Heart Report 2025: Coronary heart disease remains a major challenge in Germany – Consistent prevention is crucial

11.09.2025 18:10

Rund 4,7 Millionen Betroffene in Deutschland erhalten die Diagnose Koronare Herzkrankheit (KHK). [1] Der am 11. September vorgestellte Deutsche Herzbericht macht deutlich: Trotz Fortschritten in der Therapie ist die Krankheitslast im deutschen Raum nach wie vor hoch. Im europäischen Vergleich der Mortalitätsraten steht Deutschland weiterhin hinten an. [2] Prävention und Aufklärung sind daher entscheidende Faktoren für Medizin und Gesellschaft, um der KHK entgegenzuwirken.

Coronary heart disease is one of the most common causes of death in Germany. This chronic condition causes a narrowing of the coronary arteries due to plaque buildup. The result is insufficient blood flow to the heart. Particularly dangerous is that coronary heart disease often goes unnoticed and can lead to serious complications and secondary diseases such as shortness of breath and chest pain (angina pectoris), sudden cardiac death, or heart attack.^2,3

According to the latest heart report, presented in Berlin on September 11, coronary heart disease (CHD) is the most common reason for hospital treatment in Germany, with 538,675 hospital admissions in 2023 (2022: 538,277) (including myocardial infarction: 185,804). CHD is also the leading cause of heart failure and sudden cardiac death (SCD).³

Nevertheless, there is also positive news: When analyzing the CHD mortality rate over the period from 2000 to 2023, it is noticeable that it is trending downwards (2000: 268.8; 2011: 169.6,
2023: 133.3 deaths per 100,000 inhabitants).⁴ "Although the number of deaths from coronary heart disease and heart attacks has decreased significantly, coronary heart disease remains one of the most common causes of death in Germany. Even declining mortality rates do not diminish its seriousness. It is crucial to treat risk factors consistently and early on," emphasized Professor Holger Thiele, Past President of the German Society for Cardiology – Heart and Circulation Research (DGK), at the press conference presenting the heart report.

CHD therapy: Improving quality of life through catheter technology and bypass surgery, even in older age

Heart diseases such as coronary heart disease (CHD) affect people from middle age onwards. According to the Heart Report, the development of the CHD hospitalization rate by age group in the 2011/2023 comparison shows a significant increase from age 45 onwards, rising further from age 65 onwards, and leveling off again from age 85 onwards (2023: 45-65 years (682), 65-75 years (1,692), 75-85 years (2,344).³ However, advanced age does not significantly limit therapeutic options. Thanks to modern interventional procedures, older patients with coronary heart disease and heart attacks can be effectively treated. For example, percutaneous coronary intervention (PCI) can restore blood flow to the affected area of the heart muscle during acute treatment of a heart attack. Using a balloon and a stent (metal mesh), severe vascular constrictions can be permanently kept open.

Professor Stefan Blankenberg, President of the German Society of Cardiovascular Surgery (DGK), emphasizes: "Older patients in particular benefit from both PCI and bypass surgery. Even the very elderly can benefit from the procedure: pain decreases, blood circulation improves, and physical performance increases. Age limits alone should therefore not be a reason to withhold effective therapies – the individual situation is crucial."

Prevention as an important component for reducing the burden of disease and mortality from CHD

The most effective prevention of coronary heart disease addresses the key risk factors: high blood pressure, abnormal blood lipid levels, and elevated blood sugar. High blood pressure damages the artery walls, high blood lipids build up there as deposits, and high blood sugar accelerates this process. Together, these processes narrow and harden the coronary arteries, placing strain on the heart.

Data from 106,166 patients from 63 rehabilitation facilities, collected as part of a 2023 survey by the German Society for Prevention and Rehabilitation (DGPR) and listed in the current German Heart Report, clearly show that the aforementioned risk factors predominated: 49.7 percent of those affected (35,885 rehabilitation patients) had high blood pressure (arterial hypertension), followed by lipid metabolism disorders (47.3 percent/32,329), type 1/2 diabetes mellitus (24 percent/17,309), obesity (21.1 percent/14,243), and smoking (19 percent/10,326). Particularly worrying is that, with the exception of smokers, the proportion of those affected who exhibited these risk factors has increased compared to the previous year.³ "Prevention is our most important tool for sustainably reducing the high mortality rate from coronary heart disease. The still excessively high smoking rates in Germany demonstrate that we still have a long way to go. If we succeed in consistently controlling high blood pressure, elevated blood lipids, diabetes, and smoking, we will achieve more for heart health than if we begin treatment only after heart disease has occurred," says Professor Blankenberg.

Sources

1. Vrints C, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024 Sep 29;45(36):3415–3537, https://doi.org/10.1093/eurheartj/ehae177.
2. Robert Koch Institute. Coronary Heart Disease: Mortality. Federal Health Report. 2024. https://www.gbe.rki.de/DE/Themen/Gesundheitszustand/KoerperlicheErkrankungen/HerzKreislaufErkrankungen/KoronareHerzerkrankungSterblichkeit/koronareHerzerkrankungSterblichkeit_node.html?darstellung=0&kennzahl=1&zeit=2022&geschlecht=0&standardisierung=3, last accessed: 10.09.2025.
3. German Heart Foundation et al. (eds.), German Heart Report – Update 2025, September 2025.
4. World Health Organization (WHO), https://www.who.int/health-topics/cardiovascular-diseases/https://data.who.int/countries (for data on CHD mortality/life expectancy in European countries); Jasilionis D. et al, Eur J Epidemiol (2023), https://doi.org/10.1007/s10654-023-00995-5, last accessed: 10.09.2025.