparently healthy women. Circulation 111:1992–1998CrossRef
Zurück zum Zitat Kurth T, Mohamed S, Maillard P, Zhu YC, Chabriat H, Mazoyer B,Bousser MG, Dufouil C, Tzourio C (2011) Headache, migraine, and structural brain lesions and function: population based Epidemiology of Vascular Ageing-MRI study. BMJ 342:c7357CrossRef Kurth T, Mohamed S, Maillard P, Zhu YC, Chabriat H, Mazoyer B,Bousser MG, Dufouil C, Tzourio C (2011) Headache, migraine, and structural brain lesions and function: population based Epidemiology of Vascular Ageing-MRI study. BMJ 342:c7357CrossRef
Zurück zum Zitat Larsson SC, Akesson A, Wolk A (2015) Primary prevention of stroke by a healthy lifestyle in a high-risk group. Neurology 84: 2224–2228CrossRef Larsson SC, Akesson A, Wolk A (2015) Primary prevention of stroke by a healthy lifestyle in a high-risk group. Neurology 84: 2224–2228CrossRef
Zurück zum Zitat Lee CD, Folsom AR, Blair SN (2003) Physical activity and stroke risk. A meta-analysis. Stroke 34:2475–2481CrossRef Lee CD, Folsom AR, Blair SN (2003) Physical activity and stroke risk. A meta-analysis. Stroke 34:2475–2481CrossRef
Zurück zum Zitat Lee M, Saver JL, Chang B, Chang KH, Hao Q, Ovbiagele B (2011) Presence of baseline prehypertension and risk of incident stroke: a meta-analysis. Neurology 77:1330–1337CrossRef Lee M, Saver JL, Chang B, Chang KH, Hao Q, Ovbiagele B (2011) Presence of baseline prehypertension and risk of incident stroke: a meta-analysis. Neurology 77:1330–1337CrossRef
Zurück zum Zitat Löwel H, Meisinger C, Heier M, Hymer H, Alte D, Völzke H (2006) Epidemiologie der arteriellen Hypertonie in Deutschland. Dtsch Med Wochenschr 131:2586–2591CrossRef Löwel H, Meisinger C, Heier M, Hymer H, Alte D, Völzke H (2006) Epidemiologie der arteriellen Hypertonie in Deutschland. Dtsch Med Wochenschr 131:2586–2591CrossRef
Zurück zum Zitat Nürnberger J, Kribben A, Philipp T, Erbel R (2007) Die arterielle Compliance (Gefäßsteifigkeit) zur Aufdeckung einer subklinischen Atherosklerose. Herz 32:379–386CrossRef Nürnberger J, Kribben A, Philipp T, Erbel R (2007) Die arterielle Compliance (Gefäßsteifigkeit) zur Aufdeckung einer subklinischen Atherosklerose. Herz 32:379–386CrossRef
Zurück zum Zitat O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P,Rangarajan S, Islam S, Pais P, McQueen MJ, Mondo C, Damasceno A, Lopez-Jaramillo P, Hankey GJ, Dans AL, Yusoff K, Truelsen T, Diener HC, Sacco RL, Ryglewicz D, Czlonkowska A, Weimar C, Wang X, Yusuf S; INTERSTROKE investigators (2010) Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 376:112–123CrossRef O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P,Rangarajan S, Islam S, Pais P, McQueen MJ, Mondo C, Damasceno A, Lopez-Jaramillo P, Hankey GJ, Dans AL, Yusoff K, Truelsen T, Diener HC, Sacco RL, Ryglewicz D, Czlonkowska A, Weimar C, Wang X, Yusuf S; INTERSTROKE investigators (2010) Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 376:112–123CrossRef
Zurück zum Zitat Quinn TJ, Dawson J, Walters MR (2011) Sugar and stroke: cerebrovascular disease and blood glucose control. Cardiovasc Ther 29:e31–42CrossRef Quinn TJ, Dawson J, Walters MR (2011) Sugar and stroke: cerebrovascular disease and blood glucose control. Cardiovasc Ther 29:e31–42CrossRef
Zurück zum Zitat Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA (2011) Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 342:d671CrossRef Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA (2011) Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 342:d671CrossRef
