Man matters

From heart attacks striking in the 40s to fatty liver showing up in the otherwise fit, men’s health needs urgent attention. Experts now point to a combination of genetic, hormonal, lifestyle and behavioural factors that make men particularly prone to certain diseases. Here’s a closer look at the top health risks Indian men face, and how to stay a step ahead.

The heart disease trap

Heart disease remains the leading cause of death among Indian men, and it’s not just the elderly who are at risk. Cardiologists are seeing younger men in their 30s and 40s walk in with blocked arteries and damaged hearts. A sedentary lifestyle, rising obesity, chronic stress, and poor dietary habits are accelerating this trend.

Preventing cardiovascular disease involves more than just quitting smoking. Regular aerobic activity (at least 150 minutes a week), a Mediterranean-style diet, and managing weight, stress and sleep are essential. Screening should begin early (starting in your 20s) and become more frequent with age.

The big five tests

• Annual physical exam: BMI, waist-to-hip ratio, vitals
• Diabetes profile: Fasting/postprandial blood sugar, HbA1c, fasting insulin
• Lipid panel: Total cholesterol, LDL, HDL, triglycerides; advanced tests if there’s a family history
• Cardiac workup: ECG, echocardiogram, coronary calcium score (after 40) 
• Essential panels: Liver, kidney, thyroid function, CBC, abdominal ultrasound

The diabetes-fatty liver connection

Prediabetes and Type 2 diabetes are no longer “old people’s problems.” Indian men with central obesity and a family history are especially vulnerable. Equally concerning is the surge in non-alcoholic fatty liver disease (NAFLD), closely tied to insulin resistance and metabolic syndrome. Left unchecked, fatty liver can progress to cirrhosis or liver cancer. Annual screening for blood sugar and liver enzymes, coupled with a fibroscan or abdominal ultrasound, can make all the difference.

The breathing crisis

Not all respiratory problems are caused by pollution, although it’s a key contributor. Chronic Obstructive Pulmonary Disease (COPD) and lung cancer remain serious threats, especially in men with a history of tobacco use or occupational exposure to pollutants.

Add to that obstructive sleep apnea (OSA), an underdiagnosed condition in overweight men that leads to snoring, daytime fatigue, and increased risk of cardiac issues. A home sleep study can offer clarity and timely intervention.

Meanwhile, construction workers, miners, and heavy smokers should discuss low-dose CT scans and spirometry with their doctors for early detection of lung damage or malignancy.

The “silent” cancers

Prostate issues, ranging from benign enlargement to cancer, are increasingly common after age 50. Symptoms often go unnoticed or are brushed off as “old age” issues. Routine PSA testing and digital rectal exams can detect problems before they escalate.

Equally important is screening for colorectal cancer (CRC), now appearing earlier and more frequently in Indian men.

A colonoscopy or stool-based test from age 45 can be life-saving, particularly if there’s a family history.

The elephant in the room: Addiction. Substance abuse, be it alcohol, tobacco, opioids or cannabis, is often underplayed in men’s health conversations. But the ripple effects are undeniable: liver failure, depression, cancer, road accidents, and broken families.

Men are particularly vulnerable due to early peer exposure, stress, and lack of support systems.

Early intervention, mental health counselling, and community-based rehab can transform outcomes.

(The author is a Bengaluru-based senior interventional cardiologist & specialist in premature heart attacks.)