Valley cardiologists offer insight into top killer of men

Valley men and those around the country are still losing the battle to heart disease, but local doctors say there is plenty they can do to curb those trends.

According to data from the Centers for Disease Control and Prevention, the average death rate from heart disease in men 35 and older in Arizona between 2019 and 2021 was 353 deaths per 100,000 people.

Overall all age groups, heart disease is listed as a cause of death for 24.3% of men in the U.S., ahead of cancer, unintentional injuries, chronic lower respiratory disease and stroke.

With June being men’s health month, the Mesa Independent spoke with Dr. Rishi Patel, a service line medical director for cardiology at Banner Health in Mesa and Chandler, as well as Dr. Ghazwan Elias who works in cardiology as part of the HonorHealth Medical staff at its McKellips location, and Dr. Michael White, who is an interventional cardiologist as well as the executive vice president and chief clinical officer of Valleywise Health.

White said some of the key differences between heart disease in men versus heart disease in women, with one of the biggest being age.

“We certainly see heart disease affecting men earlier in age. We start to see symptoms in men at a younger age than in women. In men we start to see it in their 40s and 50s but in women we see it a bit later in their 50s and 60s. Men also often times have increased risk of tobacco use, which will accelerate the process of coronary artery disease as well,” White said.

The historical belief was that estrogen reduced the risk of a heart attack, which lead doctors to conclude post-menopause women were more likely to have a heart attack due to the lack of ovulation. However, both White and Elias pointed out thinking is shifting away from that conclusion.

“We did trials and we gave women estrogen after menopause and we wanted to know if that was going to prevent heart attacks and we failed to prove that and actually caused more issues,” Dr. Elias said. “We ended up increasing risk of clots and strokes and whatnot if we give empirical hormonal therapy for patients for women that are at their menopause.”

There are many different types of heart disease, including arrhythmia, coronary artery disease, cardiovascular disease, congenital defects and more. Elias and White both said coronary artery disease was the most common form of heart disease they’ve found.

Coronary artery disease happens when a buildup of fat, cholesterol and other substances form a plaque that makes it difficult for coronary arteries to send enough blood, oxygen and nutrients to the heart. Coronary artery disease is often found in people with high cholesterol or people with overly unhealthy diets.

“Heart disease is broad spectrum, but you can have hypertension or hypertensive heart disease. And so treatment of that is geared towards diet lifestyle and management of their blood pressure. High cholesterol definitely is something that we screen for aggressively and manage aggressively. Both of those are what we wanna use as primary prevention before something happens,” Patel said.

Prevention is part of the effort, but Patel said doctors also focus on treatment once a blockage is found.

“So we’re doing everything we can to prevent a blockage from forming,” he said. “But if and when a blockage does form, then we have to treat that blockage and then modify the risk factor so it doesn’t reoccur.”

To reduce heart disease risk or to treat it, the cardiologists had a few suggestions for what men can change about their lifestyle habits. At a glance, moderate exercise, a healthy diet and no tobacco are important.

“One hundred fifty minutes of physical activity a week is very important. Eating healthy, especially the Mediterranean diet, is proven to reduce the risk of cardiovascular health. Olive oil, unsaturated fats, rich in vegetables and fruits, rich in fish and poultry rather than red meats,” Elias said. “Diet, exercise, quit smoking, quit vaping, less alcohol, it’s a no-brainer.”

There’s another factor that is a bit more abstract and harder to directly treat — communication. If a patient is not willing to share symptoms or information with their primary care provider, because of embarrassment or simply because of a lack of concern from the patient, it can become an issue later down the road.

Those early signs that a healthy or younger male patient may shrug off could actually be an early sign of a heart disease. So it’s important for both the patient and the doctor to have open communication with each other.

“Taking the time with the patient to make sure they’re having these conversations is important,” Dr. White said. “Ask them how they’re doing, ask them how they go about their daily activities and if they feel limitations in those daily activities. Taking an interest in those things and asking those questions specifically to make sure people understand will help us help them feel better and live longer.”

Above all, Patel urges patients to take care of themselves and to seek help if they experience symptoms rather than trying to endure it.

“Treat yourself empathetically. If this was someone else coming to you with those symptoms, if you’re concerned about someone else having the same symptoms and you’re experiencing them, then that’s a really appropriate time to get evaluated because we don’t give out medals for suffering. We want to make sure that you’re getting the care that you need and deserve,” Patel said.