For a healthier heart, we often don’t have to change much in life. Cardiologist Ulf Landmesser also explains in an interview: Which heart problems are particularly dangerous for women and why erectile dysfunction can be an alarm signal for men.
“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. However, 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 personal heart attack risk:
“These are all risk factors that we can treat well nowadays,” explains Landmesser. “The sooner you take countermeasures, the better.”
In most cases, the cause of a heart attack is arteriosclerosis in the coronary arteries. Their creation is a process that takes many years, even decades. The expert reports that plaques are already found in the blood vessels of a third of 30 to 40 year olds.
“This means that if you have risk factors and recognize them early, even a small change is enough to reduce the lifelong risk of a heart attack or coronary heart disease by up to 90 percent – that’s what genetic studies suggest,” explains the cardiologist. This small change is again about the LDL cholesterol.
Studies have shown that in order to achieve this strong effect, it must be possible to keep the value around 100 milligrams per deciliter of blood or below. Conversely, according to Landmesser, it also means: “Anyone who checks their blood pressure and LDL cholesterol at an early stage has a very low risk of a heart attack.”
It also takes a special look at the hearts of men and women. In men, cardiovascular diseases often begin in middle age. In women, it is more likely to start after menopause (menopause), but it can occur less frequently before.
Risk factors that favor erectile dysfunction can also be risk factors for a 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 here.
The heart professor names well-known things that are dangerous to the heart: high blood pressure, high LDL cholesterol, diabetes, as well as the lifestyle factors of smoking, too little exercise and sleep, or an unhealthy diet. Erectile dysfunction and heart attack are not causally related, but often have common causes.
“Men who discover erectile dysfunction should definitely also have their cardiovascular risk factors examined. So you should not only see a urologist, but also have your cardiovascular risk checked by your family doctor or cardiologist, for example,” advises Landmesser.
Our guide shows you the most common causes of erectile dysfunction and how you can regain your male strength.
Stress is also a risk factor for the heart – especially for a woman’s heart. “In particular, permanent stress that occurs when people feel under pressure is very likely to have an unfavorable effect on cardiovascular risk,” explains the cardiologist. In fact, acute stress can lead to tako tsubo syndrome, a stress cardiomyopathy – also known as broken heart syndrome. This affects women in 90 percent of the 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 leads to the heart barely working. This can then be found out with the cardiac ultrasound and cardiac catheter examination.
If the heart is not restricted too much, the patients are given beta blockers, among other things, to protect and relieve the heart. In the acute phase, it is also very important to pay attention to cardiac arrhythmias. If it comes to the point that the heart is actually no longer pumping sufficiently, those affected must be monitored in the intensive care unit. The heart can then very often recover over time. This usually happens within four to five weeks. After that, the movement disorders in the heart muscle are often no longer visible. The therapy is usually temporary.
Another phenomenon in women around the menopausal phase is spontaneous tears in the heart vessels, so-called spontaneous dissections. Especially at the age of about 47 to 53 years, this cause of a heart attack should be considered in women. Women should definitely take pressure on the chest, back pain or upper abdominal pain seriously and remember that these could also come from the heart.
First, doctors will write an EKG (electrocardiogram) and determine the corresponding blood values. It is treated with a heart-friendly therapy – temporarily with blood-thinning or anticoagulant drugs. The treatment also depends on whether the tears in the heart vessels are already causing acute circulatory disorders. In this case, cardiologists would place a stent to prevent the vessel from closing. This is necessary to prevent a major heart attack or heart damage. If the situation is not yet so acute, the vessel usually regenerates well on its own.
In order to identify the above-mentioned risk factors at an early stage, the Charité expert advises carrying out a thorough examination. Specifically, this means that men and women from the age of 40 should have their atherogenic lipoproteins checked, i.e. the LDL cholesterol and, if there is a family history, 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 considers plaque imaging useful when 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 arrhythmia display, WHO traffic light color scale – for precise blood pressure measurement and heart rate measurement with memory function
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,” 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. 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 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, 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.