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Men and heart disease: A conversation with Dr. Michael Lenhart

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Dr. Michael Lenhart, VCU Health Pauley Heart Center at Tappahannock medical director, specializing in general cardiology and cardiovascular disease walks us through men and heart disease. Dr. Lenhart is also involved in clinical development at Pauley, helping to bridge Pauley’s high level academic cardiovascular research to smaller community hospitals.

What are the most common problems you see with men’s hearts?

Routine coronary artery disease: blockage of arteries taking blood to heart. This is still the leading killer of men in America.

What can men do to address these problems?

Basic stuff, not smoking, keeping blood pressure and cholesterol under control, keeping weight down, prevent belly fat, regular exercise, effective sleep (which we tend to overlook), and stress reduction.

What is the simplest, most effective habit men can adopt to benefit their heart?

Stop smoking and perform 30-40 minutes of regular aerobic exercise every day. Even just walking or riding a stationary bike.

What are some basic healthy heart diet principles all men should know?

Reduce intake of saturated fats, eat fewer processed foods, avoid refined sugars, and lower sodium in cases of hypertension. Even just avoiding soda is a big step.

For men with busy, stressful lives, what stress management techniques do you recommend?

Regular exercise helps with many disorders like depression, blood pressure, diabetes, etc. It won’t fix everything, but it’s a great start.

What symptoms of a cardiovascular emergency should all men be aware of?

This is something that should be focused on more. When they think of a cardiovascular emergency, most people think of pain down the left arm. In my thirty years, I find most heart attacks tend to feel like pressure, tight squeezing discomfort, and bloating. And these symptoms can radiate anywhere. Jaw, arm, elbow, shoulder. Tightness in the chest indicates the blood is not getting enough blood flow.

In the next 5-10 years, what do you see as having the greatest impact on men’s heart health or cardiology in general?

Moving toward a more complete genetic understanding of an individual disease. We’re already seeing more personalized medicine with genetic testing. At some point, you might go the doctor and he’s got your genetic blueprint, and he’ll know why you’re not responding to medicine or treatment. He can then recommend a treatment more specific to your genetic background.

What is your greatest concern regarding men’s heart health as we come out of the pandemic?

Ramifications of what COVID-19 is doing to the heart long term. This virus has affected the heart in a variety of ways, and we don’t know if it’s going to get better or worse. We are seeing damage to heart tissue, and right now we don’t know if that will get better.

We’re seeing a lot of information online about sudden death in endurance athletes. What would you say to anyone worrying about their heart health as they look into endurance-focused activities?

The risk of sudden death is exceedingly low for those looking to begin exercising. Most cases of sudden cardiac arrest are due to undiagnosed genetic conditions.

What are the most important considerations for men looking to lose weight?

Weight loss is a complex issue, but the elimination of refined sugar is the place you should start. Then combine that with some way to burn calories.

For men without access to their family medical history, is there any way to find out this information?

Unfortunately, there is no real way to access that information yet. This means it’s up to individuals to monitor their blood pressure, lipids and coronary calcium score. These are steps their doctor can help with.

What sort of screening regimen would you recommend for men?

Lipid panels should start being monitored in your 20s. I’d also recommend checking your blood pressure for hypertension and assessing diabetes. It’s hard to give a number because family history differs, but at a young age it is better.

For people living with someone at high risk of heart disease or complications, what is the most effective way they can help in the event of an emergency?

If there’s cardiac arrest, CPR is most effective. But even just having aspirin around will help. If someone is having an emergency, two baby aspirin will help. And have a ready way to contact 911 at all times.