Men face higher risks of mortality and disease compared to women across many health issues. They are more likely to engage in risky behaviors like unhealthy eating, lack of exercise, excessive alcohol and drug use, and risk-taking behaviors. As a result, men have higher rates of cardiovascular disease, diabetes, suicide, and accidental death. Screening and preventative care can help address these issues. Regular health checks including blood pressure, cholesterol levels, cancer screenings, immunizations, and lifestyle counseling are recommended starting in a man's 20s and 50s to catch problems early and improve health outcomes.

1. Men’s Health Issues
Frank W Meissner MD FACP FACC FCCP FASNC CPHIMS

2. Life is What Happens To Us As
We’re Making Other Plans
Men Live 5-6 yr Less than Women
Higher Mortality Rates all diseases < age 65
4X more likely to die - CVD
2X more likely to develop NIDDM
4X more likely to commit suicide
3X more likely to die in MVA
4X more likely to die accidentally

3. Aiding the Grim Reaper
Men More Likely Than Women to
Eat High Fat Foods
Exercise Less (after age 35)
Drink ETOH Excessively
Smoke & Use Recreational Drugs
Engage in Risk Taking Behavior
Less Likely to admit to experiencing stress

4. Ignorance isn’t Bliss,
it’s Just Stupid
Men
Less Likely to have a GP
Less Likely to seek preventive health
services
Less likely to undergo Psych Counselling
More likely to consider waiting for
appointments a waste of time

5. Preventative Care
20-49 y/o Males
Blood Pressure Check
Blood Cholesterol Level Q 5yrs
FHx (melanoma, bowel cancer, prostate
cancer, hyperlipidemia, AMI < 55 y/o,
diabetes)
Skin eval (signs of UV damage or skin cancer)
Mental Health (Depression screening/Stress)
Immunization (Td booster, HepB, MMR)

6. Counseling Topics for
20-49 y/o Males
Diet & Exercise - Abdominal Obesity
Smoking, Alcohol, & Drugs
Relationships & Sexual Health
Occupational Health + Accidents/Risk Taking
Testicular Self Exam
Coronary Calcium Screening Q 5yr @ age 45

7. Preventative Care
50-74 y/o Males
All items for 20-49 y/o
Coronary Calcium Screening Q 5yr @ age 45
Prostate screening (annual rectal exam + PSA)
Diabetes screening - Urine Glucose - Blood if
required
Glaucoma Eye Pressure Test

8. Counseling Topics for
50- 74 y/o Males
Diet & Exercise - Abdominal Obesity
Smoking, Alcohol, & Drugs
Relationships & Sexual Health
Aging Related Decrease in performance & Capacity
Retirement & Change Management

9. 4-747’s # Deaths/DDeaths(thousands)
Coronary Heart Dz Cancer Accidents HIV/AIDS
959.2
544.7
93.8
32.7
American Heart Association. Heart and Stroke Statistical Update 2007.

10. Paradigm Shift-
CAD Detection
Symptomatic
Luminal Obstruction
Asymptomatic
Arterial Wall Atherosclerosis

12. Texas Heart Attack
Prevention Bill
Rick Perry signed into Law 19Jun09 - went
into effect 1Sep09
Mandates Insurers to pay $200 Q5yrs
Measurement of Internal Carotid Media
Thickness
Coronary Artery Calcification
Diabetics, Men ≥ 45 ≤75, Women ≥55 ≤75

13. 20%
80%
80%
Plaque
Detectable
by IVUS,
Pathology
Lipid Rich
Fibrotic
Calcified
20%
80%
Total Coronary Plaque & EBCT
Coronary Calcium

14. Calcium Scoring Guidelines

15. Time to Follow-up (Years)
0 (n=11,044)
1-10 (n=3,567)
11-100 (n=5,032)
101-299 (n=2,616)
300-399 (n=561)
400-699 (n=955)
700-999 (n=514)
1,000+ (n=964)
2=1363, p<0.0001 for variable overall and for each category subset.
CumulativeSurvival
0.0 2.0 4.0 6.0 8.0 10.0 12.0
0.70
0.75
0.80
0.85
0.90
0.95
1.00
All Cause Mortality and CAC Scores:
Long Term Prognosis in 25, 253 patients
Budoff, et al. JACC 2007; 49: 1860-70

16. Taylor et al – PACC Study –
JACC 2005
2000 patients, mean age 43
Coronary calcium demonstrated 11.8-fold
increased risk for incident coronary heart
disease (CHD) (p 0.002) in a Cox model
controlling for the Framingham risk score.
In young, asymptomatic men, the presence of
coronary artery calcification provides
substantial, cost-effective, independent
prognostic value in predicting incident CHD
that is incremental to measured coronary risk
factors.

18. Calcium Scoring
Helps you individualize cardiac risk and since
it is associated with an image that is easily
understood by your patient’s it is a potent tool
that facilitates lifestyle modification, improves
medication compliance, establishes a risk
baseline, allows for reassessment of risk,
assessment of efficacy of preventative
therapy, and helps to better target the health
care dollars being spent on preventation.
Treat to Calcium Plaque stability (annualized
incr in Ca++ Plaque < 15%) rather than LDL
<70 mg/dl

19. AHA 2006
Cardiac CT improves risk prediction,
especially in individuals determined to be at
intermediate risk according to the NCEP ATP
III criteria and for whom decisions concerning
prevention strategies may be altered based on
the test results.