Movember 2024: Heart Disease, Cardiac Arrest, Winter Activities, and Men
Men, get your hearts checked out
While it is now December, I “officially” end my Movember fundraising on Giving Tuesday, which is tomorrow.
Here are the places you can donate to the Movember Foundation, which supports men’s health, specifically focusing on prostate cancer, testicular cancer, and men’s mental health:
Mary Pat Campbell’s MoSpace – a place to donate at Movember itself
My Movember Facebook fundraiser – my officially linked fundraiser, if this works better for you
And here’s a QR code if that works better for you:
Back to the stats…
Top Causes of Death for Men, 2023
Movember focuses on prostate cancer, testicular and men’s mental health issues.
However, by count, more men die from heart disease than anything else.
Whether by crude rate or age-adjusted rate, heart disease outnumbers cancer. I was going to show only the top ten, but saw COVID was #11, so extended my screenshot to include it, so you could see where it landed.
Many of the causes of Movember rank very high for men, especially compared to women — suicide ranks much higher for men than for women, for instance.
Winter is especially a dangerous time for heart disease deaths for men. Many people don’t realize that some causes of death are seasonal, and some are not — heart disease is very seasonal, with highest death rates in winter and lowest in summer. Cancer is non-seasonal.
You can see some of the COVID-related heart disease deaths in 2020 and 2021, but the “normal” seasonality appears 2018-2019 and you see it in 2023-2024 as well. The October 2024 deaths are not all reported yet.
Fall/Winter Danger Activities: Hunting and Snow Shoveling
While heart disease is not one of the Movember focuses, I’m pointing this out because there are specific dangers that are more likely to strike men.
A few weeks back, the Michigan medical examiner mentioned that some men were showing up in autopsy because hunting is more strenuous than you would think.
mlive, 20 Nov 2024: Michigan medical examiner urges hunters to get checkups after 3 die of heart attacks
The opening days of Michigan’s firearm deer season saw three hunters die from apparent heart attacks. As a result, a local medical examiner is encouraging at-risk hunters to undergo a doctor’s evaluation before trudging into the wilds in search of game.
“I’ve never seen three people die in 48 hours from heart attacks while deer hunting before, never,” said Dr. William Morrone, the medical examiner for Bay, Midland, Tuscola, Arenac, and Iosco counties. “We need to reframe some of our activities to have these preventable deaths reduced.”
Firearm season began Friday, Nov. 15. In the ensuing days, a 65-year-old Bay City man and an 83-year-old Portage man died while hunting in Arenac County. A 57-year-old Lincoln Park man died while hunting in Tuscola County.
None of these ages surprise me for death by heart attack.
“I’m seeing cardiac disease in arteries that 20 years ago I was seeing in 65-year-olds, and now I’m seeing it in 45-year-olds,” he said. “Today, cardiovascular disease is greater than it’s ever been. We’re not flattening the curve in cardiovascular disease, not at all.”
Two of the three men had bagged deer and were hauling the carcasses away when they suffered the fatal attacks. All were in isolated areas not easily accessible by medical responders, the doctor said.
“This is strenuous activity for men who have been sitting around, especially if they’re retired,” Morrone said.
The other activity, soon to be coming in my area, is snow shoveling.
American Heart Association, December 2022: Snow shoveling can be hazardous to your heart
Clearing sidewalks and driveways of snow may be essential to keep from being shut in, however, the American Heart Association, the world’s leading nonprofit organization focused on heart and brain health for all, urges caution when picking up that shovel or even starting the snowblower. Research shows that many people may face an increased risk of a heart attack or sudden cardiac arrest after shoveling heavy snow.
The American Heart Association’s 2020 scientific statement, Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective–An Update, notes snow shoveling among the physical activities that may place extra stress on the heart, especially among people who aren’t used to regular exercise. Numerous scientific research studies over the years have identified the dangers of shoveling snow for people with and without previously known heart disease.
