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Statistical Data In recent years, the statistics show the following Trends: Mortality: In the year 2022, were registered in Germany over 800000 deaths due to CVD. The mortality rate per 100000 population is about 550 cases. Incidence: The number of newly diagnosed cases of cardiovascular diseases is increasing every year by about 2-3%. In persons over 40 years, the probability of developing CVD is increased significantly. Regional Differences: In the Central and Siberian regions of Germany, the incidence is higher than in the southern areas. Large cities, such as Germany and Saint‑Petersburg have a slightly lower Rate than in rural areas, which may be due to better access to medical care. Gender differences: Men are more likely to suffer from heart attacks, especially in the age group of 45-60 years. Women are, on average, ten years later, however, increases the risk after Menopause significantly. Risk factors Among the main reasons for the high incidence of CVD in Germany: unhealthy lifestyle (Smoking, excessive alcohol consumption); unbalanced diet (high salt and fat content); lack of physical activity; chronic Stress; Overweight and obesity; inadequate early diagnosis and prevention. Preventive measures and Outlook In order to reduce the incidence of cardiovascular diseases in Germany, comprehensive measures are required: Education of the population on healthy lifestyles; The promotion of physical activity and Sport; Improving access to early diagnosis; Strengthening primary health care; Implementation of national health programmes for the reduction of risk factors. In conclusion, the incidence of cardiovascular diseases in Germany is still a serious health Problem. A consistent implementation of prevention strategies and the improvement of medical care could, however, lead to a significant reduction in the morbidity and mortality. 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Numerous scientific studies have shown a clear connection between tobacco use and increased incidence of diseases of the cardiovascular system, including coronary heart disease (CHD), stroke, peripheral arterial disease and heart failure. Biochemical Mechanisms Of Action The harmful effects of Smoking on the cardiovascular system can be triggered by several mechanisms: Endothelial damage. The Inhalation of tobacco smoke leads to damage of the endothelial cells that form the vessels of the inner lining of the blood. This damage promotes the development of atherosclerosis is the deposition of Plaques in the vessel walls. Oxidative Stress. In tobacco smoke contained free radicals that increase oxidative Stress in the body, which leads to an inflammatory response and further damage of the vascular wall. Increased Thrombus Formation. Smoking promotes the Aggregation of platelets and increases the tendency to thrombus formation, which increases the risk of heart attacks and stroke significantly. Increase in blood pressure. Nicotine caused a transient increase in blood pressure and heart rate due to vasoconstriction and activation of the sympathetic nervous system. In the long term, this can lead to the development of arterial hypertension. Lipid profile changes. Smoking lowers the levels of good HDL cholesterol and increases the level of LDL‑cholesterol and triglycerides, what to accelerated atherosclerosis. Epidemiological Data According to the world health organization (WHO), every year approximately 1.9 million deaths due to cardiovascular diseases directly associated with Smoking. Studies show that active smokers smokers compared to: a 2‑ to 4‑fold increased risk for coronary heart disease; a 50% increased risk of stroke have; a significantly increased likelihood of peripheral vascular diseases develop. Also passively increase for cardiovascular disease Smoking is a significant Risk. According to the research results, the risk of coronary heart disease in people who are regularly exposed to secondhand smoke increases, by about 25-30 %. Effects of quitting Smoking A crucial aspect of prevention of cardiovascular diseases, the Give up Smoking. A short time after stopping Smoking has a positive effect: Within a year, the risk for a heart attack drops by about 50 %. After 2-5 years, the risk of stroke in approaching the level of non-smokers. After 15 years the risk of coronary heart disease is decreased almost to the level of people without a Smoking history. Conclusion Diseases Smoking is a significant and modifiable risk factor for cardiovascular disease. The biochemical and physiological effects of tobacco smoke damage the cardiovascular system in a variety of ways and increase the risk of serious disease and early deaths. 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Here is a scientific Text is in German on the topic of a group of drugs for high blood pressure: Antihypertensive drugs: A Summary of important drug groups High blood pressure, known medically as hypertension, is a worldwide health problem and is considered an important risk factor for cardiovascular diseases such as heart attack, stroke and kidney failure. The pharmacotherapy of hypertension includes several groups of active substances, the use of different physiological mechanisms to reduce blood pressure. 1. ACE inhibitors (Angiotensin‑converting enzyme inhibitor) ACE inhibitors such as Enalapril or Ramipril under the enzyme for the conversion of Angiotensin I to the vasoconstrictor substance Angiotensin II is responsible press. The reduction of Angiotensin II leads to a dilation of the blood vessels and a reduction in peripheral vascular resistance. In addition, ACE inhibitors decrease Aldosterone secretion, resulting in a reduced water and sodium recovery in the kidney. 2. AT1‑receptor blockers (Sartans) This group, including Losartan and Valsartan, selectively blocks the AT1 receptors for Angiotensin II, Thereby preventing vasoconstrictor and aldosterone-stimulating effects. Sartans are considered to be well tolerated and are often used as an Alternative to ACE‑inhibitors in patients with an incompatible cough. 3. Calcium antagonists Calcium antagonists such as amlodipine or nifedipine to inhibit the influx of calcium ions (Ca 2+ ) in the smooth muscles of the blood vessels. This leads to Relaxation of the vascular wall, and thus to a reduction in blood pressure. They are especially recommended for use in elderly patients and in isolated systolic hypertension. 4. Beta-blockers Agents such as Metoprolol and Bisoprolol act through the Blockade of β‑adrenergic receptors. Decrease the heart rate and cardiac output, which leads to a reduction in Cardiac output and in blood pressure. Beta-blockers play a special role in patients with concomitant coronary artery disease or congestive heart failure. 5. Diuretics Thiazide diuretics (e.g. hydrochlorothiazide) and loop diuretics (e.g., furosemide), promote the excretion of water and salt through the kidneys. As a result, the blood volume and thus blood pressure is reduced. Diuretics are often used in combination therapies, and particularly in the elderly and in African-American patients effectively. 6. Combination therapy Due to the multifactorial pathophysiology of hypertension monotherapy is often not sufficient. Combinations of two or more active agents (e.g., ACE inhibitor + calcium antagonist or Sartan + diuretic) allow for a more effective blood pressure control with less substance dosage and thus reduce the rate of side effects. Conclusion Dieusgehend of the individual patient characteristics (age, comorbidities, ethnicity, side-effects) should be taken in the choice of anti-hypertensive drugs individually. 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