Developments in heart medicine affect millions of people

From 25 to 29 August 2018, 31,000 participants from 150 countries are expected at the European Cardiology Congress in Munich, making the Congress of the European Society of Cardiology (ESC) one of the world's largest medical congresses.

 "Every person should know his values": Complete screening leads to better diagnoses

From 25 to 29 August 2018, 31,000 participants from 150 countries are expected at the European Cardiology Congress in Munich, making the Congress of the European Society of Cardiology (ESC) one of the world's largest medical congresses. Congress topics include all aspects of modern cardiovascular medicine: from the spread of cardiovascular diseases, risk factors, and prevention, to drug and non-drug therapies, including all groundbreaking innovations in these areas. The Congress also offers an impressive exhibition of German cardiac medicine and cardiological care.

Latest Study Results Affect Millions of Heart Patients

"The ESC's Annual Congress is the world's largest congress in the field of cardiovascular diseases and the main presentation and discussion forum for the latest scientific findings in this field," says Prof. Dr. Stephan Achenbach, Chairman of the Congress Programme Committee, future President (President-Elect) of the European Society of Cardiology (University Hospital Erlangen). In addition to the training programme, the Abstract-based programme presents 4,500 studies selected by the Programme Committee from some 11,000 papers submitted to the Congress by researchers from around the world. Overall, the Congress covers topics from all areas and subareas of cardiovascular medicine. As every year, the ESC has one main topic, this year the "Valvular Heart Diseases": The importance of heart valve diseases for cardiologists has increased immensely in recent years. 

Is Europe following the USA in high blood pressure?

Prof. Achenbach is convinced that “the new European guidelines for the diagnosis and treatment of hypertension will be discussed very intensively among experts and later also in public”. To date, European guidelines have defined "high blood pressure", treatment need and treatment objective as 140/90 mmHg. Since last year, however, new values have been in force in the USA, according to which hypertension is present from 130/80 mmHg onwards. These guidelines are very strict, they have broadened the definition of hypertension.

The new ESC/ESH Guidelines on Hypertension will be presented in detail for the first time in Munich. They still provide for a limit value of 140/90 mmHg but retain this as a basic treatment goal, but with well-tolerated therapy 130 mmHg should be aimed at as a systolic value. "In older patients, higher threshold values are accepted, in some cases up to 160 mmHg, in order to avoid undesirable side effects caused by too intensive drug therapy," says Prof. Achenbach.

The ESC 2018 as a showcase of German cardiology

"The fact that the ESC has once again chosen Germany as its location this year is also an award for German cardiology," said Prof. Dr. Andreas M. Zeiher, future President (President-Elect) of the German Society of Cardiology (University Hospital Frankfurt). Of the total of 4,500 scientific studies presented in abstract form at the Congress, around 410 came from Germany.

Research benefits patients measurably and has practical consequences for health and life expectancy in Germany. The progress made in modern cardiology is one of the reasons why the latter is constantly on the rise. "Compared to the beginning of the 1990s, the death rate from heart attacks among men fell by almost 68 percent and among women by more than 57 percent by 2015," Prof. Zeiher cites an example. In 1990, 85,625 people died of a heart attack in Germany, compared to 49,210 in 2015 - and that in a society that was growing rapidly and getting older.

Numerous factors are responsible for this impressive development: e.g. heart attack networks that facilitate fast and guideline-oriented therapy. Progress in diagnostics and treatment plays an important role. The gentle cardiac catheter technology is decisive here: It enables the examination, reopening and keeping open of constricted or closed blood vessels via a flexible tube, the implantation of vascular supports ("stents"), but also of heart valves and certain cardiac pacemakers, as well as interventions in atrial fibrillation ("ablation"). In addition, there are innovations in drugs such as anticoagulants or drugs for heart failure.

Disease burden from cardiovascular diseases remains high

"But despite all the progress made, the burden of cardiovascular disease remains considerable in Germany: it is still the number one cause of death," said Prof. Zeiher. The most widespread cardiological diagnoses selected in the current "German Heart Report" were the cause of death of about a quarter (24 percent) of all people who died in Germany (2015). 

Cardiological care in Germany very good in international comparison

"In cardiological care, especially in interventional cardiology, we in Germany are also in a very good position by international standards," reported Prof. Dr. Ulf Landmesser, local press coordinator of the ESC in Munich (Clinic Director Cardiology, Charité Universitätsmedizin Berlin and Medical Director of the CharitéCentrum für Herz-, Kreislauf- und Gefäßmedizin). 

There have also been positive developments in care structures, for example through organizational mergers of service providers in quality-assured heart failure networks.

"In Germany, we are far less well positioned in prevention and health promotion," says Prof. Landmesser. "Cardiovascular prevention is important for the entire population in all phases of life. The creation of appropriate framework conditions here is a task for society as a whole that must be performed with commitment."

Overweight, lack of exercise, smoking, and stress neutralize some benefits of heart medicine

"We are faced with an interesting phenomenon: the methods of diagnosis and treatment are getting better and better, care in Germany is at a very high level, and heart medicine contributes to ever longer life expectancy like no other medical discipline. Despite all this, we are now possibly on the verge of or in the midst of a trend reversal," said Prof. Dr. Udo Sechtem, local press coordinator of the ESC in Munich (Stuttgart). Reversing the trend of the two previous years, in 2016 most of the diseases included in the "Heart Report 2017" in Germany did not decrease but increased significantly compared to 2015. The mortality rate for the diseases included in the Heart Report also increased again between 2014 and 2015: From 256.1 per 100,000 inhabitants to 269.6.

"One reason could be that overweight, lack of exercise, smoking, and stress neutralize some of the benefits of heart medicine," says Prof. Sechtem. In addition, many people do not know their blood pressure, cholesterol and blood sugar levels, leaving risk factors undiscovered. "It is, therefore, necessary to have as complete a screening as possible - so that the benefits of modern cardiac medicine reach as many people as possible who can benefit from them. Every person should know his values and have them measured regularly".

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