Preventing heart disease is all about the long game. It takes endurance, dedication, will-power, and a good support network. For some that may sound like pain, suffering, and torture. It doesn’t have to be like that though. Staying healthy can be challenging, but it’s rewarding, feels good, will boost your self-esteem, and can help you from becoming just another statistic.
To help you understand your risk of heart disease and what to do about it, here are 5 facts that all men need to know:
1. Just because you don’t have symptoms doesn’t mean you don’t need to see a doctor
The key thing to know about heart disease is that it’s not like a sprained ankle or a paper-cut. Heart disease takes years, often decades, to develop. When people finally have symptoms like chest pain, shortness of breath, or leg swelling, it may be too late. The best time to combat heart disease is before it starts. Although it may not be as simple as this, many people would probably prefer to exercise and eat well than have to be subjected to daily medications, procedures, and even surgeries years down the line. Modern medicine has great treatments for heart disease, but they’ll never get your heart back to what it was in the first place. There’s no better time to start than right now to get yourself on the right track.
2. Lifestyle changes are an important first step in being healthy, but some people need medications too
Let’s face it… no one wants to take medications if they don’t have to. On the flip side though, you shouldn’t feel like a failure if your doctor recommends a medication to help control your risk of having heart disease. For example, exercise and dietary changes can have great effects on your blood pressure and cholesterol. Some people still have numbers that are too high with those changes alone though. You may ask yourself, “If I feel fine and I’m living a healthy lifestyle, why do I need medicine?” If you’ve thought that before, the answer is simple. Lifestyle changes are definitely beneficial in reducing your risk of heart disease, but if they don’t bring your risk factors into a low risk category, adding a medication can actually help you prevent a heart attack, stroke, or other form of cardiovascular disease. It’s not that you’re not doing well enough, or trying hard enough. Some people have genetic contributions to their risk profile or just need a little extra to help them out. One shouldn’t be substituted for another, nor should it be an either or decision.
3. The average age of having a first heart attack in men is 65
There’s no getting around this one. In your 30s and think you’re off the hook? Think again. It takes decades for heart disease to develop? The reason why heart disease is so preventable – 80% preventable according to the World Health Organization – is because if you start early enough with lifestyle changes to prevent it, most of it won’t happen. The key point here is that you only know your risk if you check it. Since heart disease is the #1 cause of death in the US, everyone should have a heart check to make sure they understand their risk factors and how to modify them as best as possible to prevent anything bad happening years down the road.
4.Erectile dysfunction can be a sign of heart disease
Have people always told you to think with your brain and not your penis? That may be good advice, but in this case, you should definitely pay attention to what your penis is trying to tell you. Erectile dysfunction can have several different causes, but one important cause is called peripheral arterial disease. Essentially, the same way that arteries of the heart can become blocked by cholesterol, fat, and inflammation – called plaque – arteries in other parts of the body can become blocked the same way. The risk factors for both are the same, as are the treatments and preventive strategies. Don’t be embarrassed of this issue since it’s a very important one to discuss with your doctor if you have it. Research shows that erectile dysfunction can be an early sign of heart disease and present years before someone might have a heart attack.
5. Man’s best friend actually can help you live longer
Dogs have always been man’s best friend, right? Well, aside from all the other ways they’ve got your back all that drool and dog food may actually help you live longer. Dog owners actually tend to live longer than those going it alone. It probably relates to the exercise you get being active with your dog since those with hunting breeds get the most benefit. Regardless, pets are great for stress relief, companionship, and forcing you to be a little less of a couch potato. If dogs aren’t your thing, marriage can also actually help you live longer… for better or worse, in sickness and in health.
