Heart disease is the number-one cause of death in men, but it doesn’t have to be. Paying attention to risk factors and behaviors including smoking, diet, and exercise all can lower the risk of heart disease in men — who tend to develop coronary artery disease 10 years earlier than women.
“Some of that is just because of male biology, but it can also be related to family history,” says Muhammad Aftab, MD, associate professor of cardiothoracic surgery in the University of Colorado Department of Surgery. “You are at high risk if you have first-degree relatives — parents or siblings — who developed heart disease at a young age, 55 for men and 65 for women.”
Other risk factors for heart disease include diabetes, high cholesterol, and smoking. Smoking is extremely dangerous to the heart, Aftab says, because it causes inflammation and damage to the coronary arteries and blood vessels. It may increase the risk of blood clot formation in other organs as well.
All men, especially those at high risk for heart disease, should pay attention to their exercise levels to give them the best chance at avoiding coronary problems, Aftab says.
“Exercise is extremely important,” he says. “The American Heart Association recommends at least 150 minutes per week of moderate-intensity activity for all individuals, which is 30 minutes, five days a week. Two-and-a-half hours per week is optimal, and if you can do more, that’s great. Muscle strengthening exercises are also important. We encourage cardio for longevity and strengthening exercises for quality of life.”
Cardio can include brisk walks, biking, sports like soccer and skiing, treadmill, elliptical, or stationary exercise bikes, Aftab says, noting that those who exercise regularly have a 20% to 25% lower risk of death compared to those who don't exercise.
One of the most important contributors to heart health is diet, Aftab says. It’s important to avoid saturated fats such as bacon, ice cream, butter, and red meat. The ideal diet for men looking to avoid coronary artery disease is the so-called Mediterranean diet that focuses on lean proteins like fish and chicken, leafy green vegetables, and sources of healthy fat such as olive oil, avocados, and walnuts. Fruits and other vegetables are important as well because they are low in calories and a good source of dietary fiber and antioxidants. They also keep blood pressure in check.
“We say that indulgence is OK every now and then, but we want people to follow the 80-20 rule — 80% of what you eat should be healthy and 20% can be an indulgence,” Aftab says.
Also important when it comes to heart disease is knowing how it is diagnosed. General care physicians can order blood tests that measure cholesterol and blood sugar levels (high levels of either are possible signs of heart problems). More specialized tests include a stress test, which elevates your heart rate so doctors can check to see how well your heart is pumping blood; a coronary calcium screening, which looks for narrowing in the arteries caused by calcium deposits; and a coronary angiogram, a test in which dye is injected into the arteries so doctors can look for blockages.
Aftab says men should also be aware of the signs of coronary artery disease — including fatigue, chest pain with exertion that dissolves at rest, shortness of breath, and even erectile dysfunction — and should not be embarrassed or reluctant to seek medical help.
“A lot of men will neglect these signs — they will just downplay them and ignore them,” he says. “It's important that if you feel you are having symptoms, seek help from a physician.
“Men should take charge of their health,” Aftab adds. “Once they take charge of their health, they can make good decisions that will make a significant difference. Being mindful about their diet is taking charge of their health; increasing exercise is taking charge of their health. Men tend to be very stoic and avoid talking about it or seeking help when they have a health condition. It’s important not to skip the routine care or overlook any conditions or risk factors, especially family history.”