German Heart Report: Mortality from heart disease increased
More and more people are dying from heart disease. That says the new German Heart Report 2017. Coronary heart disease (CHD), which is a leading disease of the heart attack, has the greatest influence. Also important is heart failure, which is popularly known as heart failure. This also has a high mortality rate. The German Heart Report is published annually by the German Heart Foundation together with the medical associations for cardiology (DGK), cardiac surgery (DGTHG) and pediatric cardiology (DGPK).
The total number of deaths from heart disease has increased slightly. As in previous years, significantly more women than men die when considering heart diseases, as documented by the new German Heart Report 2017 (https://www.herzstiftung.de/herzbericht).
Coronary heart disease (CHD), the underlying disease of the heart attack, with 128,230 deaths in 2015 (2014: 121,166) and heart failure (heart failure) with 47,414 deaths in 2015 (2014: 44,551) have a dominant influence on mortality in all federal states. "This increase in heart failure, in particular, requires special attention from cardiac medicine and efforts in the care of sometimes seriously ill patients, also in view of the steadily increasing number of hospital admissions of over 11,000 per year," emphasizes Prof. Dr. med. Thomas Meinertz, CEO of the German Heart Foundation, at the presentation of the new heart report in Berlin.
Heart failure is one of the most common reasons for hospitalization in Germany with over 455,000 inpatient cases per year. Usually the hospital is admitted only if the disease worsens. Chronic heart failure is usually the result of other cardiovascular diseases such as CHD / heart attack, high blood pressure, valve disorders or rhythm disorders, so that the widespread disease can be prevented by early diagnosis, therapy and elimination of risk factors.
“Many hospital admissions and deaths from heart failure and other heart diseases could be avoided through improved knowledge of the symptoms of the disease, correct emergency behavior among those affected and preventive measures such as early blood pressure or pulse measurement. That is why efforts in education are indispensable, ”as Meinertz emphasizes.
Fighting heart attack mortality: more investment in prevention
In addition to CHD, the underlying disease of myocardial infarction and cardiac insufficiency, mortality increases are also evident in valve disorders and cardiac arrhythmias. From 2014 to 2015, deaths in valve diseases increased from 16,064 (2014) to 16,987 (2015), and in cardiac arrhythmias, deaths increased from 25,774 (2014) to 28,425 (2015). If one observes the development of the death rate of heart diseases from 1990 to 2015, the value (deaths per 100,000 population / inhabitant) has decreased significantly by 46.2% from 459.2 (1990) to 246.9 (2015).
For example, if 85,625 people died of a heart attack in 1990, there were 49,210 in 2015 (2014: 48,181). According to the heart report, the reason for this development is not only the decrease in the number of smokers and improvements in diagnostics and therapeutic care, but also an optimization of the processes in the clinics and emergency medical systems. "However, this decline must not hide the fact that the spread of heart disease has not decreased to the same extent and that more than 221,500 people die from it annually," warns Prof. Meinertz. Health policy in Germany must invest much more comprehensively in prevention than in the past in order to counteract the development of risk diseases such as high blood pressure, diabetes and fat metabolism disorders (high cholesterol) in the population as early as childhood.
“Limiting to the clinical approach through early detection, consistent advice and therapy is not enough. A more comprehensive approach is needed that creates framework conditions for healthy living habits for the population through physical activities or healthy nutrition and systematic information about risk factors in day care centers, schools and companies. "
Heart attack mortality: Differences between countries persist
The sometimes strong differences in mortality from heart disease between the federal states persist. Take myocardial infarction, for example: Most of the heart attack deaths continue to complain to Saxony-Anhalt with 82 deaths per 100,000 inhabitants (EW), in Brandenburg with 83, Thuringia with 69 and Mecklenburg-Western Pomerania with 68, while the lowest values are Schleswig-Holstein with 42, Hamburg with 46, North Rhine-Westphalia with 49 and Bavaria with 51 heart attack deaths per 100,000 inhabitants.
"We are critical of the fact that the federal states with the lowest cardiologist density are also fighting an above-average high infarct mortality rate, such as Thuringia, Mecklenburg-Western Pomerania, Brandenburg and Saxony-Anhalt," says Prof. "Especially in regions with a low density of doctors, for better accessibility of the Emergency outpatient clinics Improvements in cardiological care through more outpatient diagnostics or therapy are a possible approach to reducing mortality from heart diseases. ”For comparison: Thuringia with the lowest cardiologist density has a cardiologist for 31,922 PE, while the Saarland has a cardiologist for 17,467 PE.
The uneven distribution of chest emergency units (chest pain units, CPU) is also striking. CPUs are important for the care of patients with heart attacks and unclear chest pain. Thuringia with three and Saxony-Anhalt with four CPUs are among the regions with the lowest CPU density. “Federal states with high infarct mortality should have more CPUs for shorter care routes for cardiac emergency patients. Only the population would have to know more about these CPUs. As a rule, this is not yet the case, ”emphasizes Prof. Meinertz.
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Much more women die of heart disease than men
As in previous years, when considering heart diseases, more women than men die overall. In 2015, 117,518 women versus 103,993 men died of CHD / heart attack, valve disorders, arrhythmia, heart failure and congenital heart defects. It is particularly noticeable that many more women than men die from heart failure, heart valve disorders and cardiac arrhythmia.
“These differences suggest that women with these heart diseases have a less favorable prognosis than male patients. Possible gender-specific peculiarities, such as the effects of cardiac medication, anatomical differences in the heart and vessels, and different symptoms of cardiac diseases must be taken into account in cardiac medical care in order to avoid supply shortages, ”Meinertz demands. The death rate for heart failure for women was 64.4% above that of men in 2015, for cardiac arrhythmias it was 51.1% above that of men. In absolute numbers, 29,795 women died of heart failure compared to 17,619 men and 17,293 women died of arrhythmia compared to 11,132 men. (sb, pm)