Number of deaths from heart disease has risen again

Heart Report: More deaths from heart disease

In Germany, more and more people are dying of heart disease. This is the result of the new German Heart Report. Overall, many more women die from heart disease than men. Experts say that health policy should invest more in prevention.

Number of deaths from heart disease has increased

As can be seen from the new German Heart Report 2017 of the German Heart Foundation, the number of deaths from heart disease in Germany has increased slightly overall. As in previous years, when looking at heart disease, more women than men die altogether. Accordingly, coronary heart disease (CHD), the underlying disease of heart attack, has a predominant impact on mortality in all provinces, with 128,230 deaths in 2015 (2014: 121,166) and heart failure (heart failure) with 47,414 deaths in 2015 (2014: 44,551).

The number of deaths from heart disease has increased. This is the result of the new German Heart Report. Strikingly, many more women die of heart disease than men. (Image: Kzenon / fotolia.com)

Strong increase in heart failure cases

One of the causes for concern is the sharp increase in heart failure cases.

"Heart failure is the most common reason for inpatient hospital stays in Germany today. Since 1995, an increase of 101.5 percent has been recorded, "writes the German Society for Cardiology - Cardiovascular Research e.V. (DGK) in a press release, which refers to the heart report.

Prof. Dr. med. Thomas Meinertz, CEO of the German Heart Foundation, explains in a statement published by the "Informationsdienst Wissenschaft" (idw):

"This increase in heart failure, in particular, requires special attention from the heart medicine community and efforts to care for the severely ill, including the steadily increasing hospital admissions of more than 11,000 a year."

Every year, there are more than 455,000 inpatient hospital stays in Germany due to heart failure. 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, "said Meinertz.

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 still 85,625 people died, there were 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 decline in mortality in acute heart attacks is one of the impressive successes of modern heart medicine," writes the DGK in a statement.

"Compared to the beginning of the 1990s, in Germany in 2015, the death rate from heart attacks in men fell by 67.6 percent, and in women by 57.3 percent," the experts added.

But: "Between the individual federal states there are pronounced differences in the frequency of heart attack mortality."

The German Heart Foundation reports: Most heart attack deaths complained further Saxony-Anhalt with 82 dead per 100,000 inhabitants (EW), in Brandenburg with 83, Thuringia with 69 and Mecklenburg-Western Pomerania with 68, while the lowest values ​​Schleswig-Holstein with 42, Hamburg with 46, North Rhine-Westphalia with 49 and Bayern with 51 heart attacks per 100,000 inhabitants.

"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 cardiac care through more ambulatory diagnostics or therapy are a possible approach to reducing the mortality from heart disease for better accessibility of emergency outpatient services."

For comparison: Thuringia with the lowest cardiologist density has a cardiologist for 31.922 EW, while the Saarland comes to a cardiologist for 17.467 PE.

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.

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," explains Meinertz.

"Possible gender-specific features such as the effect of heart medication, anatomical differences in the heart and vessels and different symptoms of heart disease must be considered in the care of the heart to avoid supply bottlenecks."

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.

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). (Ad)