Reduce the risk of heart attack: Charité cardiologist recommends these checks from the age of 40

A healthy heart requires healthy vessels. This is the only way the blood can flow unhindered and optimally supply all organs. If blood clots slow down or block the path, it damages the heart – sooner or later. Atherosclerosis in the coronary arteries, commonly known as hardening of the arteries, is the most common cause of a heart attack.

Avoiding arteriosclerosis also means reducing the risk of heart attack. There are also many other cardiovascular diseases – and they are still the number one cause of death in Germany.

To avoid a heart attack, everyone should know these values

“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, 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 ones for your heart health, you can tackle them specifically and reduce your risk of heart attack. These include:

1. Blood pressure: Because high blood pressure is a very common cause of heart disease. The cardiology professor explains: “The earlier it is treated, the easier it is to avoid damage to the cardiovascular system.”
2. Atherogenic lipoproteins, namely certain forms of cholesterol, namely LDL cholesterol: If the value is permanently too high, it can promote the formation of deposits in the blood vessels (plaques). In addition, take a look at this Lipoprotein (a) sensible. It is primarily genetically determined. The related disease hyperlipoprotein anemia (a) is a congenital disorder of lipid metabolism that may be associated with a risk of heart attack. Furthermore the Triglyceride-rich lipoproteinswhich can also be influenced by lifestyle.
3. Genetic factors: It is important to know the family history, emphasizes Landmesser. If there is someone here who had a heart attack at an early age, suffered a stroke or… Diabetes you should pay attention. Then the risk of being affected can be increased.
4. Diabetes: Elevated blood sugar levels and the metabolic changes associated with diabetes cause long-term damage to blood vessels.

“These are all risk factors that we can now treat well,” 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 slowed down the inflammatory marker interleukin-1 beta showed good results in a large study with patients after a heart attack.

Basically have People with chronic inflammatory diseases like rheumatoid arthritis a higher risk of heart attack. It is therefore particularly important for them to treat the heart risks mentioned well at an early stage.

From the age of 40: The cardiologist recommends these checks

In order to identify the risk factors mentioned at an early stage, the Charité expert recommends examining them carefully. Specifically, this means: everyone from the age of 40 should have their atherogenic lipoproteins checked, i.e. that LDL cholesterol and with the relevant family history, that too Lipoprotein (a).

To Family history This also applies: If, for example, your father had a heart attack at the age of 40, you obviously have to take a closer look at the risk factors. Blood pressure checking is very important. Likewise the blood sugar level Diabetes recognized in time.

In addition, the heart professor also holds one Plaque imaging makes sense if there is uncertainty about the cardiovascular risk. It would be a good instrument, especially if someone determines a medium risk based on other risk factors and is concerned about how to treat them. If there is suspicion, cardiac CTs (computed tomography) could now show well whether the heart vessels are already showing damage, whether there are plaques and whether they look dangerous. However, this is not yet widely used in Germany.

The check and whether plaque formation is already visible will be even more important over the age of 50. Then one should too Cardiac ultrasound be added to determine whether there is already damage to the heart. For example, high blood pressure causes the heart muscle to thicken (hypertrophy). “You want to avoid that because it can lead to the heart stiffening,” explains Landmesser. “And thus to restrict cardiac performance and function.”

At what values ​​do you need to take a closer look?

Ideal values:

• LDL cholesterol: less than 100 mg/dl (milligrams per deciliter of blood), or less than 55 mg/dl if coronary artery disease is already present
• Lipoprotein (a): less than 30 mg/dl (milligrams per deciliter of blood)
• Blood pressure: below 140 (systolic) and below 90 (diastolic)
• Diabetes: Fasting blood sugar less than 100 mg/dl (5.6 mmol/l). Fasting values ​​between 100 and 125 mg/dl indicate prediabetes, a precursor to diabetes.

When it comes to LDL cholesterol, it depends very much on whether you already have cardiovascular disease or not. “It is ideal if the value can be maintained at 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. This should definitely be addressed.

“If the value is between 100 and 190, you will always first try to improve the value through diet,” 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, the menu should include lots of vegetables and fruit, as well as fiber-rich whole grain products and fish.

If medication is needed, a statin is used. Cardiologists adapt the dosage to the overall cardiovascular risk.

Too high, too low? This is the optimal blood pressure value

Blood pressure is usually 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 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.

• Doctors in Germany speak of high blood pressure (hypertension) from a value higher than 140 mmHg.
• Blood pressure drops less than 105 mmHgit is about Low blood pressure (hypotension).
• If optimal applies a blood pressure value of under 140 (systolic) and under 90 (diastolic).

Three keys to preventing cardiac deaths

In the future, medicine will have to focus much more on maintaining health. “At the moment we are focusing very much on disease treatment and often less intensively on prevention. This focus must change,” demands Landmesser. Especially when it comes to cardiovascular diseases, you can achieve a lot through prevention.

This essentially included three aspects:

1. Early recognition of risk factors.

2. Early recognition of impending dangers – for example, if someone already has plaques but has not yet suffered a heart attack, they need intensive preventative 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 so on an individual basis.”