What Every Man Should Know About Heart Disease

By Leslie Laurence

One-half of American men and one-third of American women age 40 and younger will develop heart disease at some time in their lives, according to the Centers for Disease Control and Prevention. For men, the situation is particularly dire. Not only do they suffer from cardiac disease an average of 10 years earlier than women, but they’re also more likely to die prematurely from it.
           
Yet healthy middle-age men “tend to minimize the potential risks and symptoms” of a cardiovascular condition, says Michael Fleming, M.D., president of the American Academy of Family Physicians. “It’s not uncommon for a man to come to see me and say, ‘I’ve been having chest pain for the last two months,’ and be unaware that he may be moments away from a heart attack.”
           
Here are four heart-healthy lifestyle facts that men—and the women in their lives—need to know.

Anger Can Be Deadly
Uncontrolled anger and hostility have been linked to heart disease in men for some time. A study published in March 2004 in Circulation, a journal of the American Heart Association, is the first to show that a fiery temper can cause a specific heart-rhythm disorder known as atrial fibrillation (AF), which can lead to stroke and death.
           
The study followed 1,769 men and 1,913 women whose average age was 49. Men who scored high on several standard psychological tests that measure anger (more angry outbursts, got furious when criticized, and felt like hitting someone when angry) and hostility (more likely to act contemptuously toward others) were 10–30 percent more likely to develop AF and 20 percent more likely to die from the cause.
           
In contrast, emotional eruptions didn’t affect women’s heart health, perhaps because they develop rhythm disorders later than men or “anger and hostility may not be risk factors for women,” says Elaine D. Eaker, Sc.D., of Eaker Epidemiology Enterprises in Wisconsin.
           
The results suggest a man prone to temper tantrums should learn to relax before he blows a gasket.

Friends are Important
Men who spend time with friends on a regular basis are about half as likely as their isolated counterparts to develop heart disease. A 2004 study published in European Heart Journal followed 741 men for 15 years, starting at the age of 50, and noted their levels of social support. It found that friendless men were more likely to have evidence of inflammation in their blood vessels.
           
While the mechanism by which relationships make for a healthier heart is still unclear, researchers note that the differences were not related to stress or other risk factors.

Exercise Is Your Best Medicine
Men with coronary artery disease often are treated with angioplasty, a procedure that uses a small, flexible tube to open clogged arteries. But now it appears that a mere 20 minutes a day of exercise may be more effective than angioplasty at preventing a subsequent heart attack, according to a report in the March 2004 issue of Circulation.
           
The study involved 101 men ages 70 and younger, all of whom had at least a 75 percent narrowing of one artery. They were randomly assigned to either the exercise regimen or the stenting procedure. After a year, 88 percent of the men who exercised were spared a heart attack, compared with 70 percent of the men who underwent angioplasty. Because this was a small study, it’s too early to suggest all men swap angioplasty for exercise. But it does indicate that adding exercise to medical treatment is a good move.

Drink and Be Merry
Cardiologists typically advise men with high blood pressure not to imbibe alcohol because heavy consumption can raise blood pressure. But new research suggests that light to moderate drinking reduces the risk of death from heart disease among this group of men.
           
A study of 14,000 males over the age of 40 with hypertension found that those who had one or two drinks a day (any type of alcohol) were 44 percent less likely to die of heart disease over a five-year period than hypertensive men who rarely or never drank. This protection may be due to the fact that alcohol raises levels of good cholesterol, which may reduce the plaque in the arteries. Ask your doctor about the benefits and risks of moderate drinking.