As you’ve probably heard, the guidelines that doctors should be considering to decide whether your blood pressure is “normal” or high have changed in the past couple years. Whereas anything less than 140/90 used to be reasonably okay for the majority of adults out there, the new guidelines have been criticized for being overly strict. So what are they? In general, the categories are now as follows:
Category
Blood Pressure
Normal
<120/<80
Elevated
120-130/<80
Stage 1 Hypertension
130-140/80-90
Stage 2 Hypertension
>140/>90
With these new categories, about 50% of adults over 40 will be classified as having at least elevated blood pressure, according to the American Heart Association (AHA)! Many have argued that for this reason it’s just a ploy to be able to prescribe more medications. They argue it’s quite the contrary though. Instead, by being able to classify more people with high blood pressure starting at lower numbers, this will provide the opportunity for many more to have recommendations to implement lifestyle changes earlier on. In fact, these lifestyle changes such as the right diet and exercise can lower blood pressure by as much as about 10 points. With that in mind, the number of people for whom a prescription medication is recommended to treat blood pressure actually isn’t much higher than it was before.
Before we get into what you can do about your blood pressure, let’s get into the nitty gritty of what blood pressure actually is. Then we can talk about why it matters and what you should do about it.
What is it?
Blood pressure is the result of the amount of fluid going through your blood vessels as a factor of how tight the blood vessels are – the resistance. Without getting into too much of the Physics, the easy way to think about why this matters is by using the analogy of lifting weights. No, this isn’t the age old trick question of whether it’s easier to lift a bag with a pound of rocks or a pound of feathers (it has to be the feathers, right?). Think of it in terms of whether it’s easier to carry a bag filled with rocks or an empty bag. Now put that in the perspective of your heart and blood vessels, which have to carry that load 24 hours per day, 7 days per week for your entire life. Of course, offloading the pressure too much – or causing very low blood pressure – might mean that there isn’t enough pressure to keep blood flowing to all of your organs given that us humans are upright and gravity is relentless. (Think of living on the top floor of a high rise versus the first floor if the water source is in the basement… your shower water pressure will be a lot better on the first floor.) However, blood pressure that’s too high forces your cardiovascular system (your heart and blood vessels) into overdrive in order to deal with it. Over the course of years, this can cause irreversible changes if left unchecked.
How should you check it?
Checking blood pressure isn’t as straight-forward as it may seem. Often times, doctors’ offices don’t even check it correctly. There’s more evidence that the best way to check blood pressure is throughout the day, multiple times with something called an ambulatory blood pressure monitor. It checks your blood pressure intermittently throughout the day and night while you do different activities to get a full range of what your blood pressure is actually like. This probably better represents your true numbers as opposed to the classic guideline-directed way of checking it in a quiet room in a seated position after you’ve had time to relax. A good, easy compromise between wearing a continuous monitor and checking in your doctor’s office all the time is to get yourself a good home blood pressure monitor. You can check your blood pressure daily and keep a log of the day, time, heart rate, blood pressure, and if you have any symptoms (such as pain, anxiety, headache, etc).
What should you do about it?
If you’re in the Normal category, great for you! It doesn’t mean you’re off the hook though. You’ll want to maintain a healthy diet and a regular exercise regimen to ensure that you stay as healthy as possible for many years to come. Since heart disease takes years to decades to develop, the sooner you start with healthy lifestyle changes, the better.
For those in the Elevated category, here’s your wake-up call. Blood pressure’s relationship to cardiovascular disease is directly related meaning that the higher it gets, the higher the risk. Although being in the category is certainly not a high risk situation, it’s an opportunity to really take advantage of the benefits that healthy lifestyle changes can have. By implementing a heart-healthy diet and an exercise program targeted at lowering your blood pressure, you could very well find yourself in the Normal category within a few weeks to months.
