Dr. David Vigder (NorthShore)
Thank you for your participation and welcome to all of you who are submitting questions or just viewing this Chat. Family history is an important risk factor for heart disease. Heart attacks in your sixties are more frequent, of course, than in your forties or fifties. I would say that your family history is a risk for you but a very minor risk. It is even less of a risk to you if your father had multiple risks for heart disease himself. More important risks to you would be your cholesterol level, your blood pressure, your blood sugar and your weight. Make sure you address these important risk factors in your attempt to avoid early heart disease.

Dr. David Vigder (NorthShore)
Blood pressure is a challenge for many people. You can do quite a lot to avoid medication. Most people can add more exercise to their week to bring the numbers down by 5-10 points. Try to add 1 - 2 more hours per week of exercise. And try to make sure you are keeping your heart rate up during exercise to properly condition your heart and blood vessels. Most people will get a very good workout if your heart rate stays in the 130-170 beats per minute range. If you have any chronic medical conditions or ongoing heart disease, make sure your internist does a thorough exam prior to increasing your exercise routine. Also, make sure you are not adding salt to your food. Extra salt can lead to increased blood pressure also. And lastly, stress plays a great role in increasing blood pressure these days. I highly recommend relaxation, meditation, or just time alone with your thoughts every day.

Dr. David Vigder (NorthShore)
I am asked this question a lot, and my answer has not changed much over time. I do not think vitamins or supplements help if you eat a healthy balanced diet. The body will take exactly what it needs if you provide a good variety of fruits, vegetables, lean meats, fiber, and other healthy foods. I think vitamins and supplements do play a role in countries with food shortages, or patients with digestive disorders leading to malabsorption, or if someone chooses to limit their food intake to only unhealthy snacks or junk food. I would much prefer my patients to choose a healthy diet than to take vitamins and supplements.

Dr. David Vigder (NorthShore)
I see a lot of men in their 30's and there really are not a lot of scientifically supported tests recommended for general screening. However, I do believe that men in their 30's should be seen and examined yearly to explore lifestyle issues, family history and general health status to see if any screening tests make sense. Occasionally a healthy 30 year old will remember that heart disease or diabetes runs in his family. I would then want to test the cholesterol and/or blood sugar levels. Sometimes there are ongoing symptoms that have seemed normal to the patient until he gives me the details. These symptoms might need additional evaluation with blood tests, imaging or referrals to specialists. Also, many men have forgotten how important it is to be screened for infectious diseases, which can be done with simple blood tests. Basically, a yearly exam and a thorough discussion of your health is a good idea. The tests can be chosen at that time if needed.

Dr. David Vigder (NorthShore)
In the United States, approximately 2140 new cases of male breast cancer are diagnosed annually, and 450 deaths occur; this represents less than 0.5 percent of all cancer deaths in men annually. The ratio of female to male breast cancer is approximately 100:1 in whites, but lower (70:1) in blacks. Risk factors for breast cancer in males are: Jewish ancestry, obesity, low levels of physical activity, prior chest wall irradiation, and benign breast disease. It typically presents as a painless, firm mass near the nipple. Any change in the skin or feel of the breast should be brought to the attention of your internist. If you have any of the above risk factors or if you have a family history of breast cancer, it would be a good idea to feel your breasts for masses every month after the age of 35 and see your internist for a thorough breast exam every year. The evaluation in men if a mass if found is similar to the women's exam - mammography and biopsy if needed.

Dr. David Vigder (NorthShore)
There are secondary causes of high blood pressure but they are very rare. These conditions are kidney disease, hormone secreting tumors, or medications. Most people have essential hypertension (or primary hypertension). Scientists are still puzzled as to the cause of this problem, but the good news is, it can be treated anyway. We usually look for secondary causes of hypertension when patients have maximized their blood pressure medication and the numbers are still too high, or if the blood pressure has gone up very quickly and severely. We do know that certain disease are more common in patients with elevated blood pressure and stroke is one them. However, if you can control the blood pressure quickly and for many years, the risk of stroke goes down substantially. Improvement in diet and exercise is critical and use of medication to bring the blood pressure down to normal levels is often needed. No need to worry, just take action.

Dr. David Vigder (NorthShore)
Genetic history plays a role in all diseases. Unfortunately, the statisticians are really having a hard time quantifying this risk. We can tell you that you are at risk, but how much risk is an unknown at this time. The most important thing you can do if you have certain diseases in your family is keep up with routine exams and testing. Do not miss your yearly exam, prostate blood test, colonoscopy. There are no reliable studies that tell us how to avoid cancer except for those who still smoke (STOP SMOKING!). There are good studies that show how to decrease your risk for heart disease, especially if it is your family - control your blood pressure, lower your cholesterol, control your weight, and exercise regularly. As new tests come out, make sure you discuss the risks and benefits of these tests with your internist.

Dr. David Vigder (NorthShore)
The answer to your second question is YES. Your are at greater risk for diabetes, which is one of the most important reasons to lose weight. Losing weight in our society is very difficult. Diet plans often fail, work habits lead to sedentary lifestyle, and the availability of cheap, unhealthy food is really damaging our health in general. The most successful patients in my practice have really changed their attitudes about diet and exercise without joining a formal program. Track your calories thoroughly every day for at least 3- 4 weeks using Sparkpeople.com or Loseit.com (available at the App stores). You might realize that you are overeating by 200-500 calories every day which really adds up. Try to make exercise mandatory during the week. Try to fit in 30-60 minutes of exercise at least 5 days per week. If you combine calorie limits with increased exercise, your weight should slowly go down.