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/home/.sites/685/site2987125/web/vivid/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-clone.php on line 35 Rauchen und Thrombose - VIVID - Fachstelle für Suchtprävention
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VIVID INSIDE

Rauchen und Thrombose

Der Konsum von Tabak und Nikotin hängt mit Thrombose zusammen. Er fördert die Entstehung von Thrombose. Das hat Ursachen in der speziellen Wirkung von Tabak und Nikotin im Körper.

Konsum von Tabak und Nikotin fördert die Bildung von Blutgerinnseln

Nikotin verengt über die Freisetzung von bestimmten Botenstoffen (Katecholamine) die Blutgefäße, wie Studien ausführen. Diese Verengung verringert den Blutfluss und erhöht Blutdruck und Herzfrequenz. Darüber hinaus unterstützt das Rauchen die unerwünschte Blutgerinnung und verklebt die Blutplättchen. So fördert der Konsum von Tabak und Nikotin die Bildung von Blutgerinnseln, die die Blutgefäße verstopfen. Das kann zu einem Gefäßverschluss und damit zu einer Thrombose führen.

Besonders erhöht der Konsum von Tabak das Risiko für „Venöse Thromboembolie“ (VTE). Dies geschieht umso eher, je mehr andere Risikofaktoren dazu kommen – etwa Übergewicht und Alter.

Je mehr geraucht wird, desto höher das Thrombose-Risiko

Es gibt eine starke Dosis-Wirkung-Beziehung. Je mehr geraucht wird, umso höher ist das Risiko für eine Thrombose. Eine Metaanalyse von 21 Studien fand heraus: Rauchende mit dem Konsum von maximal 14 Zigaretten pro Tag haben ein 20 Prozent erhöhtes Risiko für VTE, jene mit 25 Zigaretten täglich oder mehr ein 63 Prozent erhöhtes Risiko. Eine dänische Studie analysierte die Konsummenge in Relation zum Risiko und stellte fest: Stark Rauchende mit dem Konsum von 25 Gramm Tabak pro Tag (entspricht 30 Zigaretten oder mehr) haben ein bis zu zweifach erhöhtes VTE-Risiko im Vergleich zu Menschen, die noch nie geraucht haben.

Eine andere Metaanalyse von 32 Studien mit 3.966.184 Teilnehmern und 35.151 Thrombose-Ereignissen (VTE) kam zu dem Schluss, dass 8,7 Prozent der Thrombosen durch Konsum von Tabak verursacht sind. Das Risiko für eine Thrombose erhöht sich mit der Menge. Es steigt demnach um 10,2 Prozent pro zehn gerauchten Zigaretten pro Tag oder um 6,1 Prozent für jede weiteren zehn Packungsjahre.

Besonders hoch ist das Risiko für Thrombose, wenn Menschen nicht nur rauchen, sondern zusätzlich übergewichtig und älter sind. Das belegt unter anderem eine britische Studie an 731.728 Teilnehmer aus 75 Kohorten.

Rauchen plus „Pille“ erhöht das Risiko drastisch

Besonders riskant ist für die Entwicklung einer Thrombose die Kombination von Tabakkonsum und oraler Empfängnisverhütung („Pille“). Diese Kombination verstärkt das Risiko für ein Blutgerinnsel und darauffolgende Thrombose drastisch. Das fand eine Studie an knapp 9.000 Frauen – davon knapp Thrombose-Patientinnen und knapp 5.000 in der Kontrollgruppe – heraus: Frauen, die rauchen und die „Pille“ nehmen haben ein 8,8 Mal so hohes Risiko für Thrombose als Frauen, die nicht rauchen und nicht oral verhüten. Wer die „Pille“ nimmt, sollte also keinesfalls rauchen.

Auch Nikotin an sich dürfte das Risiko für Thrombosen erhöhen. Für E-Zigaretten ist bereits gut belegt, dass sie Thrombosen deutlich wahrscheinlicher machen, wie eine Studie belegt. Auch andere Herz-Kreislauf-Erkrankungen sind durch den Konsum von E-Zigarette im Vergleich zum Nichtrauchen signifikant häufiger, zeigt ein Review.

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