Heart attack mortality rate strongly dependent on where you live
In Germany, the place of residence plays an important role in determining whether a heart attack is fatal. In some cases, the risk of dying from an infarction is twice as high in the eastern states as in the west. Experts try to explain the differences.
Heart disease patients live longer today In general, heart disease patients live longer and better these days. Thanks to modern medicine, even more people can survive a heart attack without permanent damage. But in 2011 acute heart attack was the second leading cause of death in Germany. The mortality risk varies considerably in the individual federal states. This emerges from the 24th heart report of the German Heart Foundation, which appeared in early 2013 and breaks down the statistical heart attack data from 2010 regionally.
Large regional differences At the time there were a total of 212,914 cases of acute heart attack nationwide. Today, significantly more patients survive such an infarction than ten years ago. Between 2000 and 2010, death rates fell by 15.8 percent for men and by 14.8 percent for women. In 2010 a total of 55,541 people died of a heart attack in this country. There are major regional differences. Not only is the risk of heart attack higher in eastern Germany, as the German Society for Cardiology (DGK) recently announced, but the number of people who die after an infarction is almost twice as high in Saxony-Anhalt, Brandenburg and Saxony in Schleswig-Holstein, Hesse, Berlin, Baden-Württemberg or Bavaria. In the east, only Mecklenburg-Western Pomerania stands out positively.
Better cardiological treatment in the West Statistically, with 111 deaths per 100,000 inhabitants, most people in Saxony-Anhalt die of a heart attack. With 56 people in Berlin and 57 each in Schleswig-Holstein and Hesse, the numbers are lowest there per 100,000 inhabitants. Cardiologists are puzzled as to why this is so. Christian Hamm, President of the German Society for Cardiology (DGK), says: "The causes can only be speculated on." The better cardiological treatment in the West could possibly be an explanation. Thomas Meinertz, CEO of the German Heart Foundation, criticizes: "The care for patients with heart disease is not equally good in the different regions."
Deficiencies in Brandenburg According to the heart report, a lower density of doctors in the high-risk regions, a less effective emergency doctor system and the resulting longer pre-hospital time, i.e. the time between infarction and treatment, are further possible causes for the unequal distribution of risk. It had recently become known in Brandenburg that apparently every eighth call to emergency number 110 failed. And as the Ministry of the Interior said, nearly one in four of the nearly 440,000 callers had to wait more than 30 seconds to speak to whom. The average call waiting time in Brandenburg was 13 seconds. But the time until help arrives at the scene after an emergency call is apparently getting longer.
Cardiac emergency clinics distributed differently But it is precisely this time between the infarction and the start of treatment that is so important for the chance of survival. Many sufferers die before an ambulance arrives. However, if patients are brought to a clinic in good time, the blood clot that clogs the coronary artery can usually be quickly dissolved. However, special cardiac emergency ambulances, which are equipped with modern equipment and offer the best chances of survival, are distributed very differently across the federal states. They are not necessarily where they are most needed, for example where the elderly live. "Unfortunately, this is not the case, especially in some East German regions," Meinertz complains.
More heart attacks in poor neighborhoods In addition, the population, particularly in areas with high death rates, is rather poorly informed about symptoms of the heart attack. The DGK said that many people would not consider it an alarm signal if they felt pressure in the chest or cardiac arrhythmia. Such knowledge is so important for survival, because every second can count. According to studies, heart attacks would occur significantly more frequently in socially disadvantaged and poor neighborhoods. Patients from these quarters are also younger than those who come from more privileged areas and are at higher risk of dying within a year of the infarction.
Lower heart attack risk in Hamburg According to the heart report, with 342 and 341 people per 100,000 inhabitants in Bremen and Saxony-Anhalt, statistically most patients were hospitalized for a heart attack. That is why there were the fewest hospital stays in Hamburg (218), Bavaria (221) and Berlin (225). The Techniker Krankenkasse (TK) came to similar results, relying on figures from the Federal Statistical Office and finding a lower risk of heart attack in Hamburg at the end of last month.
Most common causes of death in Germany According to the Federal Statistical Office, three cardiological diseases are the most common causes of death in Germany: In 2011, coronary heart disease was the cause of death for 8.3 percent of the population, 6.1 percent died of an acute heart attack and heart failure 5.3 percent. Altogether this is about 170,000 people. However, mortality has dropped from over ten to less than six percent in recent years thanks to advances in cardiovascular disease treatment. The number of deaths has almost halved compared to 1980 to around 55,000. And this against the background that the population is getting older on average and thus the heart risks would increase.
Trend towards unhealthy lifestyle DGK President Christian Hamm believes that this is probably also a reason for the increased number of other heart diseases such as heart valve diseases, cardiac arrhythmias and heart failure in recent years. He explains: “For one thing, more and more people in Germany are getting older, and the risk of developing heart failure is increasing. On the other hand, thanks to the better treatment options and care structure, more and more people survive a heart attack, who then suffer from heart failure at an older age. ”According to Hamm, the trend towards unhealthy lifestyles is counteracting advances in the early detection and treatment of heart diseases. Obesity and diabetes are on the increase and the proportion of smokers hardly declines overall. This would relativize the successes that medical doctors can achieve with medication. (ad)