You can feel fine and still have heart disease developing.
That’s one reason men’s heart health is so important and why regular checkups matter even when you don’t have symptoms. Heart disease is the leading cause of death for men in the United States and coronary artery disease is the most common type of heart disease. But in many cases, it develops over time with minor or no symptoms.
Dr. Amar Doshi, an advanced heart failure and transplant cardiologist at Atrium Health Sanger Heart & Vascular Institute, says the goal is to find risk factors early before they lead to a heart attack, stroke or heart failure.
Here’s what men should know about coronary artery disease, heart failure, sleep apnea and the preventive steps that can help protect their heart health.
What is coronary artery disease?
Coronary artery disease happens when cholesterol and plaque build up inside the blood vessels that supply the heart. Over time, this buildup can narrow the arteries and reduce blood flow.
In the early stages, coronary artery disease may not cause any noticeable symptoms. As it progresses, men may notice:
- Chest pain or pressure during physical activity
- Shortness of breath
- Jaw pain
- Symptoms that feel like indigestion
In more severe cases, coronary artery disease can lead to a heart attack, which requires immediate medical attention.
“So, unless men go for these routine examinations, they often don’t know that they have any of these conditions,” says Doshi. “And unfortunately, we have patients who don’t know about it until they present with a massive heart attack or stroke. If we can at least start screening and seeing PCP early on, as early as age 20, with a yearly checkup, we can often prevent these issues from occurring.”
The challenge, Doshi says, is that many of the biggest risk factors for heart disease — including high blood pressure, high cholesterol and diabetes — can be silent.
“What makes it challenging is these conditions can often be silent, what we call ‘silent killers,’ where we don’t feel symptoms in our day-to-day lives, but internally, it’s causing damage to our bodies,” he says.
How can men lower their risk of heart disease?
“Many lifestyle habits can affect a person’s risk of developing coronary artery disease or heart failure,” says Doshi.
The most effective ways to lower your risk of coronary artery disease and heart failure include:
- Eating a heart-healthy diet
- Staying physically active
- Not smoking or quitting if you currently smoke
- Managing blood pressure and blood sugar
- Knowing your family history
Doshi says modern diets are often high in unhealthy fats, salt and processed sugars, which can increase the risk of heart disease, diabetes and kidney disease. A heart-healthy diet, such as the Mediterranean diet, focuses on foods like vegetables, fruits, whole grains, legumes, nuts, fish, poultry and healthy fats.
That doesn’t mean every meal has to be perfect. But small, consistent changes — such as choosing less processed food, adding more fiber to your meals, cutting back on excess salt and replacing sugary drinks with water — can make a meaningful difference over time.
Regular exercise is also important. Doshi recommends a mix of aerobic activity, such as walking, running or biking, along with strength training. Quitting smoking is another major step, since smoking significantly increases cardiovascular risk.
For men with high blood pressure, diabetes or high cholesterol, treatment can also help reduce the risk of serious heart problems.
And while genetics and family history can play a role, Doshi emphasizes focusing on the risk factors you can control.
What heart symptoms should men never ignore?
Men should seek immediate medical attention for:
- Sudden chest pain or pressure
- Jaw pain
- Pain in the neck, upper back or shoulders
- Shortness of breath
- Symptoms that feel like severe indigestion
- Or any symptoms that feel unusual or concerning
Heart symptoms do not always look the way people expect. Some men may feel pressure, heaviness or tightness instead of sharp pain. Others may notice discomfort in the jaw, neck, shoulder or upper back. Symptoms may come on during activity or at rest.
If something feels wrong, it’s better to get checked quickly than to wait and hope it passes.
What are the early warning signs of heart failure in men?
Heart failure happens when the heart cannot pump blood as effectively as the body needs. It does not mean the heart has stopped working, but it does mean the heart is under strain.
“Coronary artery disease is one of the leading causes of heart failure in this country,” says Doshi. “If men have risk factors or signs and symptoms, we can detect them quickly with bloodwork and an echocardiogram. If we can detect it early, we can treat it and help prevent it from getting worse.”
Early signs of heart failure can include:
- Shortness of breath
- Feeling more tired than usual during everyday activities
- Trouble climbing stairs or walking distances that used to feel easy
- Breathlessness when lying flat
- Needing multiple pillows to sleep comfortably
- Swelling in the legs, ankles, feet or abdomen
- Unexplained nausea, vomiting or brain fog
“They may also feel like they’re having a panic attack when they lie down to sleep at night,” he says.
These symptoms can be easy to dismiss, especially if they develop gradually. But Doshi says they can be signs that the heart is struggling.
“They are often warning signs of developing heart failure,” he says.
Can heart failure be detected early?
Yes. Heart failure can often be detected with a combination of physical exams, bloodwork and imaging tests, such as an echocardiogram, which is an ultrasound of the heart.
“Early detection of heart failure is really important,” he says.
Because coronary artery disease can weaken the heart over time, finding and treating blocked arteries, high blood pressure or other risk factors early can help prevent heart failure from getting worse. When heart failure is caught early, treatment can improve symptoms, support heart function and help patients live longer, healthier lives.
What heart health screenings should men get?
Doshi recommends that men see a primary care physician at least once a year, as early as at age 20. These visits are an opportunity to check for common heart disease risk factors and catch problems early.
A yearly checkup may include:
- Blood pressure screening
- Bloodwork to check cholesterol
- Blood sugar testing to screen for diabetes or prediabetes
- Kidney function testing
- A conversation about family history and lifestyle habits
- A discussion about symptoms, even if they seem minor
Depending on your risk factors or symptoms, your doctor may recommend additional testing, such as an electrocardiogram (EKG) or echocardiogram, or refer you to a cardiologist.
“If you have a good primary care provider you’re able to see on a regular basis, that can help prevent a lot of downstream effects,” he says.
Doshi also recommends at-home blood pressure monitoring for some patients. This can help men and their care teams better understand what their blood pressure looks like outside the doctor’s office.
Why do men put off heart checkups?
Many men delay preventive care because they feel healthy, have busy schedules or worry about taking time off work. Doshi says these barriers are real, but waiting until symptoms appear can be risky.
“If you don’t feel symptoms every day, that urgency to get checked out is not quite there, especially if you’re busy, or worried about taking time out of your day to go to the doctor,” he says. “There are a lot of barriers and that’s something we recognize in the healthcare field and are constantly working to improve.”
To make care more convenient, many healthcare systems now offer options such as virtual visits, weekend appointments and remote testing when appropriate.
“Oftentimes, patients don’t have to leave their job location or their house to be seen,” he says. “We try to make it as convenient as possible to allow our patients to seek the care they need.”
Can sleep apnea affect men’s heart health?
Yes. Sleep apnea can increase strain on the heart and lungs and may contribute to high blood pressure, daytime breathing problems and a higher risk of heart failure.
Sleep apnea happens when breathing repeatedly stops for short periods during sleep. It is often associated with:
- Loud snoring
- Pauses in breathing
- Morning headaches
- Daytime fatigue
- Poor sleep quality
Because sleep apnea is sometimes dismissed as “just snoring,” men may not realize it can affect their heart health. If you or your partner notice signs of sleep apnea, talk to your doctor about whether a sleep study is right for you.
The first step: Schedule your annual physical
You don’t have to wait for chest pain, shortness of breath or a major health scare to start taking your heart health seriously.
A yearly checkup with a primary care physician can help identify risk factors early, guide lifestyle changes and connect you with a cardiologist if you need more advanced care.
Find an Atrium Health primary care provider near you to schedule your annual physical.
