Management kardiovaskulärer Erkrankungen bei Adipositas
摘要
Due to the high burden of cardiovascular diseases in obesity, there is a growing need for structured, risk-adapted treatment strategies. Obesity amplifies classical cardiovascular risk factors, such as arterial hypertension, type 2 diabetes and dyslipidemia and additionally exerts effects on the cardiovascular system independent of the body mass index (BMI) through inflammatory and metabolic mechanisms. Visceral obesity in particular is closely linked to the development and progression of cardiovascular diseases, including coronary artery disease, heart failure (especially heart failure with preserved ejection fraction, HFpEF), cardiac arrhythmias, valvular heart disease, pulmonary hypertension and sleep-related breathing disorders. This consensus paper of the German Cardiac Society (DGK) provides a structured overview of pathophysiological principles, diagnostic characteristics and therapeutic options in the management of cardiovascular disease in obesity. The aim is to provide evidence-based, consensus-supported and practice-oriented recommendations for risk-adapted and multimodal care. The paper outlines an integrated treatment concept combining lifestyle interventions, modern pharmacotherapy, particularly incretin-based substances and bariatric procedures. It also addresses sex-specific aspects, peri-interventional challenges and the importance of structured rehabilitation and cross-sectoral care. The document is intended as a consensus-based clinical guide and does not replace formal evidence-based guidelines.