Men are significantly more likely than women to develop heart disease, and they tend to develop it earlier. In the UK, around one in eight men will die from coronary heart disease. And yet many men will go for years – sometimes decades – without a basic health check that might reveal the things quietly building in the background.
This isn't about fear. It's about the simple fact that knowing where you stand allows you to do something about it.
The Numbers That Matter
There are a handful of key markers that give a meaningful picture of cardiovascular health. Most can be measured through a routine blood test and a blood pressure check – things your GP can arrange, or which are available through the NHS Health Check (offered free to everyone aged 40–74 in England every five years).
Blood pressure is probably the most important single measurement. High blood pressure puts strain on the heart and arteries over time – and the vast majority of people with high blood pressure have no symptoms at all. A reading below 120/80 mmHg is considered ideal; 140/90 mmHg or above is high and worth addressing. Home blood pressure monitors are inexpensive and can help track patterns over time.
Cholesterol – specifically the ratio of LDL ("bad") cholesterol to HDL ("good") cholesterol – is a key risk factor. Total cholesterol below 5 mmol/L is generally the target; your doctor will look at the full picture rather than any single figure.
Blood glucose / HbA1c reflects average blood sugar levels over the past three months. Type 2 diabetes and pre-diabetes significantly increase cardiovascular risk, and both are often undetected for years.
Waist circumference is a useful simple measure: a waist above 94cm for men (or 90cm for South Asian men, who have a higher risk at lower measurements) indicates increased risk, particularly for heart disease and diabetes.
Resting heart rate – a lower resting heart rate generally indicates a stronger, more efficient heart. Under 60 bpm in healthy adults is normal; significantly elevated resting heart rate over time is worth discussing with a doctor.
Risk Factors Worth Understanding
Beyond the numbers, certain factors meaningfully increase cardiovascular risk:
- Smoking – the single most modifiable risk factor for heart disease
- High blood pressure – often called the "silent killer"
- High LDL cholesterol
- Inactivity
- Excess weight, particularly abdominal fat
- Heavy alcohol consumption
- Chronic stress and poor sleep – both have a real effect on heart health over time
- Family history – a first-degree relative with heart disease before 55 (male) or 65 (female) increases your own risk
Having one or two of these doesn't mean a heart attack is inevitable. It means it's worth taking the risks seriously and doing what you can to manage them.
What Actually Helps
The foundations of heart health are unglamorous but genuinely effective. Most of us know them; the challenge is acting on them consistently.
Regular aerobic exercise – ideally 150 minutes of moderate-intensity activity per week, or 75 minutes of vigorous activity. Brisk walking counts. Swimming, cycling, running – all beneficial. The evidence here is very strong.
A diet broadly in line with Mediterranean-style eating – abundant vegetables, legumes, wholegrains, olive oil, fish, and moderate amounts of meat and dairy – has consistently been associated with lower cardiovascular risk in research. No single food is the answer; it's the overall pattern that matters.
Not smoking. The risk reduction from stopping smoking is substantial and begins relatively quickly.
Managing blood pressure and cholesterol – sometimes through lifestyle, sometimes with medication. Both are highly treatable when identified.
Limiting alcohol – there is no "safe" level of alcohol consumption for heart health, but the risk rises significantly with heavier drinking.
Sleep and stress matter more than people realise. Chronic poor sleep and elevated stress are genuine cardiovascular risk factors, not just lifestyle inconveniences.
Knowing the Warning Signs
Chest pain is the classic heart attack symptom – but it doesn't always present that way. Other symptoms that warrant immediate attention include: pain or pressure in the arm, jaw, neck, or back; shortness of breath; unusual sweating; nausea or lightheadedness. If in any doubt, call 999. Men in particular tend to delay calling for help – and delay significantly worsens outcomes.