Kassel doctors express praise and criticism of Lauterbach’s heart law

The “Healthy Heart Act” (GHG) planned by the Federal Ministry has been met with both praise and criticism. General practitioners and cardiologists in Kassel are divided.

Kassel – A draft law from the Federal Ministry of Health is heating up tempers within the medical profession. It is the “Healthy Heart Act” (GHG), which is intended to respond to Germany's most common cause of death. According to studies, cardiovascular diseases will account for a third of all deaths in this country in 2021. But while the draft is being praised from a cardiological point of view, family doctors from the region are strongly critical.

The planned Healthy Heart Act (GHG)

The Ministry of Health states that the aim of the draft law is to “improve the early detection and treatment of cardiovascular diseases through a package of measures and thus strengthen cardiovascular health in the population.” The fact that life expectancy in Germany, at 80.8 years, is only slightly above the EU average (80.1 years), despite so much money being spent on health, is due to cardiovascular mortality. Cardiovascular means: relating to the heart and the vascular system.

Statins – which are cholesterol-lowering drugs – have been shown in many large studies to reduce the risk of cardiovascular disease and extend life expectancy. The draft law contains many details. In summary, it stipulates that children, adolescents and adults should undergo regular heart examinations in order to detect and prevent lipid metabolism disorders. This will affect the work of family doctors in particular.

Family doctors in Kassel criticize Healthy Heart Act

They are strongly criticizing the approach for several reasons. One of the critics is Dr. Uwe Popert, a general practitioner in Kassel and deputy spokesman for the Association of General Practitioners: “The draft contains so many formal and substantive errors that it was obviously written by people without much knowledge of the real conditions of primary prevention.” Specialists are being burned out trying to explain to the majority of patients whether they should take statins or not. It is questionable whether the desired effect, namely the reduction in cardiovascular mortality, is even occurring.

Popert fears that the entire outpatient health care system will be overturned in this way. He does not know how this will be financially and organizationally viable. In any case, the family doctor is of the opinion that behavioral prevention should be the focus before considering drug prevention.

In addition, Federal Health Minister Karl Lauterbach (SPD) has once again cheated his way past the Federal Joint Committee (G-BA) with the draft. The committee must examine measures such as these for quality and cost-effectiveness before draft legislation is introduced. Dr. Christoph Claus, spokesman for general practitioners in the Kassel district, agrees with the criticism: “We don't have time to deal with things for which there is no scientific basis.”

Studies with scientific evidence show that sufficient exercise, a healthy diet and, above all, not smoking have a significant impact on cholesterol levels and therefore on heart health. Claus can already see that the draft will now drive frightened patients into the doctor's office.

Who really needs statins is a very individual decision. In principle, people whose first-degree relatives are or were ill should be examined. You should also have your values ​​checked if you already have other illnesses that could be related. In addition, from the age of 35, you could have a health check every three years anyway. Claus sees the fact that the G-BA completely ignored the rules in this case as a clear violation of the Social Code. “This decision is not within Lauterbach's area of ​​competence.”

The supporters of the planned heart law

Cardiologists have a very different view of the draft law. Dr. Rainer Gradaus, chief physician of the clinic for heart and circulatory diseases at Kassel Hospital, considers it “to be a step in absolutely the right direction.” Regular screenings are carried out to prevent tumors. The same should be true for the heart. Elevated cholesterol levels are the killer of industrialized nations. There are obvious study results from beyond Germany that confirm the positive effect of taking statins. “If certain diseases are genetically determined, you can do as much sport and eat as healthily as you want,” says Gradaus. Cholesterol-lowering drugs are the treatment of choice in this case. “Why wait until it's too late?” he asks.

People in Kassel are currently becoming infected with the coronavirus again and again. One reason is possible large-scale events such as public viewing of the European Championships.