You’ve obviously heard the reference to another man as a “heart attack waiting to happen.” Well, there’s some truth in that gallows humor: Heart disease is the leading cause of death for men in the United States and worldwide.
For the man who regularly consults with his doctor, however, heart disease and its potentially fatal consequences are usually avoidable.
“Approximately 80 percent of cardiovascular disease is preventable with appropriate risk assessment and taking action to reduce the risk,” says Dr. Waseem Chaudhry, the Tallwood Men’s Health cardiologist who specializes in cardiovascular disease prevention.
It’s a fairly simple equation. If you have high blood pressure, diabetes, high cholesterol or a family history of cardiovascular disease, you could be at risk. Your obligation to good health and a long life starts with a basic exam and tests to evaluate your vulnerability.
Fast Facts
- One in every four male deaths in the United State is attributable to heart disease.
- Coronary heart disease is more common in men (7.4 percent) than in women (5.3 percent).
- Men (3.8 percent) are more likely than women (2.3 percent) to have a heart attack.
- Men who have a heart attack experience it about seven years earlier than women who have a heart attack.
- Men with erectile dysfunction are more than twice as likely to have a heart attack or stroke.
Five Symptoms Of Heart Disease
- Unusual feeling in chest (discomfort, pain, tightness).
- Difficulty breathing even after moderate physical exertion.
- Dizziness, fainting.
- Pain in back, upper abdomen, neck, throat or jaw.
- Irregular heartbeat.
The List: Types Of Heart Disease
Here are some common types of heart disease that can be identified and treated by visiting a Tallwood Men’s Health cardiologist, with support from Hartford HealthCare's Heart & Vascular Institute:
- Coronary Artery Disease: When plaque accumulates in the wall of coronary arteries that bring blood and oxygen to the heart, these small blood vessels begin to narrow. The plaque buildup, which includes cholesterol and other substances, can eventually block blood flow to the heart. Coronary artery disease, also known as coronary heart disease, is the leading cause of death in the United States.
- Angina: Chest pain, tightness or other discomfort in an area of the heart that is not getting enough oxygen-filled blood. It’s not uncommon to hear people describe it as indigestion. The pain can extend to the arms, shoulders, neck, back or jaw, is actually a sign of coronary artery disease – the most common heart disease.
- Arrhythmias: An irregular heartbeat that feels like a skipped beat, an extra beat or a mild fluttering. During this irregularity, the heart might not supply enough blood to the body.
- Atrial Fibrillation: An irregular beating of the upper chambers of the heart that can cause palpitations, light-headedness, dizziness, shortness of breath and chest pain.
- Heart Failure: When your heart doesn’t pump enough blood and oxygen for other organs in your body. It’s often called congestive heart failure because of fluid accumulation in the lungs, liver, arms, legs and gastrointestinal tract.
Five Signs You Should See A Cardiologist
- You are a smoker, or former smoker.
- You have high cholesterol, high blood pressure or diabetes.
- You are overweight or obese.
- You have gum disease (swollen gums are often a sign of heart disease).
- You have a family history of heart disease or stroke.
How We Can Help
The Tallwood Men’s Health cardiovascular disease prevention center gives you a comprehensive assessment of your risk of developing a heart attack or stroke.
“We use the cutting-edge, research-based cardiovascular risk assessment equations and blood markers such as Lipoprotein-A levels, cardiac C-reactive protein,” says Dr. Chaudhry, “combined with coronary artery calcium scoring to develop a customized plan to minimize risk of a cardiovascular event.”
Coronary calcium score screening uses a special type of imaging technology called a CT scan to take a close look at your arteries and blood vessels. This heart scan is not invasive and uses a very low dose of radiation.
The images will spot calcium buildup that can lead to heart attacks. Your calcium score is based on how much calcium you have; the higher your score, the greater your risk.
What’s In Your Blood Test?
A simple blood test is a foundation of your cardiovascular risk assessment. We use the latest risk calculations, based on a new interpretation of a formula known as Pooled Cohort Equations introduced in 2013 by the American College of Cardiology and the American Heart Association that help us determine if you need a simple clot-prevention drug like aspirin, cholesterol-lowering statins or blood-pressure medications.
“This is not the only risk-score equation we use to assess someone’s risk,” says Dr. Chaudhry. “The risk scores are there to guide but it’s clinical judgment along with other things such as family history of premature coronary disease -- which is not included in any of the risk scores – we use to evaluate a patient.”
We anticipate the revised calculations, presented in the June 2018 Annals of Internal Medicine, will greatly improve the accuracy of cardiovascular risk estimates. Almost immediately, they revealed up to 11 million Americans with cardiovascular disease might have to alter their medication.
“Anyone already on ASA (acetylsalicylic acid, or aspirin) and statin,” says Dr. Chaudhry, “can come to Tallwood Men’s Health to fine-tune their statin dose based on their lipid profile and risk of heart attack and stroke.”
