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Reduce the risk of a heart attack – often all it takes is a small thing, says cardiologist

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Reduce the risk of a heart attack – often all it takes is a small thing, says cardiologist

“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. However, there are now well-studied risk factors.

Men’s and women’s health

If you know the most important ones for your heart health, you can tackle them specifically and reduce your personal risk of heart attack:

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.”
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 trglyceride-rich lipoproteins, which can also be influenced by lifestyle.
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.
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.”

Even small changes can greatly reduce the risk of heart attack

In the vast majority of cases, the cause of a heart attack is arteriosclerosis in the coronary arteries. Their creation is a process that takes place over many years, even decades. The expert reports that a third of 30 to 40-year-olds already have plaques in their blood vessels.

This means that if you have risk factors and recognize them early, even a small change is enough to reduce your lifelong risk of a heart attack or coronary heart disease by up to 90 percent “That’s what the genetic studies suggest,” explains the cardiologist. This small change is again about LDL cholesterol.

Studies have shown that in order to achieve this strong effect, it must be possible Value to keep 100 milligrams per deciliter of blood or below. Conversely, according to Landmesser, it also means: “Those who check blood pressure and LDL cholesterol early have a very low risk of a heart attack.”

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To keep these values ​​under control, small changes such as appropriate training sessions or dietary changes are often enough – with a focus on fiber-rich whole grain foods, sufficient potassium, lots of unsaturated fatty acids and polyphenols, for example from fish, vegetables and fruit.

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.

If the values ​​are above these ideal values, you need to take a closer look.

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 the cardiologist. “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 Landmesser 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.

Men’s and women’s hearts beat differently

A special look is also needed at men’s and women’s hearts. In men, cardiovascular diseases often begin in middle age. In women it is more likely to start after menopause, but can also occur less frequently before.

Why erectile dysfunction is a warning signal

Risk factors that promote erectile dysfunction can also be risk factors for heart attack. Which are they? “Erectile dysfunction often has something to do with the vascular function in this area,” explains the cardiologist. Accordingly, risk factors that damage the coronary arteries could also cause problems for men.

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The heart professor cites well-known threats to the heart: high blood pressure, high LDL cholesterol, diabetes as well as lifestyle factors such as smoking, too little exercise and sleep or an unhealthy diet. Erectile dysfunction and heart attacks are not causally related, but they often have common causes.

“Men who experience erectile dysfunction should definitely have their cardiovascular risk factors examined. So you should not only have your cardiovascular risk checked by a urologist, but also by your family doctor or cardiologist, for example,” advises Landmesser.

These heart problems are particularly dangerous for women

Stress is also a risk factor for the heart – especially for women’s hearts. “Above all, long-term stress, which occurs when people feel under pressure, is very likely to have a negative impact on cardiovascular risk,” explains the cardiologist. In fact, acute stress can lead to… Tako-tsubo-Syndrome lead to stress cardiomyopathy – also known as broken heart syndrome. This affects women in 90 percent of cases.

Acute stressful situations such as separation from a partner, the death of a loved one or life crises can trigger such a syndrome in women. In the worst case, it causes the heart to barely work. This can then be found out with cardiac ultrasound and cardiac catheter examination.

This is how stress cardiomyopathy is treated:

If the heart is not too severely restricted, patients are given beta blockers, among other things, to protect and relieve the strain on the heart. In the acute phase it is also very important to pay attention to cardiac arrhythmias. If it gets to the point where the heart is actually no longer pumping adequately, those affected must be monitored in the intensive care unit. Over time, the heart can often recover. This usually happens within four to five weeks. Afterwards, the movement disorders in the heart muscle are often no longer visible. The therapy is usually temporary.

Another phenomenon in women around the menopause phase is spontaneous Cracks in the heart vessels, so-called spontaneous dissections. This cause of a heart attack should be considered in women, especially between the ages of 47 and 53. Women should definitely take chest pressure, back pain or upper abdominal problems seriously and remember that these could also come from the heart.

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This is how the treatment of spontaneous dissection works:

First, doctors will write an EKG (electrocardiogram) and determine the corresponding blood values. Treatment is with heart-friendly therapy – for a limited period of time with blood-thinning or anticoagulant medication. The treatment also depends on whether the tears in the heart vessels are already causing acute circulatory problems. In this case, cardiologists would place a stent to prevent the vessel from closing. This is necessary to prevent a major heart attack or damage to the heart. If the situation is not yet so acute, the vessel usually regenerates itself well.

The cardiologist recommends these checks to men and women aged 40 and over

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

To Family history Also includes: 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 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.”

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