Heart report 2018: heart disease remains cause of death no. 1
Heart report 2018 : heart disease is the biggest killer
Dusseldorf Smoking, obesity, too little exercise: patients share the blame for many heart diseases. However, the new cardiac report reveals much more: Also education. The density of doctors in a region can have an influence.
Heart disease remains the number one killer in Germany. "One in three women alone dies of heart disease", Hugo Katus, president of the German Society of Cardiology, said at the presentation of the new heart report in Berlin on Wednesday.
Men develop the disease around ten years earlier than women. Better therapies, more prevention and fewer smokers have reduced the number of deaths by around half (46 percent) since 1990 – a very impressive result. But now the latest figures are stuck at around 270 deaths per 100.000 inhabitants at a level with only slight fluctuations.
One of the main reasons for this is: there are hardly any significantly better therapies being developed than there are today. One example is cardiac surgery for the approximately 6,500 babies who are currently born each year with a congenital heart defect: 95 percent of these children survive, which is a quarter more than in 1990.
Nevertheless, differences remain when looking at the heart – from the patients' level of education, to men and women, to the federal states. The heart report analyzes the frequency of diseases every year. Deaths with regard to selected heart diseases. In terms of deaths per 100,000 inhabitants, the figures rose from 256 to around 270 between 2014 and 2015.
However, the increase does not necessarily mean more cardiac deaths. "There are more specific diagnoses on death certificates", says Thomas Meinertz, CEO of the German Heart Foundation. This could also explain the increase.
Common heart diseases
This includes the coronary heart disease, in which constriction of the coronary arteries results in a lack of blood flow to the heart. In the worst case, it leads to a heart attack.
In second place comes the Heart failure, which is often a consequence of other cardiovascular diseases such as high blood prere, valve diseases, arrhythmias or heart attacks.
At one acute heart attack In 2015, around seven percent fewer Germans died than in the previous year, thanks in part to better care. At heart valve disease On the other hand, doctors registered an increase of 4.2 percent, with Cardiac arrhythmias of 2.6 percent and, in the case of heart failure, 2.5 percent. The yardstick for the calculations is the number of inpatient treatments.
There is still a striking disparity between the German states in terms of heart diseases. With regard to the death rates (deaths per hundred thousand inhabitants), from which the age factor was deliberately excluded, Saxony-Anhalt (plus 28.5 percent), Thuringia (plus 16.3 percent), Bremen (plus 15.4) and Mecklenburg-Western Pomerania (plus 14.8 percent) show the most negative values compared to the national average.
Berlin (minus 24.2 percent), Hamburg (minus 16.4 percent) and Baden-Wurttemberg (minus 10.8 percent) developed very positively. "We are critical of the fact that the German states with the lowest density of cardiologists are at the same time battling against above-average infarct mortality.", says Thomas Meinertz. Saxony-Anhalt is at the top of the list.
"The higher the level of education, the healthier people behave: they smoke less, are more active in sports and eat more fruits and vegetables", balances Hannelore Neuhauser of the Robert Koch institute.
The World Health Organization (WHO) recommends two and a half hours of endurance exercise per week. However, less than half of men (48 percent) and women (43 percent) in Germany manage this workload.
In addition, around half of those surveyed said they mainly sit or stand at work – without exercise. While German citizens with a higher level of education have become more active in sports in recent years, there has been no change among people with a lower level of education, the report states.
Women and men
As in previous years, heart diseases affect women more frequently. The death rates for cardiac arrhythmias and cardiac insufficiency were 51 and 64 percent higher for women and men, respectively, in 2015.
Possible reasons are special features, for example, in the effect of cardiac drugs, anatomical differences in the heart and vessels, and different precursors and symptoms of heart disease. One outlier is myocardial infarction. More men still die from these.
A large proportion of cardiovascular disease is related to personal behavior: Lack of exercise, smoking and obesity as a result of an unhealthy diet. This can cause, for example, high blood prere and diabetes.
The best precaution is therefore a change in lifestyle. "However, this only works if prevention is not seen as the exclusive task of physicians", emphasizes Andreas Stang, Head of the Center for Clinical Epidemiology at the University Hospital Essen. The whole society is needed here.