Cardiologist Ulf Landmesser knows the risk factors that anyone can reduce. Many heart attacks can be avoided this way. What matters is recognizing and taking countermeasures at an early stage. You should have these values checked regularly for your heart health – from the age of 40.
Healthy vessels are needed for a healthy heart. Only in this way can the blood flow unhindered and optimally supply all organs. If blood clots slow you down or block your way, it damages the heart – sooner or later. Arteriosclerosis in the coronary arteries, commonly known as hardening of the arteries, is the most common cause of a heart attack.
Avoiding arteriosclerosis therefore also means reducing the risk of a heart attack. There are also many other cardiovascular diseases – and they are still the number one cause of death in Germany.
“The special thing about cardiovascular diseases is that they usually have a relatively long lead time before they lead to problems or, in the worst case, to death,” says Ulf Landmesser, head of the cardiology clinic at the Berlin Charité, in an interview with FOCUS Online. But there are now well-studied risk factors.
If you know the most important of these for your heart health, you can also target them and reduce your heart attack risk. These include:
“These are all risk factors that we can treat well nowadays,” explains Landmesser. “The sooner you take countermeasures, the better.”
In addition, the role of inflammation has been better studied in recent years. “Persistent inflammation is also a risk factor for a heart attack,” reports the heart professor. For example, treatment with an anti-inflammatory drug that slows down the inflammatory marker interleukin-1 beta showed good results in a large study with patients after a heart attack.
Basically, people with chronic inflammatory diseases such as rheumatoid arthritis have a higher risk of heart attack. It is therefore particularly important for them to treat the aforementioned cardiac risks early on.
In order to identify the risk factors mentioned at an early stage, the Charité expert advises carrying out a thorough examination. In concrete terms, this means that everyone from the age of 40 should have their atherogenic lipoproteins checked, i.e. the LDL cholesterol and, if there is a family history, also the lipoprotein (a).
The family history also includes: If, for example, the father had a heart attack at the age of 40, you obviously have to take a closer look at the risk factors. Checking blood pressure is very important. Likewise, the blood sugar level in order to recognize diabetes in good time.
In addition, the heart professor also considers plaque imaging to be useful if there is uncertainty about the cardiovascular risk. It would be a good instrument, especially when someone determines that there is a medium risk based on other risk factors and it is a matter of how to treat it. If there is a suspicion, heart CTs (computer tomography) can now show whether the heart vessels are already damaged, whether there are plaques and whether they look dangerous. However, this is not yet widely used in Germany.
The check and whether there is already plaque formation becomes even more important from the age of 50. Then an ultrasound of the heart should be added to determine whether there is already damage to the heart. For example, high blood pressure leads to thickening of the heart muscle (hypertrophy). “You want to avoid that because it can lead to a stiffening of the heart,” explains Landmesser. “And thus to the restriction of cardiac output and function.”
Ideal values:
With LDL cholesterol, it depends very much on whether you already have cardiovascular disease or not. “It is ideal if the value can be kept around 100 milligrams per deciliter of blood (mg/dl) or lower if there is no coronary artery disease yet,” explains Landmesser. “If someone reaches a value of 190 milligrams per deciliter or more, this is an indication of familial hypercholesterolemia.” In such a case, a defect in the LDL receptor is often the cause. That definitely needs to be dealt with.
“If the value is between 100 and 190, you will always first try to improve the value through nutrition,” explains the cardiologist about the therapy. “We also check whether there are already signs of heart disease, such as plaques in the vessels.”
For a heart-healthy diet, there should be a lot of vegetables and fruit on the menu, as well as whole grain products rich in fiber and fish.
If medication is needed, a statin is used. Cardiologists adjust the dosage to the overall cardiovascular risk.
Usually, blood pressure is given by two values - for example 110 to 80 (systolic to diastolic).
The systolic value shows the pressure with which blood is pressed from the heart into the body. The diastolic value measures the blood pressure while the heart is refilling with blood, i.e. between two heartbeats.
The devices measure blood pressure in millimeters of mercury. The abbreviation for this is mmHg. It describes the pressure required to raise liquid mercury in a tube by one millimeter.
The unit mmHg is the abbreviation for millimeters on the mercury column. Because before there were digital devices for checking blood pressure, blood pressure was measured mechanically with an upper arm cuff plus a column of mercury.
with arrhythmia display, WHO traffic light color scale – for precise blood pressure measurement and heart rate measurement with memory function
In the future, medicine will have to focus much more on maintaining health. “At the moment we are focusing very much on the treatment of the disease and often less intensively on prevention. This focus has to change,” demands Landmesser. In the case of cardiovascular diseases in particular, a great deal can be achieved through prevention.
1. Early recognition of the risk factors.
2. Recognizing impending dangers early – for example, if someone already has plaques but has not yet had a heart attack, they need intensive preventive treatment.
3. Genetics – to identify people at increased (familial) risk.
According to the heart professor, the vision for the future must be: “Treat risk factors before they lead to complications – and do it individually.”
