Heart health | Prevention continues to be under-represented

It's common knowledge that cardiovascular diseases rank high among the leading causes of death in Germany. More precisely, coronary heart disease (CHD) ranks first: Of the almost 120,000 people who died from this disease in 2023, approximately 44,000 suffered an acute heart attack. The connection: CHD manifests itself as deposits in the coronary arteries, caused, among other things, by elevated blood lipid levels. This can lead to a heart attack. If the patient survives this attack—which is increasingly common these days with timely inpatient treatment—the organ's function is subsequently reduced.

This group of heart diseases not only accounts for the highest proportion of deaths in Germany, but also for 538,000 hospital treatments . These figures from 2023 are provided by the German Heart Report (Update 2025). This overview of cardiological and cardiac surgical care in Germany was presented in Berlin on Thursday. It is published by the Heart Foundation in cooperation with four medical societies.

"We're already pretty good at repair medicine, but we need to get better at prevention."

Holger Thiele German Society for Cardiology

Advances in the technology of operations and other interventions may not yet be fully exploited, but catheters, bypass operations, and new imaging techniques have already greatly improved diagnosis and treatment. However, there is a lack at the other end: "We are already quite good at repair medicine, but we need to improve in prevention." This is what Holger Thiele of the German Society of Cardiology says. The internist, cardiologist, and emergency physician is Director of the University Clinic for Cardiology at the Leipzig Heart Center. Failures in prevention play a large role in why Germany ranks low in life expectancy compared to Western Europe, despite high healthcare expenditures. Of 16 countries, Germany ranks 14th for women and 15th for men. The gap in life expectancy at birth in this group recently widened to 1.7 years compared to the other countries.

Prevention encompasses a long list of different measures. Thiele chooses one with current relevance: vaccinations against influenza or RSV, also a viral respiratory disease: "Only 30 percent of patients with heart disease are vaccinated against these." But these diseases have the potential to worsen heart disease. Thiele believes it would be a good idea to offer these vaccinations regularly in the fall and winter when heart patients are admitted to hospital.

Many of the otherwise known risks are more closely related to an unhealthy lifestyle. In this regard, those who undergo cardiac rehabilitation after a hospital stay are conspicuous: one in two of them has high blood pressure or a lipid metabolism disorder, one in four has diabetes, and one in five is obese . This is also why the German Heart Foundation and the German Society of Cardiology advocate for regular cardiovascular health checkups, ideally starting at age 35 and at the latest starting at age 50. One of the reasons: Hospital admissions for coronary heart disease and cardiac arrhythmias increase even after the age of 40.

While Parliamentary State Secretary Georg Kippels (CDU) emphasized the importance of individuals addressing their personal risks when presenting the Heart Report, it seems there is still a long way to go to achieve the embedding of health in all policy areas, as he also promised. Special taxes on unhealthy products like tobacco, nicotine, and alcohol, lower prices for healthy foods, ubiquitous sports opportunities, and free opportunities to relax in nature – these are just a few of the possibilities that would help ensure that the healthier choice is also the easier one. All of this could certainly be enshrined in a national strategy against cardiovascular disease, but the prospects for this also appear rather bleak. This is partly because the federal government's budget plans for 2025 and 2026 propose cutting budgets for prevention by around 25 percent.