The Heart of the Matter: Heart Disease in Men

Heart disease is the leading cause of death in men in the United States. (4) You may have heard these alarming health statistics and wondered “what is heart disease and what can I do to prevent it?” Heart disease, also known as cardiovascular disease, is an umbrella term that describes problems with the heart and/or blood vessels. There are many different conditions that fall under the cardiovascular disease umbrella such as atherosclerotic cardiovascular disease and coronary heart disease. (7) While cardiovascular disease is both a serious and common health concern, there are many lifestyle factors that can be modified to prevent or reverse the condition. Keep reading to learn more about the types of cardiovascular disease as well as lifestyle considerations for prevention and addressing the condition.

What is heart disease?

As previously mentioned, cardiovascular disease (CVD) is a broad term that describes problems or diseases of the heart and blood vessel system. Conditions that are classified as cardiovascular system diseases include arrhythmias, atherosclerotic cardiovascular disease, congenital heart disease, coronary heart disease, heart failure, hypertension (high blood pressure), and peripheral artery disease. (7)

Types of cardiovascular diseases and contributing factors

While a person with congenital heart disease is born with a problem either in the structure or function of their heart, most cardiovascular diseases arise from a combination of family history and lifestyle factors. (20) The good news is that most types of CVD are preventable. The bad news is that many people do not know that they have CVD until things have progressed significantly because cardiovascular disease symptoms are typically not apparent in the early stages of disease. (12) This makes it imperative for adults to understand their risk for CVD and to act accordingly. Some expert guidelines recommend that screening and risk assessments for cardiovascular disease begin around the age of 20. (12) For men, simply having a Y chromosome and male sex hormones increases their risk of developing and dying from certain types of CVD until approximately age 65. (6) As women age and pass menopause, their risk of CVD surpasses that of men. (19) Understanding some of these differences may inform monitoring, prevention, and treatment efforts for men.

Atherosclerotic cardiovascular disease in men

Atherosclerotic cardiovascular disease, also known as arteriosclerotic cardiovascular disease, is a condition in which the walls of the arteries thicken and narrow as a result of lipid (fat) build-up inside of the artery walls. Plaque build-up in the arteries begins during childhood and continues throughout life, but the exact cause of atherosclerosis is not well-understood. Smoking, eating high amounts of saturated and trans fats, high blood pressure, and high blood glucose levels have all been associated with the development of atherosclerosis. Emerging evidence is also showing that the microbiota, the microbes that live in and on the body, may also play a role in the development of atherosclerosis. (16) The thickened/narrowed areas of the arteries can result in obstructed blood flow to the heart, a condition known as coronary heart disease.

Coronary heart disease in men

Coronary heart disease is the most common type of heart disease in the United States. (3) Men tend to suffer more frequently from this condition, experiencing blockages in the coronary arteries that have the potential to cause myocardial infarctions (heart attacks). They also tend to develop problematic atherosclerosis in their arteries at a younger age than women, so their risk for heart attacks increases about ten years earlier than women. (19) For reasons that are not well-understood; however, women are more likely to die from a heart attack than men. (11)

Men are at a greater risk of developing and dying from certain types of cardiovascular diseases until approximately age 65.

Hypertensive cardiovascular disease in men

Another common type of CVD is hypertensive cardiovascular disease, commonly referred to as high blood pressure. High blood pressure occurs when the force of the blood pumping through the arteries is too high. Blood pressure readings are measured in millimeters of mercury (mmHg) and are determined by two numbers. The first is systolic blood pressure, which measures the amount of pressure exerted against the artery walls with each heartbeat. The second is diastolic blood pressure, which indicates the amount of pressure exerted against the artery walls in between heartbeats. (1) Normal blood pressure is less than 120/80 mmHg, whereas elevated blood pressure is defined as 120-129 mmHg systolic and <80 mmHg diastolic blood pressure. (1) A person with these elevated levels may be advised that they are at risk of developing high blood pressure. Lifestyle changes and potentially medication may be recommended once blood pressure reaches 130-139/80-89 mmHg, defined a stage 1 hypertension, and these recommendations become more likely once the blood pressure exceeds 140/90 mmHg, characterized as stage 2 hypertension. (1) As with coronary heart disease, men tend to develop high blood pressure at a younger age compared to women. (19) The prevalence of high blood pressure is also higher in men aged 20 to 65 than in women, differences that appear to be attributed to the way in which the male body controls fluid balance. Therefore, there may be indications to use different treatment modalities between sexes; however, further research is needed to better understand these unique considerations. (14) Download a handout on high blood pressure.

Heart failure

Over time, the effects of cardiovascular diseases such as atherosclerotic and hypertensive cardiovascular disease can progress to heart failure. Heart failure occurs when the heart becomes unable to efficiently provide blood flow to the body, leading to symptoms like fatigue, shortness of breath, fluid retention, and congestion. (10) The prognosis for heart failure is rather poor, particularly in men. (9) Slowing the progressive nature of cardiovascular disease is the best hope to prevent heart failure and mortality from this difficult to manage condition.

Eating a healthy diet can reduce your risk of cardiovascular disease.

Top 3 lifestyle considerations for heart disease

While some heart disease risk factors, such as age or family history, are not modifiable, others are within an individual’s control. Research shows that lifestyle modifications can prevent a great deal of fatal cardiac events, even in men taking medications to manage CVD. (8) For a man of any age, below are recommendations to reduce the risk or slow the progression of cardiovascular disease.

Maintain a healthy weight

One easy target for weight management is to strive to maintain a healthy body mass index (BMI), a ratio of weight to height. The healthy BMI range is between 18 to 25.9 kg/m2. (5)(22) According to one study, reductions in baseline BMI is associated with a lower risk for fatal and nonfatal CHD. (21) Maintain a healthy weight by engaging in regular physical activity, avoiding processed foods, and consuming whole, unprocessed foods such as fruits, vegetables, lean meat and poultry, fish and seafood, eggs, beans, whole grains, legumes, and nuts and seeds. (13)

Get an adequate amount of physical activity

Moderate exercise for 30 minutes, five to seven days per week can help support cardiovascular health and maintain a healthy weight. (3)(18) Research indicates that exercise, such as weight training, running, and walking, is associated with reduced CHD risk. (17)

Consume a heart-healthy diet

Increasing the intake of fresh fruits and vegetables and whole-grains, while striving to reduce intake of red meats and foods with high sodium content can help support heart health. Increasing the intake of low-sugar fruits and vegetables is a great way to replace higher calorie processed foods and snacks, while also increasing the consumption of potassium, which can help with blood pressure control. The DASH diet is also an excellent eating pattern to improve heart health. (2)(15)

The bottom line

Heart disease, the leading cause of death for men in the United States, is responsible for more deaths in men than cancer and chronic lung disease combined. (3) Both genetic and lifestyle factors contribute to the development of CVD, and there are many different clinical presentations and treatments. The risk for CVD can be reduced through lifestyle modifications such as maintaining a healthy weight, eating a balanced diet, and being physically active. Once CVD has been diagnosed, treatment may involve a combination of lifestyle modifications, pharmaceutical agents, surgery, and possibly cardiac rehabilitation. Care for cardiovascular disease can seem complex and overwhelming; however, working with your integrative health practitioner and making a personal commitment to living a healthy lifestyle can yield successful results in improving the disease prognosis.