On World Heart Day on 29 September, it’s important to be aware of all the issues that can affect your heart.
According to the Singapore Heart Foundation, 23 people die from cardiovascular disease (heart diseases and stroke) every day here. Cardiovascular disease accounted for 31.4 per cent of all deaths in 2022, meaning that more than one in three deaths in Singapore was due to heart diseases or stroke.
Heart disease is a clear and present danger for both sexes, but men do have some heightened risks in certain situations and their symptoms can come on very suddenly with serious consequences, says Dr Tan Sian-Tsung, Specialist in Cardiology and Consultant, Raffles Heart Centre.
“If you have any concerns about the health of your heart, the best way to address them is to consult a cardiologist,” he adds.
“Ultimately, the focus should be on addressing risk factors, getting treatment early, and preventing more serious health problems from occurring.”
Q: What are some of the most common heart issues?
Dr Tan: These include:
Coronary artery disease: This occurs when the heart’s blood vessels – the coronary arteries – become narrowed or blocked due to plaque build-up and, as a result, can’t supply enough blood, which contains oxygen and nutrients, to the heart. This process, also known as atherosclerosis, can lead to angina and/or a heart attack.
Angina is a pain or discomfort in your chest, arm, neck, stomach or jaw that happens when the blood supply to your heart becomes restricted.
Heart attack (myocardial infarction) is caused by a reduction or complete cessation of blood to a part of your heart, resulting in tissue damage.
Heart failure: This happens when the heart is unable to pump an adequate supply of blood to the body to maintain bodily functions. Significant coronary artery disease for instance, is one of the major causes of heart failure.
Arrhythmias: The heart muscle has its own electrical impulses that coordinate the heartbeat. When these do not work correctly, the heart may beat too quickly (tachyarrhythmia), too slowly (bradyarrhythmia), or erratically (atrial fibrillation).
2. What are some of the most common causes of heart diseases?
Dr Tan: Some lifestyle factors and medical conditions may increase one’s risk of developing heart disease:
- Elevated blood pressure
- High cholesterol: There are two types of cholesterol, LDL (“bad cholesterol”) and HDL (“good cholesterol”). High LDL levels can be dangerous because cholesterol deposits, known as plaques, form in your arteries and can lead to blockages
- Diabetes: This common condition results in damage to the inner linings of blood vessels. Adults with diabetes are two to three times more likely to develop heart disease
- Family history of heart disease
- Unhealthy lifestyle factors: Cigarette smoking, excessive alcohol use, physical inactivity, obesity, and poor diet
Too much sodium in the diet may cause high blood pressure and heart disease. Learn how to spot hidden sodium and reduce your intake.
Q: What are the warning signs of heart disease in men?
Dr Tan: Heart disease can present in different ways, depending on the underlying problem, but the most common symptoms in men are:
- Chest pain, pressure, heaviness or discomfort
- Shortness of breath
- Dizziness or light-headedness
- Palpitations
- Fatigue
- Erectile dysfunction
Q: How can one tell he’s having a heart attack?
Dr Tan: People experiencing a heart attack often describe having chest pain that feels like a crushing weight. Some mistake a “burning” discomfort in their chest for acid reflux when they were actually having a heart attack. A “silent” heart attack can sometimes happen during one’s sleep or in people with chronic diabetes.
The most common warning signs of a heart attack are:
- Chest tightness, heaviness, or pressure
- Left arm or jaw pain
- Shortness of breath
- Perspiration
- Nausea/vomiting
Early medical intervention is crucial during a heart attack. Therefore, it’s important to know all the warning signs of a possible heart attack so you can seek appropriate treatment immediately for yourself or a loved one.
Q: Why are men more likely than women to have heart problems?
Dr Tan: Heart disease – and the conditions that lead to it – can happen at any age, but men tend to develop it, on average, 10 years earlier than women. Research has shown that throughout life, men are about twice as likely as women to have a heart attack. This increased risk persists even after accounting for traditional risk factors for heart disease. On the other hand, women are twice as likely to die after a heart attack compared to men.
There are various theories as to why men are more likely to experience a heart attack. When it comes to fat distribution, there are some differences between men and women. For instance, women tend to carry excess fat around their hips and thighs (subcutaneous fat), while men carry the fat intra-abdominally (visceral fat). In addition, women are somewhat protected by oestrogen and progesterone and mainly develop atherosclerosis following menopause. Instead, men rely on testosterone, which can also affect cardiovascular health, especially when levels of this hormone start to decrease after age 40.
Q: If heart disease runs in a man’s family, is he more likely to develop it, too?
Dr Tan: If heart disease runs in a man’s immediate family, yes. Inherited cardiac conditions can be passed from one generation to the next and the effects on you and your family can be enormous.
So, it’s important to know your medical family history and share it with your doctors so that they can run appropriate detection screenings and start treatment or monitoring early on to allow you to lead a normal and fulfilling life. Identifying heart disease early gives you the best chance of managing it well.
Q: How can heart disease impact one’s quality of life?
Dr Tan: Various physical and emotional symptoms of heart disease, such as fatigue, breathlessness, peripheral oedema (which refers to swelling in the lower legs or hands), depression, impaired sleep and chest pain, can limit daily activities.
The positive side is that medications and/or procedures can massively help people who have various types of heart disease. Most types of heart disease are easier to treat if you get an early diagnosis instead of waiting for symptoms to get worse.
Q: Can you suggest some ways for men to minimise their risk of developing heart disease?
Dr Tan: Addressing lifestyle factors is the most important, yet often most difficult, step to reduce your risk of heart disease and protect your heart health. You can start by introducing these small changes in your life:
- If you smoke, get help to quit
- Eat a balanced and fibre-rich diet, low in saturated fats, sugars, and processed foods
- Moderate your alcohol intake
- Reach and maintain a healthy weight
- Exercise regularly
- Manage your stress levels
- Get at least six hours’ sleep a night
- Attend regular medical screenings to screen for hypertension, diabetes and cholesterol levels
Aside from taking care of your heart, here are more tips for better men’s health.
Note: Please consult your GP or physician before embarking on any treatment plan.
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