The latest findings on heart disease are nothing unexpected: It's the number one killer of American men, claiming a life about every 30 seconds. Most young, fit guys shuffle statistics like these into a mental file titled, "Doesn't apply to me." But no matter how old (or young) you are, the only way to stay on top of your game is to know your risk factors and take the right steps to avoid problems down the road. We talked with two heart experts to find out everything you need to know to guarantee your ticker stays stronger longer.

In Your 20s

"There's a common problem among men in their twenties," says Dr. Eric Topol, M.D., a practicing cardiologist at Scripps Clinic in La Jolla, California. "They don't know they're vulnerable [to heart disease]." Your twenties are the prefect time to establish heart-healthy diet and exercise habits that'll extend your expiration date. That means 30 minutes of exercise five times a week and maintaining a healthy weight and cholesterol level—LDL below 130 mg/dL, HDL of at least 40 mg/dL, according to Dr. Topol.
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Every 20-something average Joe needs an annual physical to evaluate HDL and LDL cholesterol, triglycerides, fasting lipid profile, blood pressure, and family history. If the checkup goes well, one appointment is enough to clear your conscious. But if you're an athlete or you hit the weight room more than five times a week, ask your doctor for an echocardiogram to ensure you don't have a heart abnormality," says Dr. John Elefteriades, M.D., the chief of cardiac surgery at Yale University.

"If you have a silent aneurism (one that doesn't cause you to feel symptoms), you're susceptible to internal splitting of the aorta," Dr. Elefteriades says. An echocardiogram is the only way to detect this problem. The test also spots dilated cardiomyopathy (a condition of heart failure in which the heart gets stretched too big and too thin) and hypertrophic cardiomyopathy (an inherited condition where the heart muscle is overgrown).

Your 20s Checklist:
30 minutes of exercise five times a week
Annual physicals
Echocardiogram
Cholesterol: LDL less than 130 mg/dL and HDL greater than 40 mg/dL
Blood pressure: 119/79 mm HG or lower
Lipid profile: Triglycerides less than 150 mg/dL


In Your 30s

Although most heart conditions are strongly hereditary, they don't always manifest as early as your twenties, Dr. Elefteriades said. So along with your standard health check, schedule another echocardiogram 10 years after the first one—especially if you're regularly weight lifting, wrestling, playing football, or participating in any sport with short bursts of activity.

Men older than 35 should also have an electrocardiogram (EKG), which traces the electrical waves of the heart, every 5 years. This test may show evidence of hardening of the heart's arteries (arthrosclerosis)—a preventable and treatable condition that restricts blood flow and may cause a blood clot.

Your 30s Checklist:
30 minutes of exercise five times a week
Annual physicals
Echocardiogram, 10 years after the first
Electrocardiogram (EKG), if older than 35
Cholesterol: LDL less than 130 mg/dL and HDL greater than 40 mg/dL
Blood pressure: 119/79 mm HG or lower
Lipid profile: Triglycerides less than 150 mg/dL


In Your 40s

When you hit 40, your doctor should start monitoring the overall degree of inflammation within your body with C-reactive protein (CRP) testing. The higher your CRP level, the higher your risk of cardiovascular disease. But there's no need to make an extra appointment for this one—the same simple blood test that checks your cholesterol levels measures CRP levels. The best way to keep CRP levels in check? Regular exercise and being at the right body weight.

Your 40s Checklist:
30 minutes of exercise five times a week
Annual physicals
Echocardiogram, 10 years after your last one
EKG, 5 years after your last one
Cholesterol: LDL less than 130 mg/dL and HDL greater than 40 mg/dL
Blood pressure: 119/79 mm HG or lower
Lipid profile: Triglycerides less than 150 mg/dL
C-reactive protein: Less than 1 mg per liter


In Your 50s

Fifty is the typical age when some men can develop coronary heart disease, according to Dr. Topol. The prevention prescription? An exercise stress test. This test, sometimes called a treadmill test, monitors how well your heart handles work. As you walk or pedal on an exercise machine, the electrical activity of your heart and your blood pressure are measured. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood.

The test will help pick up subtle arteriosclerosis (blockage of the coronary arteries), and determine the cause of any chest pain and the exercise capacity of your heart. A stress test isn't a necessary for men younger than fifty unless you have a strong family history of heart disease, according to Dr. Elefteriades.

Your 50s Checklist:
30 minutes of exercise five times a week
Annual physicals
Echocardiogram, 10 years after your last one
EKG, 5 years after your last one
Exercise stress test
Cholesterol: LDL less than 130 mg/dL and HDL greater than 40 mg/dL
Blood pressure: 119/79 mm HG or lower
Lipid profile: Triglycerides less than 150 mg/dL
C-reactive protein: Less than 1 mg per liter


At Every Age

If you experience chest pain or shortness of breath due to exertion, get to the hospital right away. These are the two primary symptoms of heart disease and should never go unchecked. "Men are deniers," Dr. Elefteriades says. "It's usually someone else in their lives—wife, girlfriend, mom—that forces them to confront symptoms." Other warning signs to speak up about are light-headedness and heart palpitations (an abnormal heart beat).

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