Finding hidden risk for heart disease

The text Heart Disease appearing behind torn brown paper.

Most men are familiar with the common strategies to reduce their heart disease risk: keep cholesterol in check, manage high blood pressure, follow a heart-healthy diet, and perform regular exercise. But there may be other preventive steps you can take.

“Some age-related conditions can further increase your risk without you knowing it, which is why it’s important to be mindful about all aspects of your health,” says Dr. Michael Gavin, a cardiologist with Harvard-affiliated Beth Israel Deaconess Medical Center. “Fortunately, once they are recognized, these other risk factors can be addressed and managed.”

Here is a look at the top hidden heart disease “red flags” you should watch for.

Hidden belly fat

Extra body fat puts you at a higher risk, yet exactly where that extra fat lies may determine the extent of the threat, according to a 2016 study in the Journal of the American College of Cardiology.

Researchers performed abdominal CT scans on more than 1,000 people from the Framingham Heart Study — 56% of whom were men — to see how much abdominal fat they had accumulated. Both subcutaneous fat (the fat you can feel just under the skin) and visceral fat (hidden fat inside the abdominal cavity) were measured.

After six years, researchers found that, on average, people had a 22% increase in subcutaneous fat and a 45% increase in visceral fat.

In general, each additional pound of fat — whatever the type — was associated with higher levels of heart disease risk factors like blood pressure, blood sugar, and triglycerides. However, people with more visceral fat had the highest increases.

Help yourself. “Even people who are just a little overweight can have too much hidden fat,” says Dr. Gavin. One of the best ways to attack this type of fat is with high-intensity interval training.

This exercise approach involves alternating between periods of high-intensity and low-intensity activity for a set amount of time. High intensity activity is a perceived intensity of 6 to 7 out of 10, while the low intensity activity is rated as 3 to 4.

For example, on a treadmill, begin with a ratio of 1:3, in which you walk or run at moderate-to-high intensity for one minute and then at a lower intensity for three minutes. As you improve, you can vary the ratio to 1:2 or 1:1, or even work for longer high periods with shorter low periods. Always make sure to check with your doctor before you begin any new exercise program.

Erectile dysfunction

There is a good chance that if you deal with erectile dysfunction (ED), you have a higher risk for heart disease. “That’s because both ED and heart disease share many of the same risk factors, such as older age, smoking, obesity, and diabetes,” says Dr. Gavin.

ED can be an early sign of vascular problems caused by the buildup of fatty deposits in arteries throughout the body. A meta-analysis in the February 2018 Vascular Medicine found coronary artery calcification (CAC) scores on a heart scan were more likely to be abnormal in men with ED compared with those who had no erection problems.

CAC reflects the presence of fatty deposits in heart arteries and in turn predicts a higher risk of having a heart attack or stroke.

Help yourself. See your doctor if you have ED issues, says Dr. Gavin. “Being aware of ED helps physicians to better individualize blood pressure and cholesterol management goals,” he says. “It also facilitates a discussion around the general safety of sexual activity and ED medications in people with heart disease.”

Gum disease

People with gum disease (periodontitis) are two to three times more likely to have heart disease, according to the American Academy of Periodontology. “Periodontitis is an inflammatory condition, and chronic inflammation is a key contributor to many health problems, especially heart disease,” says Dr. Gavin.

Have you lost any teeth in middle age? That also could be a sign of higher heart risk. Researchers from Harvard’s T.H. Chan School of Public Health recently reviewed several large studies that involved adults ages 45 to 69 who were initially free of heart disease.

The studies tracked the incidence of heart disease over a 12- to 18-year period and found that people who had lost two or more teeth when they were younger had a 23% higher risk of heart disease compared with those who’d had no tooth loss.

“It should be noted that these associations are at least in part driven by diet, smoking, and lower socioeconomic status, all of which are linked with poor dental health and heart disease,” says Dr. Gavin.

Help yourself. Besides practicing good dental hygiene — brushing at least twice a day for two minutes each time, and flossing daily — you should have a dental exam every six months to check for gum disease and protect against tooth loss.


Research has found that people who have been diagnosed with depression or who suffer from depression symptoms have a 64% greater risk of developing heart disease. They’re also 59% more likely to have a heart attack or die from a heart-related cause.

“Many of the symptoms of depression, such as low energy and lack of motivation, can make it easier to adopt unhealthy habits like smoking, drinking, and lead to social isolation that can cause people to resist heart-healthy habits like regular exercise and eating right,” says Dr. Gavin.

Help yourself. You can find signs of depression as well as better understand the different types at If you think you have depression, consult your primary care doctor. There are many treatment options available, depending on the severity of your depression. For example, you could try talk therapy with a mental health provider.

Your doctor also may prescribe an antidepressant, like a selective serotonin reuptake inhibitor (SSRI), including citalopram (Celexa), fluvoxamine (Luvox), or sertraline (Zoloft). SSRIs might even offer some extra heart protection.

Below are spiritual recipe for health and wellness: Matthew E. McLaren

Your beauty should not come from outward adornment, such as elaborate hairstyles and the wearing of gold jewelry or fine clothes. Rather, it should be that of your inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God’s sight. 1 Peter 3:3-4 NIV

Above all else, guard your heart, for everything you do flows from it. Proverbs 4:23 NIV

As water reflects the face, so one’s life reflects the heart. Proverbs 27:19 NIV

May he give you the desire of your heart and make all your plans succeed. Psalm 20:4 NIV

The heart is deceitful above all things and beyond cure. Who can understand it? “I the Lord search the heart and examine the mind, to reward each person according to their conduct, according to what their deeds deserve.” Jeremiah 17:9-10 NIV

You will seek me and find me when you seek me with all your heart. Jeremiah 29:13 NIV

Let love and faithfulness never leave you; bind them around your neck, write them on the tablet of your heart. Then you will win favor and a good name in the sight of God and man. Proverbs 3:3-4 NIV

Trust in the Lord with all your heart and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight. Proverbs 3:5-6 | NIV

Create in me a pure heart, O God, and renew a steadfast spirit within me. Psalm 51:10 NIV

But the Lord said to Samuel, “Do not consider his appearance or his height, for I have rejected him. The Lord does not look at the things people look at. People look at the outward appearance, but the Lord looks at the heart.” 1 Samuel 16:7 NIV

Jesus replied: ‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ Matthew 22:37 NIV

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