Die polyvaskuläre Atherosklerose geht mit einem stark erhöhten kardiovaskulären Risiko
einher und bedarf daher eines konsequenten Managements der Risikofaktoren. Durch präventive
Maßnahmen wie Lebensstil-Änderungen oder medikamentöse Therapien kann eine Risikoreduktion
erreicht werden. Der folgende Beitrag stellt wichtige Präventionsmaßnahmen und Therapieoptionen
vor.
Abstract
Polyvascular atherosclerosis is characterized by atherosclerosis in several vascular
territories, leading to an extremely high risk of myocardial infarction, ischemic
stroke, and cardiovascular death. These patients derive a higher absolute risk reduction
from preventive measures compared to individuals with monovascular atherosclerosis.
The most important lifestyle factors are non-smoking and physical exercise. Pharmacological
management includes lipid-lowering with an LDL-cholesterol target of <40mg/dl (1,0mmol/l)
and blood-pressure control with a systolic target of 120mmHg. Diabetes type 2 in patients
with polyvascular atherosclerosis should be treated with SGLT2-inhibitors and/or GLP1-receptor
agonists. Patients with obesity and polyvascular disease should receive GLP1RA – regardless
of the presence of diabetes. Thus, a comprehensive risk factor management in patients
with polyvascular atherosclerosis is essential to improve long-term cardiovascular
outcomes.
Schlüsselwörter
Atherosklerose - polyvaskulär - kardiovaskulär - Risikofaktormanagement - Prävention
- Lebensstiländerung
Keywords
atherosclerosis - polyvascular - cardiovascular - risk factor management - prevention
- lifestyle change
Bibliographical Record
Annika Reuser, Ulrich Laufs. Risikofaktor-Management bei polyvaskulärer Atherosklerose.
Dtsch Med Wochenschr 2025; 150: a23624893.
DOI: 10.1055/a-2362-4893