The 2013 risk calculations might have been off by an average of 20 percent, with African Americans -- underrepresented in the data that contributed to the original standards – even more likely in need of a new medical evaluation. (The original data included information from people who were between 30 and 62 years old in 1948.)
The new guidelines project more African Americans with an increased risk for cardiovascular disease and more older, white adults with a lower risk estimate.
Researchers also say adding three biomarkers – the body’s molecules that can reveal your health – easily identified in a blood test will help doctors better determine the risk of all cardiovascular disease events, including heart failure, in older adults.
Cholesterol
Excessive cholesterol that accumulates in your arteries increases your risk of heart disease.
“Men develop lower testosterone levels as they age,” says Dr. Chaudhry, “leading to development of unfavorable blood cholesterol levels, abdominal obesity and weight gain that increases their risk of a heart attack.”
Two types of lipoproteins deliver cholesterol to your body, low density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL earned its nickname (“the bad cholesterol") because it can clog your arteries. HDL cholesterol helps prevent heart disease, so higher amounts in your blood is better. That’s why HDL is known as “the good cholesterol.”
What are your cholesterol levels? You can see what they mean using these guidelines:
Total Cholesterol Level
- Less than 200 mg/dL: Desirable.
- 200-239 mg/dL: Borderline High.
- 240 mg/dL and higher: High.
LDL (Low Density Lipoprotein) Cholesterol Level
- Less than 100 mg/dL: Optimal.
- 100-129 mg/dL: Near Optimal/above optimal.
- 130-159 mg/dL: Borderline high.
- 160-189 mg/dL: High.
- 190 mg/dL and above: Very high.
HDL (High Density Lipoprotein) Cholesterol Level
- Less than 40 mg/dL: Major risk factor for heart disease.
- 40-59 mg/dL: Better.
- 60 mg/dL or higher: This level is considered a protector against heart disease.
Lipoprotein(a) Test
Lipoprotein(a): A standard blood cholesterol test reveals low-density lipoprotein (“bad” cholesterol), high-density lipoprotein (“good cholesterol”), triglycerides and total cholesterol levels. If you have a family history of heart disease or an existing heart condition, your doctor can get greater insight into your risk of heart attack and stroke with a measure of lipoprotein(a), a particle in the blood that transports cholesterol, fats and proteins. Lp(a), rich in cholesterol, represents a strong risk factor for cardiovascular disease.
Why You Should Know Your Family Health History
If you don’t know your family health history, do a little research before you see your doctor. A little knowledge could help you avoid both heart disease and stroke.
Try to get the answers to these questions:
- Do your parents or siblings have high blood pressure or high cholesterol?
- Did your mother or sister have a heart attack before age 55?
- Did your father or brother have a heart attack before age 45?
- Do your parents or siblings have a heart rhythm disorder?
- Were your mother or sister diagnosed with heart disease or vascular disease before age 65?
- Were your father or brother diagnosed with heart disease or vascular disease before age 55?
C-Reactive Protein Test
Levels of this protein, produced by the liver, increase inflammation in the body that, inside arteries, accumulates plaque. It’s the beginning of atherosclerosis.
Coronary Calcium Scanning
A computed tomography (CT) scan of the heart is called a coronary calcium scan when your doctor is using this X-ray test to determine if you have calcium buildup in your arteries. (When needed, it’s available at Hartford Hospital.)
“We use coronary calcium scanning to evaluate someone for definitive atherosclerosis (hardening of the arteries)," says Dr. Chaudhry, “and guide the decision to treat and how aggressively to treat. The coronary calcium score greatly helps to reclassify a patient to lower or higher risk based on absence or presence of coronary calcium.”
High Blood Pressure
Blood-pressure results, using a familiar device (wrapped around the upper arm) with an unfamiliar name (sphygmomanometer), are provided with one number on top of another. The numbers represent millimeters of mercury (mmHg).
Systolic blood pressure (top): This is the pressure of your blood against the artery walls as the heart beats. Pay close attention to this number. For people over age 50, it’s considered a major risk factor for cardiovascular disease.
Diastolic blood pressure (bottom): A similar measure taken between beats, with the heart at rest.
The results are given as the top number “over” the bottom number, as in “120 (systolic) over 80 (diastolic).”
Here are the five blood pressure ranges recognized by the American Heart Association:
- Normal blood pressure: 120/80.
- Prehypertension (early stage high blood pressure): 120-to-139/80-to-89. Recommendation: If you don’t follow your doctor’s plan to control your blood pressure, you will likely develop hypertension.
- Hypertension Stage 1: 140-to-159/90-to-99 mm Hg. Recommendation: Lifestyle changes, possible blood-pressure medication.
- Hypertension Stage 2: Greater than 160/100 mm Hg. Recommendation: blood-pressure medication, lifestyle changes.
Heart & Vascular Institute Locations