Men at Greater Cardiovascular Risk

At age 54, I suffered a heart attack. Little did I know I had been building risk from the time I was about 11 or 12. I never smoked. I thought I was taking care of myself in my 40s. Yet, my road to cardiac ruin, so they say, started, according to an article in a recent edition of Circulation, the American Heart Association’s (AHA) journal, when I was much younger.

Looking back on it all, I can see how all this makes so much sense. In a study led by Antoinette Moran MD, a professor and division chief of pediatric endocrinology and diabetes at the University of Minnesota’s Children’s Hospital in Minneapolis, my risk, as compared to my female counterparts, began rising when I was 11.

During the study, Moran and her researchers tracked 507 Minneapolis school children during the ages of 11 to-19, when they all had reached sexual maturity. Fifty-seven percent were male, 80 percent were white. Nearly 1,000 observations were made, including blood-pressure readings, insulin sensitivity, blood glucose levels and cholesterol measurements.

As boys and girls gain weight during adolescence (the genders are similar in body composition through age 11), the study points out changes differ largely by gender. While the study revealed fat decreased in males and increased in females during puberty, cardiovascular risks increased much more in males. The findings included:

• Triglycerides increased in males and decreased in females.
• High-density lipoprotein (HDL, or good cholesterol) decreased in males and increased in females.
• Systolic blood-pressure readings increased in both, but significantly more in males.
• Insulin resistance, much lower among males at age 11, increased at age 19 until the boys were more insulin resistant than the girls.
• No difference was found with two other cardiac risk factors — total cholesterol and low-density lipoprotein LDL or bad cholesterol).

Moran’s conclusion was, “by age 19 boys are at greater cardiovascular risk,’’ with the findings “particularly surprising’’ because the risk increased at the time the boys were gaining muscle mass and losing fat. The girls gained more cardiovascular protection even though their level of fat increased.

The researchers also confirmed obesity is the wild-card that increases cardiovascular risk in both genders. The researchers also noted more study is needed to “better understand the development of cardiovascular protection during adolesence.’’ One idea to be further looked into is whether estrogen may be cardiovascular protective and testosterone harmful.

I found this study fascinating because, after an athletic career that included two sports in high school, I was much less active during my college years.

In fact, except for a year or so of workout and fitness regimens, I wasn’t active from my early 20s until my heart attack at 54. My blood pressure also rose during those years, with hypertension being disagnosed at age 47.

Presently, thanks to diet, medication and exercise, I am probably in the best shape I’ve been in since I was of the age of the children in Moran’s study. There is a tinge of regret here. The seeds of cardiovascular problems were planted before I was 21. There were factors I coulds have changed, but did not. Until I received life’s wakeup call nearly two years ago.