Heart disease in men: risk factors, causes and how to prevent it

Heart disease kills more than 3,600 men in New Zealand each year. Heart disease disproportionately affects more Māori and Pacific men, with the mortality rate among Māori being more than twice that of non-Māori.

Asian man holding chest in black active gear

Men generally develop heart disease at a younger age and have a higher risk of heart disease than women. Find out why men die earlier than women and learn about the risk factors to avoid.

What could contribute to men’s higher risk of heart disease?

On average, men develop heart disease 10 years earlier than women. They are more likely to have a heart attack than women.

In part, this relates to hormonal differences – women have greater protection due to higher levels of oestrogen.

Yet, in a 2016 study, researchers concluded that hormonal differences alone do not explain the difference in heart disease risk.

Furthermore, they found that even differences in well-established risk factors (such as high cholesterol, blood pressure, smoking, diabetes, body mass index, and physical activity) didn’t thoroughly explain the difference either.

What is clear, however, is that men can reduce their personal risk through behaviour changes such as:

Causes of heart disease and heart issues

Heart disease is a term encompassing a wide range of conditions affecting the heart. Heart disease includes but is not limited to:

The most common heart condition is coronary artery disease, which is the main cause of heart attacks. The prevailing cause of coronary artery disease is a build-up of fatty plaque in the arteries. This makes the arteries narrower and stiffer, making it more difficult to get blood to the heart muscle.

There are several risk factors for coronary artery disease, some of which you can change and others can’t.

Controllable risk factors include:

Uncontrollable risk factors include:

  • age

  • gender

  • ethnicity

  • mental health history

  • family history of heart disease.

Common causes and/or triggers of irregular heartbeats (arrhythmias) and factors that affect heart rate include:

  • damage to the heart due to other conditions

  • excessive alcohol or caffeine

  • high blood pressure

  • drug misuse

  • emotional stress and use of certain medications or supplements.

Some heart rhythm conditions can be inherited from your parents (hereditary) or something you’re born with (congenital).

A GP can do simple tests for high blood pressure and high cholesterol levels in the blood.

Do you know your blood pressure?

High blood pressure, or hypertension, describes the action as the heartbeat pushes blood against the artery walls. The strength of this ‘pushing’ is your blood pressure. Optimum blood pressure is at or below 120/80.

Learn more about your blood pressure and why it’s important to remember to ask what it is and what it means for your health.

Signs and symptoms of an unhealthy heart

Early signs of heart disease in men may include:

  • feeling tired during the day

  • weakness or fatigue

  • fainting

  • easily getting short of breath

  • chest discomfort (particularly during exertion or activity)

  • swelling of the legs, belly area, feet, ankles or hands

  • light-headedness

  • fluttering in the chest.

If you experience any of these, don’t hesitate to speak with your health professional.>

Unlike women, men have tell-tale signs that their heart health may be suffering, which they shouldn’t ignore. This sign relates to sexual health. Sexual problems such as erectile dysfunction may foretell or be an early warning sign of heart problems.2

Erectile dysfunction is often overlooked as a symptom of heart disease. Doctors are increasingly seeing it as a related link to heart disease.

It can be lifesaving to know that changes in sexual function are closely interrelated to the rest of the body. Noticing these subtle differences is vital and must not be ignored so a doctor can pick up on any cardiovascular problems early.

Heart disease is easier to treat when detected early, so talk to your healthcare provider if you have any concerns about these warning signs. A healthcare provider can discuss ways to reduce heart disease risk. This is especially important when men have a family history of heart disease. If you think you recognise any symptoms of heart disease, make an appointment with the doctor.

Ten men in New Zealand die from heart disease every day, and heart attacks are a leading cause of death in New Zealand. But, anyone can pick up on other early warning signs of a heart attack. These might not be as dramatic as you think:

  • pain, discomfort, pressure, tightness or heaviness in the jaw, neck, shoulders, chest, back or arms

  • shortness of breath

  • dizziness

  • tiredness

  • sweatiness

  • nausea.

Minutes matter - if you think you or someone you know is having a heart attack, call 111 now.

Too many New Zealanders die or live with a permanent disability because of the lack of awareness of heart attack warning signs and delays in seeking medical help. Even if someone has already had a heart attack, they may experience another, and the symptoms can be different next time.

Men’s heart health tips

Many men put their heart health on the back burner until it’s too late. We share our top tips for making positive lifestyle changes that can ensure Kiwi men look after their hearts.

Even though men’s lives are, on average, four years shorter compared with women, men are much less likely to talk to their doctor or whānau about their health.

That’s why now is the perfect opportunity to take stock and think about the conversations we can have to support men to take charge of their health.

1. Make heart health a priority

Many men only think about their health if there is a problem. In reality, there are many reasons for men to prioritise their health. For example, being able to work to support the family, seeing children and grandchildren grow older, staying active or being well enough to spend time with family and friends all need men to be in good health.

Sometimes men don’t know how to communicate their feelings, and it’s often hard to describe what’s happening with their bodies physically. This is why having a conversation is the first step.

2. Prevention is the best medicine

Regular check-ups are essential for men’s health. Even if they feel fine, men should be getting heart checks to prevent any problems from arising in the first place.

