Heart disease is the No. 1 killer of men (and women) in the USA, so it's no wonder that cardiologist Gordon Tomaselli dispenses direct, no-nonsense advice: "Get up and move more, don't smoke, make sure you control your blood pressure and cholesterol, and don't ignore symptoms of heart disease, particularly if you have a family history."
It may sound difficult, but the results could be lifesaving, says Tomaselli, president of the American Heart Association (AHA) and director of the division of cardiology at the Johns Hopkins University School of Medicine in Baltimore.
Heart disease or cardiovascular disease are umbrella terms used to describe disease processes of the heart.
Although the rate of death from cardiovascular disease declined by 31% from 1998 to 2008, the disease is still the leading cause of death in the USA. One in every three deaths are from heart disease and stroke, according to the heart association and the Centers for Disease Control and Prevention.
Men often develop and die from heart disease at a younger age than women, says Russell Luepker, Mayo professor of public health at the University of Minnesota and a spokesman for the American Heart Association. "While more women die of heart disease, they die at a later age from it than men."
Why men are vulnerable
Men suffer from the disease at a younger age because they "tend to have higher blood pressure, higher cholesterol, and they are more likely to be smokers than women," says Luepker, program director of the Minnesota Heart Survey, a population-based study that tracks trends in heart disease.
And men are less likely to be treated for high blood pressure than women, he says. "Men are not seekers of care. We did a study a couple of years ago, and we autopsied people who were under 60 who died a premature, sudden death - 95% of them were men. Practically all of them had heart disease. They all had physicians and medical insurance but rarely went to the doctor.
"They may have gone to the doctor because they cut their finger with a hedge trimmer, but they weren't going in and being evaluated for heart disease."
One big problem for men is a lot of them don't manage their blood pressure as well as women do, he says. "It's better than it was 10 years ago, but women still do better."
High blood pressure is the most significant risk factor for heart disease, Tomaselli says. It means the blood running through your arteries flows with too much force and puts pressure on your arteries, stretching them past their healthy limit and causing microscopic tears, the heart association says.
Unfortunately, the scar tissue that forms to repair those tears traps plaque and white blood cells, which can lead to blockages, blood clots and hardened, weakened arteries, the heart association says.
One in three adults have high blood pressure, but many people don't even know they have it, the heart group says. The risk can be reduced by following a healthful diet, including cutting back on salt; exercising; keeping a healthy weight; managing stress; limiting alcohol; and avoiding smoking, Tomaselli says. But some people who do those things may still need medication, he says.
If one prescription medication for hypertension doesn't work, you usually can find another that is going to cause you few or no side effects, Luepker says.
Maintain your plumbing
Heart disease is largely preventable, says Gina Lundberg, a cardiologist in Atlanta.
She tells her patients that there are multiple things that can go wrong with your heart, just like the things that go wrong with your house. Your heart, like your house, has plumbing, electricity, doors and walls.
The plumbing in your heart is the coronary arteries that can get blocked up, Lundberg says. The heart has an electrical system that can result in irregular heartbeat or arrhythmia. The doors of the heart are the heart valves and the valves can leak or not open properly and need to be replaced. The walls of the heart can be weak or enlarged which can lead to congestive heart failure, she says.
Adds Tomaselli: "If you have known risk factors for heart disease - diabetes, high blood pressure, high cholesterol, you need to get them under control. It's better to be safe than sorry."