If your blood pressure falls into one of the Hypertension categories, fear not! Depending on your risk factors and how high your blood pressure is, you may be able to start with lifestyle changes to see if that brings you down to a normal range. However, most people in Stage 1 require at least one medication and most people in Stage 2 require two or more medications in order to control their blood pressure. The worst thing you can do is blame yourself for this and think of taking medications as a failure on your part. If that thought crossed your mind, let it keep crossing until it’s far gone. Many things factor into what your blood pressure is: diet, exercise, weight, stress level, hormones, age, sex, genetics, etc. While you can modify some of these factors, there are a good number of them we refer to as non-modifiable risk factors for heart disease, several of which are associated with higher blood pressure. While these things certainly aren’t your fault, it’s crucial to know about them because there are medications out there nowadays that you can couple with those important lifestyle changes to help you bring your blood pressure down to the normal range, essentially “curing” your high blood pressure. If you do take medication for hypertension and it’s working, don’t stop! Medications only work if you take them. It’s not like an infection where once you treat it for a little while, you’re good to go.
Furthermore, just because you take a medication doesn’t mean it replaces a good old fashion healthy lifestyle ((the best medicine of all).
Speaking with your doctor regularly to make sure you’re meeting your treatment goals is important since most people will require adjustments in their medications over time.
Key dietary changes you can make to help lower blood pressure are to decrease the amount of salt and red meat you eat. Salt has a tendency to hide in a lot of foods so it’s important to look at the nutrition labels of what you’re eating to truly get a sense of how much you’re taking in. Common offenders are processed foods such as deli meats or sausages, pasta sauce, and soup. You’ll want to aim for less than 2 grams of salt (sodium) per day if you’re looking to have an effect on your blood pressure.
If you’re worried that food won’t taste good without much salt, you’re in luck! Some great alternatives to salt that can really pack some flavor into food are garlic powder (not garlic salt) and salt-free seasoning mixes such as Mrs. Dash. Replace your salt shaker with those on your dinner table and you won’t even remember what salt is. If you really must have some of that salty flavor in your food, try potassium-based salt products instead of the usual sodium-based table salt.
Exercise
When it comes to exercise for blood pressure control, it’s important to add in resistance training to your workout plan. The new guidelines put forth by the AHA recommend 2.5-5 hours of moderate intensity physical activity that includes aerobic activity most days of the week and strength/resistance training on two or more days of the week. Basically, you’ll want to try to do some form of physical activity such as brisk walking, jogging, swimming, or biking that’s hard enough where you can’t say more than a few words without needing to take another breath. Then at least a couple days per week, you’ll want to do something like weights, squats, or yoga where you’re actually working on different muscle groups.
Aerobic exercise is important for your blood pressure because it gives your heart a workout that makes its usual job of pumping easier. Strength training is just as important though because as you work out individual muscles in your body – called skeletal muscles – the muscles grow and more blood can flow to them. As more blood flows to more places in your body, your overall blood pressure will go down. A good analogy for this is the water pressure flowing through your tap when you just have the sink running versus when you have every sink and shower running at the same time. When the water has to go to a lot of different places, the water pressure goes down… a concept that’s not good for your morning shower, but great for your blood pressure.
Summary
The job of Cardiologists is to individualize the guidelines. More than that, one single blood pressure reading that is elevated does not necessarily mean someone has a diagnosis of high blood pressure (hypertension). Even further, just because the guidelines classify blood pressure into these categories doesn’t mean that everyone has the same blood pressure goals. It very much depends on each individual person’s other medical issues as well as some other considerations.
All that said, as long as your doctor said it’s safe to do so, the first steps in lowering blood pressure are recommendations that everyone should follow. This includes lifestyle changes such as diet, exercise, and weight loss (if appropriate).
When it comes to heart health, things can get complicated. There are many more risk factors for heart disease than people may initially be aware of, but that doesn’t mean they don’t matter. More importantly, we don’t have control over all of our risk factors. The ones that we can change are called modifiable risk factors, such as blood pressure and diet. The ones we can’t, such as our age and family history, are called non-modifiable risk factors. Knowing some important information about your risk profile for heart disease can help you frame your outlook on how aggressive you should be about preventing it. One thing is certain… prevention works!
Here are five numbers you should know about yourself to help define your risk. Furthermore, they are the numbers you should try to work toward to optimize your risk and not become just a statistic.