Men should also get a regular heart health check at the following ages:

  • Men with no known risk factors from age 45.
  • Māori, Pacific and South-Asian men from age 30.
  • Men with known risk factors, such as a family history of heart problems or at risk of developing diabetes, from age 35.
  • Men with severe mental illness from age 25.
  • Men with diabetes yearly from the time of diagnosis.

Talk with family members to learn about any family history of medical conditions and what to look out for. Just asking men how they are doing can have a huge impact, and you may find out something they should have mentioned. Often these casual conversations about health and health-related experiences can be why a friend gets an overdue check-up.

3. Get active

Being active and moving more is vital to having a healthy heart. A great goal is to be active in as many ways as possible throughout the day and reduce the time you spend sitting down.

Remember that mowing the lawns, getting out and about with the kids, or catching up with friends to kick the ball around all count as physical activity.

Doing just 30 minutes of moderate-intensity physical activity daily can help reduce the risk of heart disease.

There are plenty of benefits to exercising and moving more, including both mentally and physically.

When starting an exercise regime, remember it’s important to:

  • start slowly, stretch and build the exercise routine up over weeks and months.
  • make it interesting and enjoyable, perhaps by working out with a friend or group.
  • set some achievable goals, try to stick to them and don’t give up if there are setbacks.

4. Cut back on the alcohol

In the past, a persisting myth suggested that a glass of red wine every day is good for your heart. Yet, the evidence does not support this to be true. Drinking alcohol increases your risk of high blood pressure, a significant risk factor for heart disease. If you drink alcohol, there’s no safe amount, and drinking less is better.

If the men in your life drink alcohol, any steps they can take to drink less will benefit their heart health, such as:

  • having alcohol-free days and weekends whenever they can.
  • replacing alcohol with other beverage options.
  • taking advantage of the many low-alcohol or zero-alcohol drinks available in situations which might have involved alcohol.

Alcohol is also high in calories, and reducing alcohol intake, eating healthily, and regular physical activity could help manage weight.

Low-carb beers are often thought of as a healthier option. Although they contain a lower amount of carbohydrates and, therefore, energy, they usually contain a similar amount of alcohol.

5. Power up on plants

Choose more fruits, vegetables, whole grains and plant proteins (e.g., beans, chickpeas). These foods are nature’s powerhouse and contain fibre, vitamins, protein and a range of phytonutrients (naturally occurring plant compounds that reduce disease risk and promote health).

Some simple steps to power up on plants include:

  • eat one extra snack of seasonal fruits or vegetables throughout the day
  • replace some or all the meat in bolognese with extra vegetables and kidney beans
  • try falafel and hummus in burgers or wraps instead of meat
  • at main meals, aim for at least half the plate to be non-starchy vegetables like carrots, broccoli or cauliflower
  • choose vegetables from all the colours of the rainbow, as each colour provides a different range of nutrients
  • use the Heart Foundation’s recipes to help power up on plants when cooking at home.

6. Get enough sleep

Many New Zealanders don’t get the recommended 7–9 hours of sleep each night. Sleep helps to support healthy brain function and maintain your physical health. Insufficient or poor-quality sleep can affect how we think, react, work and learn.

Ongoing poor sleep can also increase the risk of some chronic health conditions.

Learn how to get better sleep.

7. Quit smoking

Smoking causes damage throughout the body and is the biggest risk for heart disease, heart attack or stroke. If the men in your life smoke, a range of support services are available to help them quit smoking.

8. Open up about mental health

Whether it’s feelings of being stressed, anxious or feeling down, men don’t tend to talk about their mental health and can be slow to get help.

Stress or anxiety is caused by various factors, from relationship difficulties to major life changes or problems at work. When stressed, our bodies release chemicals into our bloodstream, which create many harmful health effects.

How to deal with stress?

  • Talk to someone, whether family, friends or even a work colleague. It always helps to have someone to listen, help identify the cause of the stress and provide support.
  • Make sure men look after themselves – by keeping a healthy sleep routine, healthy eating and activity so they are in good shape for dealing with life’s challenges.
  • Encourage men to find what relieves their stress – it could be listening to music, running, walking or reading a book.

Lowering the risk of heart disease

Men have an important role to play in their health, and the choices we make every day can alter the risk of heart disease. Sometimes men may need a helping hand to point them in the right direction. Encouraging men to keep on top of their health through being active, eating a heart-healthy diet, quitting smoking and managing stress can lead to fundamental changes in heart health.

All men are different, but maintaining a healthy heart and improving heart health is something we can all do. Expanding knowledge about the best ways to prevent health issues from arising can also ensure a heart-healthy future.

There is no easy answer to why we are losing so many men to heart disease. But looking at the heart risk factors, it is clear that we could all play a part in helping prevent it.

Be proactive and take some realistic first steps

The best thing to do is to get proactive about improving men’s health. Preventative steps can reduce the risk of developing heart disease, diabetes and other health conditions.

Be aware of where men’s health is and get up to date with the necessary health checks. An excellent first step is to try My Heart Check and encourage your mates to do the same.

When introducing lifestyle changes, many men will be doing well in some areas and perhaps less well in others. Start with small changes and keep them realistic so they are sustainable over time.

This will, in turn, give men the best chance of preventing heart disease and enable them to live the long, happy life they deserve.

Find out your heart age