Vaskuläres Altern, Hypertonie und körperliche Aktivität

 

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Zusammenfassung

In der vorliegenden Übersicht wird die Bedeutung der Intima-Media-Dicke, der Gefäßelastizität und der endothelialen Funktion für die Gefäßalterung beschrieben. Für die Intima-Media-Schicht und Gefäßsteifigkeit liegen umfangreiche Daten vor, die zeigen, dass die strukturellen Veränderungen nicht nur durch das gesunde Altern, sondern auch durch körperliche Inaktivität und weitere kardiovaskuläre Risikofaktoren zunehmen. Diesbezüglich nimmt die arterielle Hypertonie eine zentrale Rolle ein. Beide Parameter sind darüber hinaus eng mit dem kardiovaskulären Risiko assoziiert.

Die endotheliale Funktion, gemessen durch postischämische, flussvermittelte Vasodilatation ist ein funktioneller Parameter, der sowohl bei Gesunden mit dem Alter als auch beim Vorliegen klassischer kardiovaskulärer Risikofaktoren abnimmt. Körperliche Aktivität ist in der Lage, den Einfluss von Alter und Risikofaktoren positiv zu modifizieren

Ein Ausdauertraining hat in zahlreichen Studien einen positiven Einfluss auf Gefäßsteifigkeit und endotheliale Funktion gezeigt. In Langzeitstudien konnte eine regelmäßige körperliche Aktivität auch die Progression der Intima-Media-Dicke zumindest verzögern.

Die arterielle Hypertonie beschleunigt über die genannten Mechanismen die Gefäßalterung, während sich körperliche Aktivität günstig auf vaskuläre Alterungsfaktoren auswirkt.

Abstract

The present review delineates the significance of intima-media-thickness, arterial stiffness and endothelial function for vascular aging. There is profound evidence for an increase in intima-media-thickness and vascular stiffness not only during healthy aging but induced also by cardiovascular risk factors. There is a central role of arterial hypertension for this progression in both structural factors. In addition, both parameters are strongly associated with cardiovascular risk.

Endothelial function measured as postischemic flow-mediated vasodilatation is a functional parameter which is decreased both in healthy aging and by cardiovascular risk factors. Physical activity modifies the influence of aging and risk factors on endothelial function.

A positive influence of endurance exercise on vascular stiffness and endothelial function has been demonstrated in numerous studies. In long-term studies, regular physical activity has been shown to reduce the progression of intima-media-thickness.

Thus, arterial hypertension accelerates vascular aging, while physical activity has a positive influence on a variety of vascular parameters associated with vascular aging.

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Prof. Dr. med. Arno Schmidt-Trucksäss

Institut für Sport und Sportwissenschaften
Bereich Sportmedizin
Universität Basel

Birsstr. 320B

St. Jakobs-Turm

4052 Basel, Schweiz

Phone: +41/61-3778740

Fax: +41/61-3778742

Email: arno.schmidt-trucksaess@unibas.ch