4.7 million people with heart disease in Germany – how to detect problems early

The number of people in Germany who have died due to heart disease has decreased slightly. However, the number of those requiring hospitalization has increased. This is according to the "German Heart Report - Update 2025," presented by the German Heart Foundation together with medical societies. The data is from 2023.

In total, there were 1,635,903 hospital admissions for all heart diseases in the reporting year – a good 61,500 more than in 2022. This is a "high level," explains Heribert Schunkert, Deputy Chairman of the Board of the German Heart Foundation. According to the press release, the increase is primarily due to the aging population.

538,675 hospital admissions were recorded for coronary heart disease, including heart attacks. Of these, 185,804 were heart attacks. However, this trend is not solely due to the aging population : According to data, more hospital stays for coronary heart disease and cardiac arrhythmias are evident starting at the age of 40.

In 2023, a total of 211,152 people died from the consequences of one of the many heart diseases. This is fewer than the previous year's 216,944 deaths. Comparing the so-called mortality rate, there were 215.7 deaths per 100,000 inhabitants in 2023, compared to 224.2 the year before.

"The fact that mortality from coronary heart disease and heart attack has again decreased noticeably in the current year confirms a positive trend that has been evident for years," explains Schunkert. According to the press release, this is due, among other things, to improvements in rehabilitation and therapy. However, the mortality rate from coronary heart disease is "still far too high" compared to other European countries, such as France or Denmark, according to Schunkert. Therefore, the causes of coronary heart disease must be given greater focus in Germany.

According to the press release, the "extremely widespread" risk factors for heart attacks and heart failure in this country include: high LDL cholesterol, high blood pressure, diabetes mellitus, smoking, and obesity. "To get these risk factors under control, we need to identify and treat people at risk earlier," Schunkert demanded.

More than 200,000 Germans suffer a heart attack each year, and approximately 50,000 die as a result. You can assess your personal risk by answering eleven questions about your health: The more often you answer "yes," the higher your risk.

The following questions are based on the German Heart Foundation's Heart Attack Risk Test. This is an abbreviated version of the test. You can interactively click through the full test here to receive the Heart Foundation's best possible assessment of your personal heart attack risk. Important: This test is intended for people who do not currently suffer from vascular disease.

If a close relative, such as your parents or siblings, has already had a heart attack, your personal risk may also be increased. Our genes can play a role in the development of heart attacks. In 2014, international scientists led by the University of Lübeck identified 23 genetic variants that increase the risk of heart attacks. Among them were 13 previously unknown risk genes. The researchers examined two million markers each in the genomes of approximately 87,000 subjects worldwide.

It's well known that smoking can lead to lung cancer. Many people are less aware of how much smoking also increases the risk of vascular disease and thus heart attacks, strokes, and brain damage. Smoking can cause plaque to form in the blood vessels, which, in the worst case, can completely block the vessel. Every cigarette harms the body. According to the German Heart Foundation, the risk of heart attack is particularly high in people who smoke an average of more than 20 cigarettes a day—six times higher than in non-smokers.

Regular exercise can prevent calcification of the arteries and even help existing plaques to regress. This reduces the risk of heart attack. Ideally, at least 20 minutes of exercise twice a week—or more—is recommended.

Obesity is a risk factor for many diseases, including heart attacks. You can calculate whether you are considered overweight using your body mass index, or BMI for short. Use the following formula: body weight in kg / (height in m) 2 . A BMI of 25 or higher is considered overweight; 30 or higher is considered obese.

Where fat is stored in the body can be important for health. Doctors consider visceral belly fat, which accumulates around the organs and produces inflammatory substances that damage the heart, to be particularly dangerous. Men are considered at risk with a waist circumference of 94 centimeters and above, and women with a waist circumference of 80 centimeters and above.

A diet that promotes obesity and diabetes is bad for the heart. These foods should therefore only be included in your diet rarely. Instead, the German Heart Foundation recommends eating vegetables, salad, fruit, legumes, whole grain products, fiber, olive and rapeseed oil, and fish rather than meat every day.

Deadlines, time pressure, overwork: Those who are constantly stressed at home or at work suffer not only mentally but also physically. Stress causes the heart rate to race and blood pressure to rise. In the long run, this is harmful.

As mentioned, persistently high blood pressure puts a strain on the heart. The German Heart Foundation recommends that your blood pressure should be below 140/90 mmHg. It's best to have your blood pressure measured by a doctor. Various errors can distort the readings at home—for example, a loose or too small cuff, or an arm that's positioned too high during the measurement.

To find out, you can have a test done by your doctor or get a measuring device or rapid home tests. Cholesterol is a blood fat that can build up on the inner walls of blood vessels and constrict them to the point where blood flow to the heart is disrupted, potentially life-threatening. Eggs were long considered bad cholesterol bombs, but today researchers know that diet only plays a part in cholesterol levels. The rest is genetic. Therefore, if your levels are high, it's not enough to just skip your morning fried egg. Anyone with high LDL cholesterol levels should discuss with their doctor what measures are appropriate.

Elevated blood sugar levels also promote the formation of plaque in the arteries. Diabetics therefore have an increased risk of heart attack. Since many diabetics also suffer from obesity and high blood pressure, they face several risk factors.

The German Heart Foundation describes pain that can precede a heart attack as follows: It occasionally occurs in the chest area and may radiate into the neck or an arm. Pressure, tightness, or shortness of breath may also occur. In these cases, you should consult a doctor immediately about these symptoms.

Doctors refer to chest pressure as angina pectoris. Initially, it only occurs during physical exertion, such as exercise, but later also during rest periods. It becomes particularly serious if the chest pressure or burning sensation behind the breastbone lasts for more than five minutes. In this case, you should not hesitate to call 112. This could be a warning sign of a heart attack.

Even then, you should pay particular attention to your body's warning signs in the future and prevent further incidents with a healthy diet and sufficient exercise.

The more questions you answered "yes," the higher your risk of a heart attack. If you have an increased risk, talk to your doctor. You can also obtain detailed information after completing the risk assessment on the German Heart Foundation website .