Zurück zum Zitat Rothwell PM, Coull AJ, Silver LE, Fairhead JF, Giles MF, Lovelock CE, Redgrave JN, Bull LM, Welch SJ, Cuthbertson FC, Binney LE, Gutnikov SA, Anslow P, Banning AP, Mant D, Mehta Z (2005) Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study). Lancet 366:1773–1783CrossRef Rothwell PM, Coull AJ, Silver LE, Fairhead JF, Giles MF, Lovelock CE, Redgrave JN, Bull LM, Welch SJ, Cuthbertson FC, Binney LE, Gutnikov SA, Anslow P, Banning AP, Mant D, Mehta Z (2005) Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study). Lancet 366:1773–1783CrossRef
Zurück zum Zitat Rothwell PM, Howard SC, Dolan E, O'Brien E, Dobson JE, Dahlöf B, Sever PS, Poulter NR (2010) Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet 375:895–905CrossRef Rothwell PM, Howard SC, Dolan E, O'Brien E, Dobson JE, Dahlöf B, Sever PS, Poulter NR (2010) Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet 375:895–905CrossRef
Zurück zum Zitat Schrader J, Lüders S, Diener HC (2010) Arterieller Blutdruck. In: Hermann DM, Steiner T, Diener HC (Hrsg) Vaskuläre Neurologie. Thieme, Stuttgart, S 29–35 Schrader J, Lüders S, Diener HC (2010) Arterieller Blutdruck. In: Hermann DM, Steiner T, Diener HC (Hrsg) Vaskuläre Neurologie. Thieme, Stuttgart, S 29–35
Zurück zum Zitat 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 281:2005–2012CrossRef 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 281:2005–2012CrossRef
Zurück zum Zitat Wen CP, Wai JP, Tsai MK, Yang YC, Cheng TY, Lee MC, Chan HT, Tsao CK, Tsai SP, Wu X (2011) Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet 378:1244–1253CrossRef Wen CP, Wai JP, Tsai MK, Yang YC, Cheng TY, Lee MC, Chan HT, Tsao CK, Tsai SP, Wu X (2011) Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet 378:1244–1253CrossRef
Zurück zum Zitat Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, Kastarinen M, Poulter N, Primatesta P, Rodríguez-Artalejo F, Stegmayr B, Thamm M, Tuomilehto J, Vanuzzo D, Vescio F (2003) Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 289:2363–2369CrossRef Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, Kastarinen M, Poulter N, Primatesta P, Rodríguez-Artalejo F, Stegmayr B, Thamm M, Tuomilehto J, Vanuzzo D, Vescio F (2003) Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 289:2363–2369CrossRef
Zurück zum Zitat Wolf PA, Abbot RD, Kannel WB (1991) Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke 22:983–988CrossRef Wolf PA, Abbot RD, Kannel WB (1991) Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke 22:983–988CrossRef
Zurück zum Zitat Wright JT Jr, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, Reboussin DM, Rahman M, Oparil S, Lewis CE,Kimmel PL, Johnson KC, Goff DC Jr, Fine LJ, Cutler JA, Cushman WC, Cheung AK, Ambrosius WT (2015) A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 373: 2103–2116CrossRef Wright JT Jr, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, Reboussin DM, Rahman M, Oparil S, Lewis CE,Kimmel PL, Johnson KC, Goff DC Jr, Fine LJ, Cutler JA, Cushman WC, Cheung AK, Ambrosius WT (2015) A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 373: 2103–2116CrossRef
Metadaten
Titel
Risikofaktoren eines Schlaganfalls
verfasst von
M. Nückel
Copyright-Jahr
2017
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-53625-4_4