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Many risks for heart diseases can be minimized with a conscious lifestyle.
April 3, 2025
Birgitta Dunckel
Stay fit into old age – a well-functioning heart contributes to this, among other things. But what measures strengthen it and protect against diseases? For example, the right diet – and seven other factors.
With
Prof. Dr. Dr. Ferdinand Vogt
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A healthy heart is the key to a long and active life. Yet cardiovascular diseases are still responsible for over a third of all deaths in Germany. Worldwide, around 17.3 million people die each year as a result of cardiovascular disease, with estimates predicting an increase to up to 23.6 million by 2030.
Even though the spectrum of cardiovascular diseases is broad, many of these diseases are closely linked to risk factors such as high blood pressure, obesity, and diabetes, and develop over the years, also influenced by an unhealthy lifestyle. Because many risks can be minimized.
Which heart diseases are often the result of lifestyle? "Before you start healing someone, ask them if they are willing to give up the things that made them sick," Hippocrates of Cos said, who was born around 460 BC. So the question arises, what unhealthy things do we do that harm us?" so PD Dr. Dr. Ferdinand Vogt, Senior Consultant Cardiac Surgery at Artende Klinikum München Süd.
"Unhealthy diet, smoking, alcohol, lack of exercise, negative stress, and lack of sleep are the strongest triggers here, which cause high blood pressure leading to damage to the vessel walls and thus to atherosclerosis, that is, deposits in our vessels, and thus causing narrowing or even blockages. In the worst case, this leads to a heart attack or stroke. But heart rhythm disturbances or heart failure (heart weakness) can also be the result." (By the way: Our expert explains how high the risk of heart attack is for women here in the podcast.)
The American Heart Association (AHA) has developed the "Life’s Essential 8" – a scientifically based list of eight key factors for optimal heart health. These recommendations not only help reduce the risk of cardiovascular diseases but also slow down biological aging. Even people with a genetic predisposition to accelerated aging benefit from these simple yet effective measures for heart health:
A balanced diet is the foundation for a healthy heart. The AHA recommends eating vegetables, fruits, whole grains, beans, legumes, nuts, plant-based proteins, lean animal protein, skinless poultry, fatty fish, and seafood daily.
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The consumption of nuts strengthens the heart.
Sugary drinks, alcohol, sodium, red and processed meats, refined carbohydrates like added sugars and processed grains, full-fat dairy products, heavily processed foods, and tropical oils like coconut and palm oil should be consumed in moderation.
Trans fats and partially hydrogenated oils (found in some commercially baked goods and fried foods) should be completely avoided. (Find out here which oils promote health.)
At least 150 minutes of moderate activity or 75 minutes of vigorous activity per week is recommended. Exercise strengthens the heart, lowers blood pressure, and improves circulation. Suitable activities include:
Smoking is one of the biggest risk factors for heart disease. Secondhand smoke can also be harmful. Quitting smoking significantly reduces the risk of heart attacks and strokes.
Good sleep (seven to nine hours a night) works like a medicine: During the night, heart rate and blood pressure drop. In addition, fat and sugar metabolism are optimized, the immune system is strengthened, and cellular repair processes are initiated. Conversely, lack of sleep has serious consequences for the body - especially for the heart.
"Healthy sleep regenerates the body, blood pressure drops, and both body and mind recover," explains Dr. Ferdinand Vogt. "Chronic sleep deprivation promotes obesity, diabetes, and elevated blood fats - all risk factors for heart disease. A disturbed sleep rhythm leads to elevated stress hormones (cortisol levels), which strain the cardiovascular system. There are also pathological sleep patterns such as obstructive sleep apnea syndrome (OSAS), which in turn is favored by obesity, alcohol, nicotine, or sleeping pills."
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A healthy sleep regenerates the body, blood pressure decreases, and both body and mind recover, says Dr. Vogt.
A healthy weight reduces the risk of heart disease. The AHA uses the body mass index (BMI) as a guide: a BMI between 18.5 and 24.9 is considered optimal. Belly fat is particularly harmful as it is associated with a higher risk of heart disease.
High blood sugar levels may indicate diabetes, which increases the risk of heart disease. A low-sugar diet and exercise help keep blood sugar levels stable. (Find the perfect breakfast for stable blood sugar levels here.)
A healthy blood pressure should be below 140/90 mmHg. High blood pressure can damage the heart and arteries. Low salt intake, regular exercise, and stress management can help lower blood pressure. The doctor decides whether blood pressure needs to be controlled with medication.
High LDL cholesterol levels (“bad cholesterol”) can lead to clogged arteries. A healthy diet, regular exercise, and possibly medications help keep levels within the normal range.
From a certain age or with a family history, regular heart check-ups are essential. "Depending on the family history, I recommend a general cardiovascular screening from the age of 35: This should include blood pressure measurement (possibly also long-term examination), blood sugar and cholesterol levels, an ECG (electrocardiogram) and a heart ultrasound examination (echocardiography) to check heart function," says Dr. Ferdinand Vogt.
"Further examinations could be a stress ECG or a stress echo examination. From the age of 50, regular check-ups are recommended, especially for risk factors such as being overweight, high blood pressure, or family history. From the age of 60, annual check-ups are advised as the risk of cardiovascular diseases increases. People with pre-existing conditions or high risk should individually discuss with their doctor how often they should go for check-ups."
Reading tip: You can also find a lot of information about diseases and treatment methods in our Department of Cardiovascular Medicine.
