Heart disease is the number one killer of men. In 1999 alone, 446,000 males died of heart and cardiovascular disease.

The good news is that men's risk of dying of heart disease has fallen dramatically. In 1950, the death rate was 697 per 100,000 men; by 1999, it had dropped to just 328/100,000 (1).

But the bad news is that men's risk of death is still much higher than women's risk. While the male death rate in 1999 was 328, it was only 221 for women - about a 50% difference!

Documented reasons for this 50% sex disparity include:

1. High blood pressure -- While 28% of women with high blood pressure have their condition under control, only 13% of hypertensive men are under control.

2. Cigarette smoking -- While 22% of women smoke cigarettes, 26% of men are cigarette smokers (3).

Other reasons may include undiagnosed male depression (which is believed to predispose to heart disease), the physical and psychological demands of being the primary breadwinner, and the adverse effects of divorce, which harms men more than women (4).

Proven measures for preventing heart disease include quitting smoking, reducing cholesterol and saturated fat intake, and getting regular exercise.

Racial and Ethnic Disparities
According to a recent report (5), there is a substantial disparity in heart disease death rates among various racial and ethnic groups, especially under the age of 65 years. Heart disease deaths that occur before age 65 are generally considered preventable. Following are the percentage of heart deaths that affect men in this age group:

American Indian: 31%
Asian/Pacific Islander: 26%
Black: 40%
Hispanic: 37%
White: 21%

So while only one-fifth of heart disease deaths among Whites are preventable, two-fifths of heart disease deaths among Blacks can be prevented.

Special Programs Needed
Heart disease often strikes men in their 40s and 50s, when they are in the middle of establishing their careers and caring for their families. So male heart disease is not simply a medical problem -- it is a disparity that has major effects on wives, children, and on society at large.

In order to overcome the disparities of male heart disease, special programs directed to men in general, and minority men in particular, need to be mounted by the DHHS and the American Heart Association.

-Carey Roberts

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References:

1. Eberhardt MS, Ingram DD, Makuc DM et al. Urban and Rural Health Chartbook. Health, United States, 2001. Hyattsville, MD: National Center for Health Statistics, 2001, Table 30.

2. Department of Health and Human Services. Healthy People 2010. Washington, DC: Government Printing Office, 2000, page 12-22.

3. Department of Health and Human Services. Healthy People 2010. Washington, DC: Government Printing Office, 2000, page 27-5.

4. Men's Health America: Heart Disease: Why Are Men Still at Higher Risk of Death? 2002. Message no. 582.

5. Barnett E, Casper ML, Halverson JA et al: Men and Heart Disease: An Atlas of Racial and Ethnic Disparities in Mortality. Morgantown, WV: West Virginia University, 2001.