More deaths from heart disease in the East

In eastern Germany, the mortality rate is higher in a heart attack than in the west

01/29/2014

In eastern Germany people die more often from heart disease than patients in the West. This is the result of some research published in the German Heart Report. Only in Berlin, this difference does not show.

Although fewer and fewer people are dying from a heart attack, the mortality rate in East Germany is alarmingly high. Most deaths occurred in the federal state of Saxony-Anhalt. Here 104 people per 100,000 inhabitants died of an infarction. The fewest infarct deaths were recorded in the state of Bremen. Here the rate was 35 to 100,000 Bremern. The numbers refer to studies from the year 2011. It is possible, said the doctors, that in less-favored areas less specialized cardiologists are established. In addition, in many regions there is a lower level of health awareness and less specialized knowledge.

Heart attack with the most common cause of death in Germany
The most frequently reported cause of death in Germany is the heart attack. However, fewer and fewer people are dying of heart attacks today than was the case 30 years ago. For comparison: In 2011, this fate befell about 52,000 people. In 1980 there were still 92,800.

According to the chairman of the German Heart Foundation, Prof. Dr. med. med. Thomas Meinertz believes in improved diagnostics, treatment and prevention. Also, more and more people would prefer a healthier lifestyle. Nevertheless, one third of Germans still do not do enough sport. Also, many people hesitate too long to go with their complaints to a specialist. In acute heart attacks, many call too late the emergency number 112. This would waste too much valuable time to enable a patient to survive. It also takes too long in the country until the ambulance arrives at the victim. „Long journeys to the clinic can be fatal.“

Despite the overall decline in the number of fatal cardiac deaths, the report would continue to show clear regional differences. According to this, heart patients in the East have a much higher risk of falling victim to a heart attack than patients in the western federal states. The death toll in Saxony-Anhalt was highest, since 372 deaths per 100,000 inhabitants would be recorded here, closely followed by Thuringia with 352. In Berlin, the mortality rate is 185 per 100,000 inhabitants, 213 in Hamburg and 219 in Baden-Württemberg.

A major requirement of the Heart Foundation is therefore to improve care in the structurally weak areas. Qualified cardiac emergency ambulances and cardiologists are often missing. In Mecklenburg-Western Pomerania, for example, there is only one cardiologist for 37,000 inhabitants. For comparison: in Bremen, a heart specialist is responsible for just 19,500 people.

Significant improvement in acute care
According to the DGK, the acute care of heart attack patients is at a very good level. In almost 90 percent of patients, the circulation of the heart muscle can be restored. The only downer: more and more people are getting older, and so is the risk of developing heart failure. The experts also warn that the trend towards a healthier lifestyle is undermining advances in early detection and treatment. "Obesity and diabetes are increasing alarmingly, the proportion of smokers is on the whole hardly back," said Hamm. The success, which can be achieved for example by drugs in lowering blood pressure or blood lipid levels are relativized. Therefore, more prevention programs need to be developed to help patients change their lifestyle.

Too few heart donor organs
Too few donor organs would be available according to the physicians. In 2012, just 346 hearts were transplanted. Despite a much higher demand, these are just as many as in 1995. According to Prof. Anno Diegeler of the German Society of Thoracic and Cardiovascular Surgery, however, there are „around 900 patients on the waiting list“. For many patients, this fact means death.

There are also positive reports: More and more elderly patients today can get new heart valves using keyhole surgery and catheters. These procedures are much gentler. This also increases the survival rate. In 2012, 9000 patients were undergoing this procedure. About 11,700 people underwent conventional surgery. The mortality rate is just 3 percent.

More children could be saved
Another improvement is the gentler operation of infants and children with a congenital heart defect. The procedures today are much more effective. 85 to 90 percent of operated children today can reach the age of majority. In infants, the mortality rate has therefore been reduced by 70 percent (Compare 20 years ago). (Sb)