March 2020, AHA Scientific Statement, Circulation: Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective–An Update: A Scientific Statement From the American Heart Association
(emphasis and some acronym expansion added)
Other activities that are associated with excessive cardiac demands and a greater incidence of acute cardiovascular events include deer hunting103 and snow removal.104,105
Snow shoveling has repeatedly been associated with increased cardiovascular events soon after major snowstorms,105–107 probably because it can elicit higher rate-pressure products than maximal treadmill testing108 and is often performed by unfit individuals with known or occult CAD [coronary artery disease]. Also, some cardiac patients develop angina at lower rate-pressure products during exercise in cold temperatures,109 possibly because of cold-induced vasospasm. Ventricular arrhythmias, coronary plaque rupture and ST-segment–elevation MI [myocardial infarction],110 and subacute stent thrombosis111 have also been reported with snow shoveling.
To make this simpler: a lot of out-of-shape people who also have undetected coronary artery blockage shovel snow, especially after huge snowfalls.
Being out in the cold can also cause one’s blood vessels to constrict somewhat (cold-induced vasospasm), which can make arterial blockage more of a problem.
Result: heart attack (also known as a myocardial infarction — or: blockage in the blood supply (infarction) to the heart muscle itself).
Now, women could also suffer these risks, but it’s most often men:
American Journal of Emergency Medicine, 2009: Snow shovel-related injuries and medical emergencies treated in US EDs, 1990 to 2006
[emphasis added, initialism expanded]
Results: An estimated 195 100 individuals (95% confidence interval, 140 400-249 800) were treated in US EDs [emergency departments] for snow shovel-related incidents during the 17-year study period, averaging 11 500 individuals annually (SD, 5300). The average annual rate of snow shovel-related injuries and medical emergencies was 4.15 per 100 000 population. Approximately two thirds (67.5%) of these incidents occurred among males. Children younger than 18 years comprised 15.3% of the cases, whereas older adults (55 years and older) accounted for 21.8%. The most common diagnosis was soft tissue injury (54.7%). Injuries to the lower back accounted for 34.3% of the cases. The most common mechanism of injury/nature of medical emergency was acute musculoskeletal exertion (53.9%) followed by slips and falls (20.0%) and being struck by a snow shovel (15.0%). Cardiac-related ED visits accounted for 6.7% of the cases, including all of the 1647 deaths in the study. Patients required hospitalization in 5.8% of the cases. Most snow shovel-related incidents (95.6%) occurred in and around the home.
All of the deaths were cardiac in cause, unsurprisingly.
[emphasis added]
Impact of Sex
The incidence of exertion-related SCD [sudden cardiac death] is much lower in women than men. In multiple populations, the risk of SCD in association with exercise is 15- to 20-fold higher in men.49,50,76 This sex difference in exercise risk is much more pronounced than the baseline 2- to 3-fold higher overall incidence of SCD observed in men versus women in epidemiological studies not focusing on exercise alone.49–51
If I were just to compare heart disease death risk, as noted above, the sex ratio is between 2-to-3 times males vs. females.
But if we’re just looking at exertional-related (they talk about items like hiking, going to the gym, etc. - not just shoveling snow), the ratio is much higher - 15x to 20x.
That’s partly due to more out-of-shape men attempting these activities, but also more men having more cardiac arterial blockage at the same ages.
Please, Get Your Heart Checked
Sudden Cardiac Death (SCD) has been around for a long time, and many people went nuts about it as a cause of death during the pandemic, as it did increase during the waves of COVID. It’s still elevated.
I don’t care if it’s from Long COVID or the vaccines or something else (like crappy diets) — there is a lot of cardiac arterial blockage out there at young ages, and a lot of people don’t know about it.
SCD is how my dad died at the age of 38.
He was a smoker, and a sedentary worker at IBM as a systems engineer. He was stressed out, drinking loads of coffee and had a crap diet. He was overweight.
And he had blocked arteries. Extremely blocked. We didn’t know until he died.
We also found out later, from our grandmother, that he had a couple of uncles who had died of heart attacks in their forties — which was unusual, even back then. We have a family history of early cardiac death.
…which is how I had heart health checks in my 20s when I was at NYU (my heart was fine, and they even asked if they could do some more extreme things, because they rarely had healthy people in the cardiac unit there. The people in the waiting room looked grey. Yeah, I could believe they rarely saw healthy people.)
So, men, please get your heart health checked.
Also, please just pay someone else to clear your drive. Or at least, take it easy and slow. Go inside often and warm up (get those blood vessels open.)
Mary Pat has an extraordinary ability to make complex issues clear and obvious. As we all know, chronic diseases are preventable and treatable.