Originally published in Men’s Health
May 30, 2003

Here’s something men are good at: dropping dead of heart disease. Every year, cardiovascular problems cause nearly half of U.S. male deaths—a third of them by complete surprise. 

Don’t follow that pack. Every year scientists discover new ways men can protect their hearts—from steps you can take to avoid problems, to drugs and gadgets that can help if you already have heart disease. We asked heart researchers to boil it down to 10 simple rules men can follow.

Get the Latest, Greatest Test

That’s the highly sensitive C-reactive protein test, or HSCRP. A study reported in the New England Journal of Medicine found that this blood test is twice as effective as a standard cholesterol test in predicting heart attacks and strokes. It measures the levels of a specific blood protein that indicates that you have inflamed heart arteries—the kind that rupture and cause heart failure. Advertisement – Continue Reading Below

When researchers at Brigham and Women’s Hospital in Boston monitored 30,000 women for 3 years, they found that those with the highest levels of CRP suffered a much higher rate of heart attacks and strokes. And this result is perfectly applicable to men, says Paul Ridker, M.D., the lead study author.

“Since half of all heart-attack victims have normal cholesterol levels, the HSCRP test is a much better way to figure your true risk,” he explains. Ask your doctor to perform the $15 HSCRP test (not the standard CRP test; that’s important) along with your regular cholesterol test. “That gives you plenty of time to make some serious lifestyle changes to reduce the risk,” concludes Dr. Ridker.

Keep up With Your Exercise

Over the past 4 decades, dozens of studies have shown that exercise is good for your heart. But here’s the catch, according to a recent survey: You’re only as strong as your last workout.

Doctors from the Framingham Heart Study in Massachusetts compared people who’d only recently started exercising with those who used to exercise regularly but stopped. Their finding: The cardiovascular mortality rate was 40 percent lower among the current exercisers.

“The benefits of exercise wear off quickly,” says Scott Sherman, MD, of the UCLA school of medicine. Fortunately, the benefits of exercise also show up quickly, so if the only physical activity you ever have is moving pawn to knight six, you’re not dead–yet. “The study shows that for sedentary patients, it’s never too late to start being active,” says Dr. Sherman.

Lift Weights

Weights can make your biceps look good, but they’re also good for your heart. Why? In addition to lowering cholesterol and blood-pressure levels, stronger muscles make physical exertion, especially lifting or carrying things, less taxing. “Stronger muscles result in a significant reduction in heart rate and blood pressure while you’re carrying a heavy object,” says Barry Franklin, Ph.D., director of cardiac rehabilitation at the William Beaumont Hospital in Michigan. This may help you avoid straining your heart during exertion, which can cause a heart attack.

Don’t Smoke Pot

The only thing more pathetic than a 43-year-old guy who still gets high is a 43-year-old guy who gets high then drops dead of a heart attack. Unfortunately, if you’re still smoking pot, that could be where you’re heading. A new study from Beth Israel Deaconess Medical Center in Boston shows that inhaling marijuana quintuples your risk of a heart attack for 1 hour after lighting up. Trust us on this: Dropping dead in a 7-Eleven with a bag of Chee-tos in one hand and a Big Gulp in the other is no way to leave this world. Put down the weed.

Buy Extra-Virgin Olive Oil

Spend the extra buck—it could cut your risk of heart disease. In a recent Spanish study, subjects who ate meals drizzled with extra-virgin olive oil lowered their LDL (bad) cholesterol levels by 4 percent more and raised their HDL (good) cholesterol by 2 percent more than the people who ate refined olive oil, which has fewer antioxidants than extra-virgin oil. That’s impressive. Even more impressive? Nowhere in the study did doctors make fun of the phrase “extra-virgin.”

Talk to a Genetic Counselor

In spite of the time-sucking questionnaire he gives you, your doctor probably knows next to nothing about your family health history. That’s bad, because it’s the most important medical information you have. The solution: See someone trained to give your background the attention it deserves. Advertisement – Continue Reading Below

Genetic counselors analyze your family health data (going back to your great-grandparents, if possible) and determine your risk of heart disease, cancer, and other problems. “We determine if an individual is at risk for disease and then target therapies to reduce that risk,” says Helen Hixon, of the GenRisk program at Cedars-Sinai Medical Center in Los Angeles.

Most major hospitals now have genetic counselors. To find one near you, call the National Society of Genetic Counselors at (610) 872-7608. Yes, most insurance carriers pay for this service.

Take a Picture of Your Heart

The problem with heart disease? You may not know you have it until you’re clutching your chest and hearing harp music. A new procedure called an electron-beam cat scan (EBCT) could be a solution. Aimed at men over 40, the EBCT gives your doctor a 3-D image of your heart and blood vessels and can show blockage in its early stages—before it causes problems. “The key benefit of this is early detection,” says Douglas Triffon, MD, of the Scripps Clinic and Research Foundation in La Jolla, California. An EBCT takes only 5 minutes, costs $495, and doesn’t even require you to take off your clothes. For more information on the test, check the Web at http://www.lifescore.com.

Get on the Treadmill

It’s not new technology, but according to a study from the University of Maryland school of medicine, the traditional treadmill stress test is the single best predictor of heart trouble—better than age or blood pressure.

The catch, of course, is that you can’t ignore the results if they suggest a problem. “We do sometimes see false positives in the stress test, and there has been a tendency for people to ignore their results. But this study shows it’s not smart to do that,” says Leslie Katzel, MD, of the University of Maryland. Dr. Katzel says it’s not necessary to undergo a treadmill test every year, but it’s a good idea to have one when you turn 40, especially if you’re starting an exercise program.

Pop a Pill, Not a Balloon

Every year nearly 500,000 men undergo angioplasty. A doctor inflates a balloon inside a patient’s coronary artery to clear out blockage and start blood flowing again. Problem is, the procedure can be dangerous, and in up to 30 percent of cases the artery clogs again within 6 months.

Fortunately, there may now be a better alternative: taking high doses of cholesterol-reducing statin drugs. In a study last year of patients with coronary-artery disease, half underwent angioplasty and half were treated with the statin drug atorvastatin. The atorvastatin group had fewer heart attacks within the next 18 months. “Statins are proving that blood vessels aren’t just plumbing that needs to be reamed out,” says James Froehlich, M.D., director of vascular medicine at Beth Israel Deaconess Medical Center in Boston. Dr. Froehlich says statins do more than clear blood vessels—they actually help the vessels become larger to accommodate greater bloodflow.

Ask Your Doctor About Ramapril

For 30 years, Ramipril has been used as a hypertension drug. But a study from McMaster University in Ontario shows that it actually helps prevent heart attacks and strokes, and even makes you less likely to need bypass surgery.

In the study, which included nearly 10,000 patients (80 percent of whom had coronary artery disease), vitamin E and Ramipril were tested against placebos. The subjects taking vitamin E showed no benefit, but those taking Ramipril had a 25 percent reduction in death rate.