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Every fourth German dies of heart disease
More and more people are dying from heart disease. This is what the new German Heart Report 2017 says. The major influence is the coronary heart disease (CHD), which is an ancillary disease of the heart attack. Also of importance is heart failure, which is also popularly called cardiac insufficiency. This also has a high mortality. The German Heart Report is published annually by the Deutsche Herzstiftung together with the medical societies for cardiology (DGK), cardiac surgery (DGTHG) and pediatric cardiology (DGPK).
The number of deaths from total heart disease has increased slightly. As in previous years, when looking at heart disease, more women than men die, as the new German Heart Report 2017 (https://www.herzstiftung.de/herzbericht) documents.
(Image: Kzenon / fotolia.com) Cardiovascular disease (CHD), the underlying cause of heart attack, has 128,230 deaths in 2015 (121,166 in 2014) and cardiac insufficiency (47,414) in 2014 (2014: 44,551). "This increase in cardiac insufficiency, in particular, requires special attention on the part of the heart medicine and efforts in the care of the partially seriously ill patients, also in view of the steadily increasing hospital admissions of over 11,000 per year," emphasizes Prof. Dr. med. med. Thomas Meinertz, CEO of the German Heart Foundation, presenting the new Heart Report in Berlin.
Heart failure is one of the most frequent occasions for hospitalization in Germany, with more than 455,000 in-patient cases per year. It usually comes only by an aggravation of the disease for hospital admission. Chronic heart failure is usually the result of other cardiovascular diseases such as CHD / cardiac infarction, high blood pressure, valve disorders or arrhythmias, so that the common disease can be prevented by early diagnosis, treatment and elimination of risk factors.
"Many hospitalizations and deaths from heart failure and other heart disease could be avoided by improving knowledge of disease symptoms, proper emergency response and preventive measures such as early blood pressure or heart rate monitoring. That is why efforts in the Enlightenment are indispensable, "Meinertz emphasizes.
Fight against heart attack mortality: more investment in prevention
Increases in mortality are seen in addition to CHD, the underlying disease of heart attack, and cardiac insufficiency, also in valve diseases and cardiac arrhythmias. From 2014 to 2015, deaths from valvular disease increased from 16,064 (2014) to 16,987 (2015), and deaths from cardiac arrhythmias increased from 25,774 (2014) to 28,425 (2015). If one observes the development of the death rate of heart disease from 1990 to 2015, the value (deaths per 100,000 inhabitants / person) decreased significantly by 46.2% from 459.2 (1990) to 246.9 (2015).
For example, at the heart attack in 1990, 85,625 people died, compared to 49,210 in 2015 (2014: 48,181). According to the Heart Report, this development is due not only to the decline in the number of smokers and improvements in diagnostics and therapeutic care, but also to an optimization of the processes in the clinics and emergency medical systems. "However, this retrograde effect must not hide the fact that the spread of heart disease has not diminished to the same extent and continues to kill more than 221,500 people every year," warns Prof. Meinertz. Health care policy in Germany needs to invest far more extensively in prevention than in the past, in order to counteract the onset of risk-related diseases such as high blood pressure, diabetes and high-cholesterol disorders in the population as early as childhood.
"Limiting the clinical approach through early detection, consistent counseling and therapy is not enough. A more comprehensive approach is needed to provide the population with a framework for healthy lifestyles through physical activities or healthy diets and systematic education about risk factors in day care centers, schools and businesses. "
Heart attack mortality: differences between countries persist
The sometimes strong differences in the mortality rates of heart diseases between the federal states persist. Example heart attack: Most heart attack deaths still lamented Saxony-Anhalt with 82 dead per 100,000 inhabitants (EW), in Brandenburg with 83, Thuringia with 69 and Mecklenburg-Vorpommern with 68, while the lowest values Schleswig-Holstein with 42, Hamburg with 46, North Rhine-Westphalia with 49 and Bayern with 51 heart attack deaths per 100,000 PE.
"We are critical of the fact that the federal states with the lowest cardiologist density simultaneously fight against an above-average infarct mortality rate, such as Thuringia, Mecklenburg-Vorpommern, Brandenburg and Saxony-Anhalt," said Prof. Meinertz. "Especially in regions with a low physician density, improvements in cardiological care through more outpatient diagnostics or therapy are a possible approach to reducing mortality from heart disease for better accessibility of emergency outpatient departments." For comparison: Thuringia with the lowest cardiologist density has 31,922 PE Cardiologists, while the Saarland comes to a cardiologist for 17,467 EW.
The uneven distribution of cardiac emergency ambulances (Chest Pain Units, CPU) is striking. CPUs are important for the care of patients with heart attack and unclear chest pain. Thuringia with three and Saxony-Anhalt with four CPUs rank among the regions with the lowest CPU density. "Provinces with high infarct mortality should have more CPUs for shorter emergency heart care delivery routes. Only the population would need to know more about these CPUs. This is usually not the case, "emphasizes Prof. Meinertz.
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Many more women die of heart disease than men
As in previous years, more women than men die when looking at heart disease. In 2015, 117,518 women, compared with 103,993 men, died from CHD / heart attack, valvular disease, arrhythmia, heart failure, and congenital heart disease. It is particularly noticeable that many more women than men die of heart failure, valvular heart disease and cardiac arrhythmias.
"These differences suggest that women with these heart diseases have a less favorable prognosis than male patients. Possible gender-specific features, such as the effects of heart medication, anatomical differences in the heart and blood vessels and different symptoms of heart disease must be taken into account in cardiac care to avoid supply bottlenecks, "Meinertz says. Cardiac insufficiency for women was 64.4% higher in 2015 than in men, 51.1% higher for cardiac arrhythmias than for men. In absolute numbers, 29,795 women died of heart failure compared to 17,619 men and 17,293 women died of arrhythmia compared with 11,132 men. (Sb, pm)