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  • 1 Siófok Város Kórház-Rendelőintézete Belgyógyászati Osztály Siófok Semmelweis u. 1. 8600
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A cardiovascularis kórképek gyógyításában elért eredmények ellenére a szív-ér rendszeri megbetegedések gyakorisága a fejlett és fejlődő világban növekszik. Ez a tény összefügg a világméretű elhízás-, illetve diabetespandémiával, valamint az úgynevezett urbanizált életforma térhódításával. A szerzők ismertetik a civilizációs életforma és a krónikus stressz összefüggését, valamint a következményes életforma-változások, szív-ér rendszeri kockázatnövekedés érveit. Továbbá megfogalmazzák a cardiovascularis kockázatcsökkentés mai gyakorlatának (polipill-alkalmazás, úgynevezett célértékek elérése) kritikáját. Hangsúlyozzák a cardiovascularis kockázati tényezők következményes természetét, ebből adódóan a kockázati faktor csökkentésére irányuló kezelés mérsékelt hatásfokát. Kiemelik az oki kezelés (életmód-intervenciók, krónikus stresszkezelés) elvi elsőbbrendűségét a gyógyszeres intervenciókkal szemben. Tárgyalják a macroangiopathia és a microangiopathia patogenezisének azonos és eltérő jegyeit. Ismertetik a krónikus stressz szerepét a diabetes kialakulásában, valamint a krónikus stressz létrejöttének kiváltó okait. Tárgyalják a metabolikus szindróma, a 2-es típusú diabetes hátterében levő anyagcserezavar (diszmetabolizmus) létét támogató experimentális és klinikai adatokat, hangsúlyozzák a nem ischaemiás diabeteses cardiomyopathia önálló cardiovascularis kockázati faktorának szerepét. Részletezik a diabeteses cardiovascularis kockázatcsökkentés lehetőségeit: hangsúlyozzák a magas vérnyomás, a hyperlipidaemia csökkentésének hatékonyságát szemben a vércukorcsökkentés mérsékeltebb hatásosságával. Hangsúlyozzák, hogy a fokozott diabeteses cardiovascularis kockázat megszüntetése csak az alapokot képező anyagcserezavar (diszmetabolizmus) ismerete és kezelése által lehetséges. Ismertetik az úgynevezett metabólikus promóterekkel elért eredményeket. Orv. Hetil., 2011, 152, 1353–1361.

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