Blood Pressure
There has been more recent evidence from research studies looking at what the best blood pressure is. To summarize the current train of thought for how low you should go, you must ask yourself, “How low can you go? Can you go down low?” We’re not talking about the dance floor here, but a blood pressure of less than 120/80 is ideal.
Checking blood pressure is easy and since it fluctuates throughout the day, the more data points you have, the better idea you’ll have of what your “real numbers” are. Just checking at your doctor’s office might not be enough to give an accurate representation of what your blood pressure is when it comes to how it affects your risk of heart disease. Automatic blood pressure cuffs are reasonably priced and could help keep you on top of your health game.
Cholesterol
There are a few different types of cholesterol hat doctors will check for to fully understand your risk, but in general you want a total cholesterol less than 200, an LDL less than 130 (or lower if you have other risk factors), and an HDL over 40 for men or 50 for women. If you have other health issues such as diabetes or a history of heart disease, your target numbers might be lower.
Blood Sugar
The best way to check for diabetes is to check a blood test called hemoglobin A1c (HbA1c). This test gives a sense of how high your blood sugar has been over the past 3 months. Type I diabetes, or the kind that people get diagnosed with as children is fundamentally different than type II diabetes, which is the more common type that more often affects people in middle-age or later. This is how type II diabetes happens.
It’s normal for blood sugar levels to fluctuate depending on whether you eat or are fasting, but the range of blood sugar should not be that wide. Insulin is something that our bodies make that comes from the pancreas and is responsible for allowing the cells in our body to use blood sugar for energy or store it for a later time. Just like the boy who cried wolf, if blood sugar remains high for long periods of time, our cells become less sensitive to the insulin our body is making, which results in the sugar staying in our blood stream. Insulin levels rise as blood sugar remains high to attempt to get cells to take up the excess circulating sugar. However, the cells in our body are trying to ignore the insulin because they don’t need any more sugar than they already have. When this imbalance of circulating sugar levels that get too high gets to a certain point, we call it diabetes. The more sugar there is sticking around in the bloodstream, the more it will cause changes to the cells in the blood. That’s exactly what we measure with the HbA1c. It’s essentially measuring the amount of “sugar-coating” on red blood cells, which are always circulating. A HbA1c less than 5.7% is ideal. Between 5.7% and 6.4% is called pre-diabetes, which is an at-risk category. More than that is when we diagnose diabetes.
BMI
BMI, or body mass index, is a calculation that gives a measure of how you weigh relative to your height. The formula is:
BMI = Weight (in kilograms) / [height x height] (in meters)
A BMI of 18.5-24.9 is normal. 25-30 is considered overweight and above 30 is obese. If you’re a bodybuilder and have a lot of muscle mass, the BMI equation doesn’t account for that. For most people though, it’s a reasonably good estimate at deciding whether you weigh too much, too little (yes, that’s not a good thing either), or just right.
Exercise
Uh oh… yes, I said it. Exercise is an important part of having good heart health. Research shows that about 8% of deaths and $117 billion of spending could be prevented by meeting the exercise guidelines recommended by the American Heart Association. The new guidelines allow you to choose your own adventure, so-to-speak. If you’re a go big or go home kind of person, you can do as little as 75-150 minutes of strenuous aerobic exercise that incorporates some type of strength training (such as circuit training) each week. If you prefer to enjoy the journey, you can do 150-300 minutes of moderate intensity aerobic exercise spread throughout each week incorporating strength training on at least 2 days each week. The choice is yours, but the recommendation is important.
It may seem daunting to have to think about all these numbers and what they mean for you. The good news is that it’s not the snapshot of these numbers at any one point in time that’s the be-all-end-all for someone. The important part is what these numbers, along with other risk factors for heart disease, do over time. Heart disease usually takes decades to get to the point of a heart attack or stroke. That means you have plenty of time to work on your health and invest in making the future you the best version yet!
