Cardiovascular and metabolic diseases share a common foundation. Considering them together reveals risks earlier — and allows them to be influenced in a targeted way. An overview of the medical background.
Cardiometabolic diseases — including coronary heart disease, heart failure, stroke, type 2 diabetes, arterial hypertension as well as obesity and lipid disorders — are among the leading causes of disease burden and premature mortality in Germany.
Their shared pathophysiological foundation of insulin resistance, chronic low-grade inflammation, endothelial dysfunction and atherogenic dyslipidaemia justifies an integrated approach — rather than treating individual risk factors in isolation.
A substantial share of this disease burden is preventable. Yet in everyday care this potential often goes unused: risk factors are recognised late, target values are not maintained, and care is frequently fragmented. This is precisely where structured, evidence-based prevention begins.
Effective prevention begins with clearly defined risk factors. The crucial distinction is between modifiable and non-modifiable factors — it forms the basis of risk assessment.
| Category | Risk factors | Entry point |
|---|---|---|
| Metabolic | Elevated fasting glucose, impaired glucose tolerance, dyslipidaemia, visceral obesity | Highly modifiable |
| Vascular | Arterial hypertension, elevated LDL cholesterol, lipoprotein(a) | Highly modifiable |
| Behaviour | Smoking, physical inactivity, unhealthy diet, alcohol | Very highly modifiable |
| Non-modifiable | Age, sex, family history, genetic predisposition | Risk stratification |
Particular attention is paid to the metabolic syndrome — the simultaneous presence of several components: central obesity, elevated blood pressure, dyslipidaemia and a glucose metabolism disorder. This constellation amplifies overall risk beyond the sum of the individual factors and is a priority group.
Resource-conscious prevention matches the intensity of measures to individual risk. A three-tier model combines established risk scores (such as SCORE2 / SCORE2-OP) with clinical and laboratory parameters.
No or only isolated, mildly expressed risk factors. General advice, re-screening every 3–5 years.
Several risk factors, early-stage metabolic syndrome. Structured lifestyle intervention, annual review.
Manifest factors, diabetes, end-organ involvement or existing disease. Guideline-based therapy, close monitoring.
Table 2: Three-tier risk stratification model.
Basic screening takes place during regular medical contacts and health checks — based on individual indication. It comprises at least the following parameters:
Measures follow the principle of graduated care: lifestyle measures form the foundation at every risk level and are supplemented by pharmacological and structured care elements as risk increases.
This text serves as general information on the medical foundations of cardiometabolic prevention. It does not replace individual medical advice, diagnosis or treatment decisions and does not constitute a specialist guideline.
Whether and to what extent individual examinations or measures are appropriate is always decided individually, based on your personal history, risk factors and findings, in consultation with a physician.