Men—Your Vascular Health Called. Time for a Checkup

Men face heart-related conditions earlier in life than women. Men often have their first heart attack 6 to 10 years sooner than women, face strokes at younger ages, and are more likely to develop AFib.

Here’s the big question: why does it affect men more—and sooner?

Hypertension and high cholesterol occur earlier

High blood pressure often starts in men between the ages of 40 and 60. They also tend to have lower levels of nitric oxide, a compound that helps blood vessels relax and stay flexible. Without routine checks, high blood pressure may go unnoticed and silently damage the vascular system for years.

Men are also more likely to have high LDL (the “bad” cholesterol) at younger ages, which contributes to artery clogging plaque that can start as early as the teenage years. Estrogen helps regulate cholesterol levels, which may explain why women often have lower LDL levels until menopause.

Hormones and lifestyle habits play a role

Before menopause, estrogen helps protect women’s blood vessels by reducing inflammation, improving flexibility, and lowering plaque buildup. Men have higher testosterone levels, which may lead to more inflammation and unstable plaque that's more likely to rupture.

In some large studies, men were more likely to smoke, be less active, and skip checkups. Delayed screenings mean that warning signs can go unnoticed until something more serious occurs. These behaviors increase the risk of earlier disease.

How Men Can Lower Their Risk

Men can take simple steps to lower the risk of heart attacks, strokes, and afib. These changes matter—even if you start later in life.

• Get regular checkups. Ask your doctor to check your blood pressure, cholesterol, and blood sugar at least every few years—more often if you're over 40 or have other risk factors.

• Be active most days. Try to get 150 minutes of moderate activity (like brisk walking, biking, or swimming) each week. Short on time? Just 30 minutes a day, 5 days a week, can make a big difference.

• Eat for your heart. Focus on fruits, vegetables, whole grains, fish, nuts, and lean proteins. Cut back on red meat, processed food, sugary drinks, and foods high in salt or trans fats.

• Watch your weight. Extra weight, especially in the belly area, raises your risk for high blood pressure and AFib. Losing just 5 to 10 percent of your body weight can help improve how your heart and blood vessels function.

• Quit smoking. Every tobacco-free day helps lower your risk of blood clots and other serious health problems. If you're ready to take the next step, smokefree.gov offers support and tools to help you get started.

• Drink less alcohol (or none at all). Too much can raise your risk for AFib and stroke. It’s also linked to other serious health issues, including some cancers, especially in older adults.

• Manage stress. Long-term stress raises blood pressure and increases inflammation. Daily walks, deep breathing, and getting enough sleep can help.

• Take sleep problems seriously. Loud snoring, gasping during sleep, or always feeling tired could be signs of sleep apnea, which is linked to high blood pressure and AFib. It’s treatable—so bring it up at your next checkup.

You don’t have to change everything at once. Pick one or two areas to start with and build from there. Many men start making changes in midlife (around ages 40 to 65) or beyond and still see major benefits.

References

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Beller J, Bauersachs J, Schäfer, A. et al. Diverging trends in age at first myocardial infarction: Evidence from two German population-based studies. Sci Rep. 2020;10(9610). doi: 10.1038/s41598.020.66291.4 

Stanhewicz AE, Wenner MM, Stachenfeld NS. Sex differences in endothelial function important to vascular health and overall cardiovascular disease risk across the lifespan. Am J Physiol Heart Circ Physiol. 2018;315(6):H1569-H1588. doi:10.1152/ajpheart.00396.2018

Millett ERC, Peters SAE, Woodward M. Sex differences in risk factors for myocardial infarction: Cohort study of UK Biobank participants. BMJ. 2018;363:k4247. doi:10.1136/bmj.k4247

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