The State of Our Health - Men's Health: Hearty Progress

The top killer of men, as of women, is heart disease, of which ischemic heart disease (the heart muscle is starved of oxygen) is the leader. The graphic shows overall progress in reducing the death rate for this disease by a variety of interventions — new technology and surgical techniques, better management of the condition through pharmaceuticals, and postponement of death by regimens of diet and exercise.

In this as in the other panels that follow, data are shown for "all men" — men of all races — for whites, blacks, and "non-white men." The comprehensive data set used for these assessments does not break data down by Asians, Pacific Islanders, and Native Americans. Typically the values for "all men" will be close to those for whites because whites, by sheer numbers, dominate the statistics. Similarly, the non-white category, which includes African Americans, is dominated by blacks, who are the majority. It is the difference between values for blacks and total non-whites that is, by inference, the Asian/American Indian category in combination. Data for women are included, where appropriate, as a dotted line as are data for women of all races.

This chart shows that the prevalence of heart disease is greatest among whites. Asian and American Indian men have a higher death rate from coronary heart disease than black males. Black males are, on the whole, the most physically active and least over-weight group in the U.S. population. This shows up rather vividly in this graphic. Exercise pays dividends. But black males still have a higher death rate from heart disease than black females; in 1998, the difference was 35 deaths per 100,000 population.

Between 1979 and 1998, the death rate has declined nearly 45% for white males, 37% for non-white males as a group, and 30% for black males. Black men are less likely to be diagnosed early or to be treated as intensively as other racial groups — a phenomenon we have remarked on before. The death rate for women of all races dropped 39% in this same period (40% among white women, 32% among non-whites, which includes blacks, and 27% among blacks viewed as a separate grouping).

More men than women are at risk for heart disease. Past age 40, 49% of men and 32% of women are likely to have heart disease. Heart disease can run in families. Vigorous exercise, a healthy, low-fat diet, abstention from tobacco, and stress-control are actions individuals can adopt for keeping coronary heart disease at bay and controlling its ravages after it appears.

Surgical/technological interventions for controlling heart disease are making great strides and are no doubt reflected in the results on the chart.⁴ These methods are becoming less and less invasive and produce longer-lasting results, beginning with balloon angioplasty, a procedure that opens clogged arteries by the expansion of a tiny balloon, the insertion of tiny tubes that hold the artery open (stents), and most recently stents coated so that they inhibit the re-clogging of the opening after some period of time (not yet available in the U.S.). These interventions do not involve major surgery.

Surgical interventions now include minimally invasive direct coronary artery bypass surgery (MIDCAB): the heart continues to beat while surgery is performed. Conventional coronary bypass surgery "bypasses" clogged arteries in the heart; during the procedure, blood is circulated by a pump. Eventually, no doubt, minute little robots will be launched into the arteries that chew away or dissolve the build-up of plaque. But in the meantime, a word to the wise: Eat sensibly and exercise, exercise, exercise…

Source: Centers for Disease Control and Prevention. National Center for Health Statistics. National Vital Statistics System. Online. Available: http://www.cdc.gov/nchs/default.htm. May 29, 2002. Background information obtained from MEDLINEplus. Online. Available: http://www.nlm.nih.gov/medlineplus/ency/article/001566.htm.