Wienbergen Harm, Hanses Ulrich, Kerniss Hatim, Hambrecht Rainer
Bremer Institut für Herz- und Kreislaufforschung (BIHKF), Stiftung Bremer Herzen, Senator-Weßling-Str. 2, 28277, Bremen, Deutschland.
Klinik für Innere Medizin II, Gesundheit Nord - Klinikverbund Bremen gGmbH, Bremen, Deutschland.
Herz. 2025 Mar 28. doi: 10.1007/s00059-025-05305-1.
Despite an expensive healthcare system Germany performs poorly with respect to life-expectancy compared to other countries, for which cardiovascular diseases and deficits in cardiovascular prevention in particular are responsible. The basis of cardiovascular prevention is a healthy lifestyle with regular physical exercise, a predominantly plant-based diet, nonsmoking, good sleep and mental health. In many cases additional lipid-lowering, antidiabetic and antihypertensive medications are necessary. Recent studies have proven the prognostic effects of different groups of medications, such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, sodium-glucose transporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists, in the appropriate indication areas. To improve the cardiovascular prevention in Germany, intensified public efforts are crucial. In addition, individual support of patients is effective for long-term preventive measures. To achieve this healthcare professionals must be trained (physicians, cardiovascular prevention assistants), who can sustainably support patients in lifestyle modifications and medicinal prevention.
尽管德国拥有昂贵的医疗体系,但与其他国家相比,其在预期寿命方面表现不佳,这尤其归因于心血管疾病以及心血管预防方面的不足。心血管预防的基础是健康的生活方式,包括定期体育锻炼、以植物性食物为主的饮食、不吸烟、良好睡眠和心理健康。在许多情况下,还需要额外使用降脂、抗糖尿病和抗高血压药物。最近的研究已经证实了不同类药物,如前蛋白转化酶枯草溶菌素/克新9型(PCSK9)抑制剂、钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂,在适当适应症领域的预后效果。为改善德国的心血管预防状况,加大公共投入至关重要。此外,对患者的个人支持对于长期预防措施是有效的。要做到这一点,必须培训医疗专业人员(医生、心血管预防助理),他们能够在生活方式改变和药物预防方面为患者提供可持续的支持。