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Getting to the Heart of the Matter with Men

OUR HEALTH:

Rob Johnson

May 04, 2011

             The widely publicized advice that doctors have been giving men for decades about maintaining healthy hearts just isn’t getting through to many patients.
            “Certainly smoking cessation has a huge impact on reducing cardiovascular events, but in our area and around the country men continue to smoke at a high rate,” says Dr. David Sane, chief of the cardiology section at Roanoke’s new Carilion Clinic and Virginia Tech School of Medicine.
            Sane’s concerns about men’s poor heart-health habits also include the widespread potential for lack of sleep due to worry over personal finances and job security as the sluggish economy lingers. “Quite a bit of research links poor sleep patterns to” heart disease and obesity, says Sane. He adds, “With the economy making a lot of people sleep poorly and take two jobs to make ends meet,” there’s the potential for many patients to lack proper rest.
            So while the message about healthy heart behavior isn’t new, neither is the failure of many men to follow through.
            What’s more, some men who experience certain symptoms in areas of the body other than their chests often aren’t recognizing them as potential warnings of cardio threats. One common example is pain in the back of the thighs or buttocks that Dr. Sane says is best described as “cramping or aching.”
            These pains are frequently associated with exercise and men, in particular, may be inclined to tough it out. But Sane says such soreness can be a warning of peripheral arterial diseases, and should prompt seeing a doctor.
            Another malady that tends to be viewed by men without connection to potential heart problems is erectile disfunction. “The principal cause of erectile disfunction is a blood flow issue, so the man that has ED also has an increased cardiovascular risk profile. He should be concerned not only about his ED but about” possible heart disease.
            Sane adds, “If a patient has ED, that should be fully discussed with his doctor.”
            Then there’s depression, another issue that some men may view in a vacuum, without considering its possible cardiovascular implications. Sane says there’s a growing body of research that shows depression tends to “accentuate cardiovascular risk,” but male patients have “historically been reluctant to bring that up.”
            Thus no matter what treatment, if any, a patient decides to seek for depression, the primary physician should be consulted with regard to possible heart problems.
            Like some other cardiologists in Southwest Virginia and across the nation, Sane has taken note of recent research indicating that vitamin D supplementation could make a difference in heart disease risk among people who have low levels of the nutrient. But he holds the widely shared medical opinion that the early results of vitamin D studies aren’t conclusive.
            Sane is among the many cardiologists who are also dubious about recent studies that show a relationship between levels of low testosterone and high cholesterol in men. He recalls early research a few years ago that seemed to show a similar connection between women’s estrogen levels and their cardiovascular risks. But further studies, he says, indicated “estrogen is not effective against cardiovascular events and may actually be detrimental.”
            Indeed, some of the most reliable research may seem like ancient history to many. But Sane asserts that recent research on a healthy diet points out that “what our mothers told us about eating your fruits and vegetables was right.”
            One result of healthy eating is almost impossible to miss: a waistline that doesn’t bulge. Roanoke area physicians are among those routinely displaying posters asserting that men, regardless of height and bone structure, should have waistlines measuring a maximum of 40 inches.
            That standard, research indicates, is more reliable than the numerous charts that specify desirable weights for patients of various body builds. Doctors say that some men may try to reassure themselves they’re on the right eating track when dropping a few pounds as indicated on their bathroom scales. But single-digit weight differences can come and go almost daily, while the waistline is a more consistent gauge.
            And if men aren’t being vigilant or entirely honest with themselves about waistlines, pain, depression, erectile disfunction or other possible indicators of cardio risk, says Sane, “their spouses or significant others can serve as a positive force” by being insistent they seek medical advice.

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