Every year in June, the U.S. observes Men's Health Month and Men's Health Week, which will be June 14 – 20 this year. The purpose of Men's Health Week is to encourage the men in our lives (and ourselves) to focus on improving health and wellness. Men should be vigilant in seeking out routine health and wellness visits as well as seeking care for illnesses and other concerning symptoms when they arise. ACC's CV Team Section is uniquely positioned to promote and educate on men's health topics.

Diseases of the heart continue to be the number one killer of men, according to data from the Centers for Disease Control and Prevention (CDC), with cerebrovascular disease also listed as the fifth leading cause of death amongst men.1 The CV team has the ability to make significant impact in improving men's health through our multidisciplinary modalities. That impact can be simple to start, as we must look no further than the men in our circle of family and friends and encourage them to live a healthier lifestyle.

As we look at all of the tools available to us, we should strongly consider using the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease and supporting data to utilize as a framework for discussions with our family, friends and patients.2 We have all heard the old adage that "An ounce of prevention is worth a pound of cure." This particular set of guidelines reinforces what many of us inherently know from years of experience, which is that lifestyle modifications and prevention of cardiovascular disease also decreases the likelihood of developing other co-morbid conditions like type 2 diabetes and various forms of cancer.

10 points to remember when discussing and encouraging men's health:

1. We should all promote a team-based approach to care. Each member of the health care team has an area of expertise that could be beneficial to men. Shared decision-making should help guide all of the strategies to improve men's health.

2. Men should be routinely assessed for psychosocial stressors and provided with appropriate counseling.

3. Comprehensive lifestyle intervention consists of a structured program, which includes regular self-monitoring of food intake, physical activity, and weight for those men who are overweight (BMI ≥25 kg/m2) or obese (BMI ≥30 kg/m2). These same principles could also be applied to those men who fall within an optimal BMI range of 20-25 kg/m2.

4. Adults should be routinely counseled to optimize a physically active lifestyle, preferably engaging in at least 150 minutes per week of accumulated moderate-intensity exercise or 75 minutes per week of vigorous-intensity aerobic physical activity. Based on these recommendations, about half of adults in the U.S. do not meet the minimum physical activity recommendations.

5. Men should have their blood pressure checked regularly and should have a blood pressure targeted to <130/80 with a preferred BP of <120/80.

6. Nonpharmacological interventions (exercise, dietary changes, tobacco cessation) are recommended for men with an elevated blood pressure or hypertension.

7. Men should be encouraged to consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish. This diet should also minimize the intake of trans fats, red meat, processed red meats, refined carbohydrates, and sweetened beverages.

8. Plant-based and Mediterranean diets, along with increased fruit, nut, vegetable, and legume consumption have consistently been associated with lower risk of all-cause mortality compared to control diets, like the standard American diet.

9. Men should be screened annually for type 2 diabetes mellitus (T2DM) utilizing a Hemoglobin A1c. If there is evidence of prediabetes or onset of T2DM, then initial recommendations should be for previously discussed lifestyle interventions. It is also reasonable to initiate metformin as first-line therapy along with lifestyle interventions at the time of diagnosis of T2DM.

10. Men should also be screened annually for high blood cholesterol levels and appropriate interventions initiated based on calculated risk of atherosclerotic cardiovascular disease (ASCVD) and family history. The ACC offers a free, interactive app called ASCVD Plus with built-in evidence-based guidance on how to treat patients based upon their ASCVD risk.

References

1. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2019 on CDC WONDER Online Database, released in 2020. Data are from the Multiple Cause of Death Files, 1999-2019, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on May 24, 2021 12:39:13 PM

2. Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Muñoz, D., Smith, S. C., Virani, S. S., Williams, K. A., Yeboah, J., & Ziaeian, B. (2019). 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Journal of the American College of Cardiology, 74(10), e177–e232. https://doi.org/10.1016/j.jacc.2019.03.010

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