5 MEN’S HEALTH Chapter Two Be Heart Smart ED is often the first sign of cardiovascular disease. In fact, it’s the primary cause in 50 percent of all men with ED. But poor circulation doesn’t just effect erectile function, it can indicate atherosclerosis—a condition in which plaque builds up in your arteries, compromising blood flow throughout your body. Atherosclerosis is sneaky, silently developing over many years. It starts when the endothelium (the inner lining of your arteries) becomes damaged. This, in turn, triggers the formation of a fatty substance called plaque that causes endothelial tissue to malfunction. As plaque accumulates, it further damages the arterial lining and causes the arteries to become narrow and stiff. If plaque becomes unstable it can rupture, creating a blood clot that can block the artery completely and trigger a heart attack or stroke. There are a number of factors that contribute to endothelial damage and plaque buildup. Some are things you have less control over like advancing age or familial heart disease. But there are several preventable risk factors like high blood pressure (hypertension), blood glucose, and coronary artery calcium levels that you can do something about. High Blood Pressure High blood pressure—at or above 140/90 mmHg—can injure the lining of your arteries, causing plaque to accumulate at a faster rate. Aptly called the “silent killer,” high blood pressure has no symptoms, so it’s easy to ignore. But left untreated, it can lead to stroke, enlarged heart, congestive heart failure, atherosclerosis, mental decline, and early death. Recent changes in the American Academy of Family Physicians set new standards recommending that blood pressure greater than 120/80 should be treated. Making a few simple changes can help keep your blood pressure in a healthy range. A healthy diet that’s low in sodium (effective in some people), refined sugar, and caffeine, and high in vegetables with some fruit, legumes, lean protein, and healthy fats can help to prevent and treat hypertension. Exercise is another factor that can rein in high blood pressure. Aerobic exercise—like walking, jogging, rowing, swimming, or biking—not only helps lower your blood pressure, it also increases blood flow throughout the entire body. Aerobic exercise is so effective that German researchers found it reduces both systolic and diastolic blood pressure in people that are resistant to medical treatment for their hypertension. MEN’S HEALTH 5