What keeps our hearts fit and healthy for a long time

Many cardiovascular diseases develop unnoticed over a period of years. High blood pressure, high cholesterol, diabetes, being overweight and smoking, in particular, put a long-term strain on the heart. Cardiologist Andreas Zirlik emphasises in the ‘Hörgang’ podcast by Springer Medizin and the Medical University of Graz that prevention is the best form of protection.

Professor Zirlik, what is the general state of people’s heart health these days?
Basically, there are two things to bear in mind. On the one hand, people are living longer than ever before. Cardiology has certainly played a part in this, having advanced enormously over recent years and decades. We now detect diseases much earlier and can therefore treat them more quickly and effectively. On the other hand, our Western lifestyle takes its toll over time. Of particular concern is the rising number of people who are overweight or have diabetes, which leads to narrowing of the coronary arteries and, consequently, to heart disease. We could do much more to prevent this than we currently do.

Which factors put the greatest strain on our hearts?
Above all, obesity and diabetes, which cannot be considered in isolation from one another. Another factor that often goes completely unnoticed, but which, after years of the condition, has a very significant impact on heart health, is high blood pressure – arterial hypertension. This is such a key factor for me because, as I said, it goes completely unnoticed for so many years. Other factors include frequently elevated lipid levels and nicotine consumption. This includes not only traditional cigarettes but also vaping.

So what preventive measures can be taken to ward off heart disease?
First and foremost, exercise and sport. This makes sense at any age and in any state of health. Even people who are already unwell have a better prognosis if they engage in regular, proportionate or adapted exercise. Whether you’re healthy or unwell, young or old – I always advise my patients to do whatever makes them feel good. So don’t force yourself to exercise if you don’t enjoy it. It’s not necessarily about competitive sport, but it is about getting your heart working hard enough to cause a measurable rise in your heart rate and blood pressure. That’s when we achieve the best training effect. 4 to 6 sessions of 30 minutes’ physical activity per week – that’s certainly something to be viewed very positively. On top of that, of course, you should avoid all forms of nicotine, and alcohol should only be consumed in moderation.

What role do digital devices play in modern cardiology?
Clearly, an ever-increasing one. Whether they’re smartwatches or genuine medical devices such as pacemakers – devices that also record additional information are becoming increasingly important. They are, for example, hugely important for diagnosing atrial fibrillation, one of the most common cardiac arrhythmias. On the one hand, these technologies make our work easier; on the other hand, I would also like to offer a word of caution against focusing solely on these parameters.

What options does cardiology offer today in terms of early diagnosis?
Firstly: we naturally have options through laboratory diagnostics and certain biomarkers. We are very good at assessing these – including in a personalised way – that is, tailored to the individual patient. We now have access to very modern, non-invasive imaging methods. In the past, we often needed a cardiac catheterisation. Today, we can answer many diagnostic questions using such non-invasive methods. For example, we use computed tomography or magnetic resonance imaging when assessing the heart’s musculature.

Secondly, we have a whole range of truly minimally invasive techniques at our disposal to treat such conditions. For instance, in cases of narrowing of the coronary arteries, we can now provide effective treatment via a cardiac catheterisation procedure using a wide variety of methods. Here, we can dilate the artery, sometimes insert a stent, but also follow up with various other methods. We have seen very rapid developments over the last 20 years. In the case of valve diseases, particularly in older patients, where major surgery often poses a certain risk, we can now use minimally invasive, catheter-based techniques accessed via an artery in the wrist or groin. There really has been a tremendous amount of progress in this area.

What three things would you advise us to do to keep our hearts healthy well into old age?
Firstly: avoid being overweight.
Secondly: follow a balanced diet, combined with regular physical activity.
And finally: have a health check-up regularly – that means at least every five years.

The full interview as a Hörgang podcast (german)