Anders G
I. Medizinischen Klinik, Städtischen Krankenhauses im Friedrichshain, Berlin.
Z Gesamte Inn Med. 1989 Jan 15;44(2):38-41.
Within the framework of the control of cardiovascular diseases the prophylaxis of the sudden heart death is an actual problem of health policy and medicine. Since the most frequent cause of the sudden heart death is the coronary heart disease, elements of the primary and secondary prophylaxis of the coronary heart disease are also of importance for the prevention of the sudden heart death. Central points of the prophylaxis of the sudden heart death are the improvement of the prehospital care and the shortening of the prehospital times of delay in acute myocardial infarction as well as the recognition, registration and care of risk persons. Nowadays the demand is existing more to fulfil these tasks in the daily practice. The actual possibilities of the medicamentous prophylaxis are analysed and discussed. More and more comprehensive knowledge about the prophylactic effect of the beta-receptor blockers as to the reduction of the frequency of the sudden hearth death is existing. They are most effectful in persons with a high risk particularly after an acute myocardial infarction. Though beta-receptor blockers shall cause changes of the serum lipids, on the basis of a more fundamental analysis of literature can be stated, since there is no clue to it, that beta-receptor blockers further the development of arteriosclerosis. On the contrary there are references for the fact that the development of arteriosclerosis is delayed. For this reason the demand has to be made to fully use the therapeutical potential of the beta-receptor blockers in the therapy of the chronic cardiovascular diseases and their complications.(ABSTRACT TRUNCATED AT 250 WORDS)
在心血管疾病控制框架内,预防心脏性猝死是卫生政策和医学领域的一个现实问题。由于心脏性猝死最常见的原因是冠心病,冠心病一级和二级预防的要素对于预防心脏性猝死也很重要。预防心脏性猝死的重点是改善院前护理,缩短急性心肌梗死的院前延误时间,以及识别、登记和护理高危人群。如今,在日常实践中完成这些任务的需求更为迫切。对药物预防的实际可能性进行了分析和讨论。关于β受体阻滞剂对降低心脏性猝死发生率的预防作用,已有越来越全面的认识。它们对高危人群,尤其是急性心肌梗死后的人群最为有效。尽管β受体阻滞剂会引起血脂变化,但基于对文献的更深入分析可以表明,由于没有相关线索,β受体阻滞剂不会促进动脉粥样硬化的发展。相反,有证据表明动脉粥样硬化的发展会延迟。因此,必须充分利用β受体阻滞剂在慢性心血管疾病及其并发症治疗中的治疗潜力。(摘要截取自250字)