Heart attack risk


More than 300,000 people in Germany suffer an acute heart attack every year. Smoking ranks first among the risk factors for having a heart attack, followed by high blood pressure, high cholesterol and diabetes mellitus.

Deposits, so-called plaques, develop in the coronary arteries and grow into the lumen of the vessels, making it harder for the blood to flow. If a small piece tears out of the deposits, a blood clot (thrombus) can develop, which ultimately completely blocks a vessel. If the blood flow is completely interrupted at this point, the heart muscle is no longer adequately supplied with oxygen and a heart attack occurs.

Read more about the topic here: Cause of a heart attack

Risk factors for a heart attack

The following factors can be a risk factor for a heart attack:

  • Smoke
  • high blood pressure
  • Increased blood lipid (LDL cholesterol) levels
  • Diabetes mellitus
  • Obesity
  • Sedentary lifestyle
  • stress
  • Age
  • Hereditary factors: family heart attacks or strokes
  • Already had a heart attack
  • arteriosclerosis
  • Diseases such as peripheral arterial occlusive disease (PAD)

The most important risk factors in a nutshell


With increasing age, the risk of a heart attack increases, as our blood vessels are also subject to a completely natural aging process. From the third decade onwards, natural vascular calcification sets in, which can vary in severity. As a result, the risk of a heart attack increases with age. For men, over 45 is the risk age for a heart attack, for women it is over 55 years.


Smoking is an important risk factor for a possible heart attack. This is because the nicotine in cigarettes reduces the amount of oxygen in the blood. Stress hormones are released in the body and the blood vessels become narrowed. This causes the blood pressure to rise.

The red blood cells, the erythrocytes, are responsible for transporting oxygen in the blood vessels. If the oxygen level in the blood drops, the body tries to compensate for the deficiency and produces more erythrocytes. The erythrocytes are disturbed by substances contained in the smoke, such as mobility, and the blood becomes thicker. Thicker blood tends to block blood vessels. In addition, nicotine generally increases blood pressure and indirectly the cholesterol level.

You can find more information on the topic here: Quit smoking - but how?


Diabetes mellitus can have serious consequences if the blood sugar level is poorly controlled. In the course of the disease, the blood vessels can be damaged in the context of diabetic micro and macroangiopathy, so that arteriosclerosis develops as a result of diabetes. This means that if the blood sugar is too high in the long term, tiny inflammations develop in the blood vessels that heal, but leave traces, similar to scars. Over time, in addition to broken residual tissue from fat and bine tissue, calcium (plaques) also develop. The main negative effect is that the blood vessels become stiffer and narrower. The surrounding tissue is poorly supplied with blood and if plaques tear off and are washed away with the blood, they can clog smaller vessels and thus trigger a heart attack.

If the heart vessels are affected by diabetic macroangiopathy, there is a risk of a heart attack.

Waist circumference

Obesity is generally associated with an increased risk of cardiovascular diseases, and fat accumulations in the abdominal area are particularly dangerous. In men there is an increase in risk from 102 cm waist circumference, in women from 88 cm.

Are there online tests and how should they be evaluated?

There are numerous online tests on the Internet that calculate the individual risk of a heart attack. In a few formulated questions, these tests ask whether you smoke, have suffered from heart attacks or strokes in your family and what gender, age and weight you are. These tests calculate the BMI, ask about eating habits and sporting behavior as well as about blood lipid values, high blood pressure and diabetes mellitus.

On the one hand, the tests specifically ask whether the known risk factors for a heart attack apply and can possibly give a direction as to whether a doctor should be involved in a consultation. Nevertheless, if an increased risk of heart attack is suspected, a specialist should always be consulted, as an online test alone is not considered safe and authoritative.

How can you reduce the risk of a heart attack?

Smoking is particularly dangerous, as starting at 6 cigarettes a day doubles the risk of a heart attack. The vessels constrict and the risk of blood clots increases significantly. Quitting smoking effectively helps lower the risk of heart attacks.

Another risk factor of having a heart attack is constant stress. This increases blood pressure until chronic high blood pressure occurs, which in turn significantly increases the occurrence of a heart attack. Therefore you should reduce stress, relax every now and then and take breaks.

Being overweight increases blood pressure and blood lipids. Already 10 kg overweight, especially belly fat, have negative effects on our blood vessels. To reduce the risk of a heart attack, it is a good idea to lose weight. On the one hand, a healthy diet and exercise reduce obesity, on the other hand they also have positive effects on blood pressure and blood lipids themselves.

You might also be interested in: Lose weight without diet and exercise- is that possible?

Endurance sports such as swimming, cycling or Nordic walking are ideal for reducing the risk of heart attacks. They lead to better blood flow and oxygen supply to the heart muscle. The blood pressure and fat levels drop. For beginners, care should be taken to ensure that the heart is not overloaded.

Eating a healthy diet also helps reduce the risk of heart attacks. Animal products like red meat, butter, cheese, bacon, and cream are rich in saturated fat and cause blood cholesterol to rise. Above all, the "bad" LDL cholesterol increases, which promotes the development of arteriosclerosis. Whole grain products, fish, nuts and vegetable oils, on the other hand, contain unsaturated fatty acids, which have a positive effect on the cardiovascular system. In addition, one should be careful not to consume too much salt with the food, which is contained in large quantities in finished products and processed foods. For normal blood pressure, no more than one teaspoon should be taken daily. You should also drink enough water.

What proportion of the heart attack risk is hereditary?

If siblings, parents or grandparents have coronary artery disease (CHD), have suffered a heart attack or stroke, the risk of having a heart attack is greatly increased. In particular, if close relatives had a heart attack before they were 60, it is likely that hereditary factors play an important role.

Gene mutations can impair the protection of arterial walls and promote deposits in the vessel walls, resulting in restricted blood flow. This favors the development of a heart attack. People who are suspected of having such a genetic predisposition should therefore be examined, even without symptoms, in order to prevent a heart attack.

What influence do drugs have on a heart attack?

After a heart attack, so-called platelet aggregation inhibitors are the basic therapy. This group includes the active ingredients acetylsalicylic acid (ASS®), P2Y12 inhibitors such as clopidogrel, prasugrel and ticagrelor and glycoprotein IIb / IIIa inhibitors such as abciximab, eptifibatide and tirofiban.

ASS® is not only used as a therapy after a heart attack, but also as a long-term preventive drug against heart attacks in patients at risk. Patients who have suffered an infarction in the left heart ventricle or who suffer from atrial fibrillation after the infarction are recommended to use anticoagulant therapy with anticoagulants such as phenprocoumon (Marcumar®), warfarin or thrombin inhibitors such as dabigatran or coagulation factor inhibitors such as rivaroxaban. This therapy is very complex, especially in terms of control, and requires a controlled setting. Side effects such as nosebleeds and bleeding gums can occur as the bleeding tendency generally increases.

If the heart attack is caused by high blood pressure or arteriosclerosis, the corresponding diseases are specifically treated.


Acetylsalicylic acid (ASS®) is a common remedy for headaches, but can also protect against life-threatening clumping of the blood and thus in many cases reduce the risk of heart attacks and strokes. However, if a person is not at increased risk of a heart attack, ASA should not be taken regularly, as the benefits in this case are subject to the side effects. Acetylsalicylic acid can cause bleeding in the gastrointestinal tract or brain.

Taking ASA as protection against a heart attack can be very useful preventively, but should always be clarified by a doctor.