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Risikoreduktion kardiovaskulärer Erkrankungen durch körperliche Aktivität

Risk reduction in cardiovascular diseases by physical activity

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Zusammenfassung

Bewegungsmangel gilt als bedeutender Risikofaktor für kardiovaskuläre Erkrankungen. Regelmäßige körperliche Aktivität und Bewegung führen zu Anpassungen in der Muskulatur, an Herz und Kreislauf sowie im Stoffwechselgeschehen. Im Rahmen der Primärprävention sinkt durch körperliche Aktivität die Gesamtmortalität um 22–34% und die kardiovaskuläre Mortalität um 27–35%. Diese Befunde sind in zahlreichen prospektiven Kohortenstudien erhoben worden und durch 4 Metaanalysen an bis zu 800.0000 Probanden belegt (Evidenzgrad IA). Eine Subgruppenanalyse ergibt eine bessere Wirkung bei Älteren im Vergleich zu Jüngeren und ebenso bei Frauen. Gleichzeitig erfolgen eine Steigerung der Leistungsfähigkeit (Fitness) sowie eine krankheitsbezogene Abnahme der Symptomatik (IA). Dies gilt für die koronare Herzkrankheit, die Herzinsuffizienz und den arteriellen Bluthochdruck (IA). Weitere evidenzbasierte Befunde liegen für das Auftreten von Schlaganfällen vor, für Auftreten und Entwicklung einer Demenz sowie für die periphere arterielle Verschlusskrankheit. Auch die zugehörigen Trainingsempfehlungen sind auf hohem Niveau evidenzbasiert (bis IA). Entsprechend sollte jeder Arzt, unabhängig vom Fachgebiet, bei jedem Patientenkontakt nach körperlicher Aktivität fragen und diese zur Prävention und Therapie empfehlen.

Abstract

A sedentary lifestyle or physical inactivity is recognized as an important risk factor for cardiovascular diseases. Regular physical activity improves muscular function, cardiac function, and metabolic syndrome-related disorders. Leisure time physical activity reduces all-cause mortality by 22–34% and cardiovascular mortality by 27–35%. These data have been shown in many prospective cohort studies and published in four large meta-analyses with more than 800,000 participants (evidence IA). The risk reduction is somewhat more pronounced in the elderly and in women (IB). In addition to reduced mortality, physical activity also improves cardiopulmonary function and quality of life (IB). This also holds true for coronary artery disease, cardiac failure, and arterial hypertension with high-grade evidence (IA). Furthermore, evidence has been shown a risk reduction in stroke, development of cognitive dysfunction, and intermittent claudication. Training recommendations for physical activity have reached high-grade evidence (IA). Therefore, regular physical activity is one of the most important components of a healthy lifestyle. All physicians should ask their patients at all clinic and office visits about physical activity and recommend activity for prevention and therapy.

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Danksagung

Kommentare und kritische Bemerkungen durch Diskussion mit S.N. Blair, Columbia, University of South Carolina, USA, werden dankbar gewürdigt.

Acknowledgement

Comments and critical remarks by discussion with S.N. Blair, Columbia, University of South Carolina, USA, are gratefully acknowledged.

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  1. Praxis für Innere Medizin/Kardiologie, Bermesgasse 32 b, 42897, Remscheid, Deutschland

    H. Löllgen

  2. Deutsche Gesellschaft für Sportmedizin und Prävention e.V., Frankfurt am Main, Deutschland

    H. Löllgen

  3. Esslingen, Deutschland

    D. Löllgen

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Löllgen, H., Löllgen, D. Risikoreduktion kardiovaskulärer Erkrankungen durch körperliche Aktivität. Internist 53, 20–29 (2012). https://doi.org/10.1007/s00108-011-2889-1

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