Men's Cardiovascular Health

Cardiovascular disease (CVD) remains the leading cause of mortality in men globally. Integrative and functional medicine emphasises a systems-based approach, combining targeted diagnostics with personalised prevention strategies to identify early risk factors and support long-term heart health.

1. Nutrition & Dietary Patterns 

Diets rich in whole foods, with minimal saturated fats and processed sugars, are foundational to cardiovascular prevention. A Cochrane review found that reducing saturated fat intake by 5–6% of total energy led to a 17% lower risk of cardiovascular events (Cochrane, 2018). However, there is considerable evidence from clinical controlled trials, suggesting low-carb and carnivore diets as good alternatives for the reduction of CVD risk. 

The Mediterranean and DASH diets, emphasising fruits, vegetables, legumes, whole grains, and healthy fats (olive oil, nuts, fish), are robustly supported. The DASH diet consistently lowers blood pressure by 5–11 mm Hg systolic and reduces 10-year Framingham risk by ~13% in randomised feeding trials (USDA & NHLBI, 2015; National Vascular Disease Prevention Alliance, 2012). 

A UK-based lifestyle intervention trial using personalised nutritional guidance alongside exercise and stress reduction reduced 10-year coronary risk from 11.1% to 7.8% over ten months (Williams et al., 2009, pp. 106–112).

2. Physical Activity & Cardiorespiratory Fitness 

Regular physical activity is essential. The European Society of Cardiology reports a 27% decrease in cardiovascular mortality among those achieving recommended exercise levels (ESC, 2023). Resistance training and aerobic exercise also significantly improve lower urinary tract symptoms—a common comorbidity in men with cardiovascular risk (Parsons & Kashefi, 2008, p. 1232).

3. Stress Reduction & Mind–Body Interventions 

Chronic stress drives autonomic imbalance and inflammation. Integrative therapies such as meditation, yoga, and acupuncture have demonstrated modest improvements in blood pressure, quality of life, and inflammatory biomarkers in CVD patients (AHA, 2021; IFM, 2024). 

A specific integrative programme combining personal lifestyle goals and mind–body practices significantly reduced calculated 10-year CHD risk by 3.3 percentage points versus usual care (Williams et al., 2009, pp. 109–110).

4. Targeted Supplementation

Supplements and botanicals often play supportive roles, yet evidence varies:

• Coenzyme Q10 supplementation in heart failure patients reduced mortality and hospitalisation over two years (Q-Symbio trial), but its role in prevention is not yet defined (Mortensen et al., 2014).
  
  

• Vitamins C and E have not proven effective in preventing major cardiovascular events in middle-aged and older men and may increase stroke risk (Steinberg et al., 2005).
  
  

Emerging interest surrounds mitochondrial support (CoQ10, NAD+ precursors) and proteomic-based risk prediction, though clinical utility remains under evaluation (IFM, 2024; Mensah et al., 2024).

5. Functional and Integrative Diagnostics 

Functional practitioners utilise advanced diagnostics to personalise prevention:

• Carotid intima-media thickness (CIMT) and coronary artery calcium (CAC) scanning provide subclinical atherosclerosis assessment and inform early intervention (Bale & Doneen, 2011, p. 2).

• High-sensitivity CRP testing offers an inflammatory metric linked to major cardiovascular events, independently of traditional risk factors (Mensah et al., 2024).

• eHealth platforms, including remote monitoring of vitals, biomarkers, nutrition and physical activity, demonstrate promise in reducing risk factor trajectories in men (Zhang et al., 2020).

• A large retrospective cohort from the Cleveland Clinic found functional medicine practice significantly improved PROMIS physical health scores, supporting the broader integrative model (Pacetti et al., 2019).
  
  

6. Personalised Lifestyle Medicine 

Prevention is optimised through patient-centred planning:

1. Nutrition: Adopt a nutritious diet, focusing on a good supply of quality proteins (all essential amino acids), omega 3's, avoid refined sugars, highly processed and ultra-processed food, and have a daily supply of vitamins and minerals (if possible from food).

2. Exercise: At least 150 minutes weekly of moderate-to-vigorous activity, including strength training and pelvic floor work if indicated.

3. Stress Resilience: Incorporate daily 10-minute mindfulness or breathing sessions; consider yoga, Tai Chi, or acupuncture for added benefits.

4. Diagnostic Review: Use CAC/CIMT and hs-CRP to refine risk beyond traditional models, interpreted in consultation with primary care providers.

5. Supplement Strategy: Support mitochondrial health (e.g., CoQ10 in heart failure), while advising against indiscriminate antioxidant use.

6. Ongoing Support: Monitor outcomes with digital tools and repeat functional labs every 6–12 months, adjusting intervention holistically.
   
   

References

American Heart Association. (2021) Complementary and Alternative Medicines in the Management of Cardiovascular Disease. Circulation, 124(19).
Bale, B.F. and Doneen, A.L. (2011) Beat the Heart Attack Gene. New York: Third Millennium Publishing.
Cochrane (2018) Effect of cutting down on saturated fat. Available from: https://www.cochrane.org/CD011737/VASC_effect-cutting-down-saturated-fat-we-eat-our-risk-heart-disease .
Eckel, R.H. et al. (2014) ‘Lifestyle interventions to modify cardiovascular disease risk’, Prog Cardiovasc Dis, 56(5), pp. 369–381.
European Society of Cardiology (2023) Physical activity for cardiovascular prevention. Available from: https://www.escardio.org/.
IFM – Institute for Functional Medicine (2024) Lifestyle interventions to modify cardiovascular disease risk. Available from: https://www.ifm.org/articles/lifestyle-interventions-modify-cardiovascular-disease.
Mortensen, S.A. et al. (2014) ‘Effect of Coenzyme Q10 on morbidity and mortality in chronic heart failure: Q-Symbio trial’, Journal of the American College of Cardiology: Heart Failure, 2(6), pp. 641–649.
Pacetti, A. et al. (2019) ‘Functional medicine model and health-related quality of life: Cleveland Clinic study’, JAMA Network Open, 2(10), e1910247.
Parsons, J.K. and Kashefi, C. (2008) ‘Physical activity, benign prostatic hyperplasia, and LUTS: meta-analysis’, Eur Urol, 53(6), pp. 1228–1235.
Prostate Cancer UK. (2022) Diet and prostate cancer risk guidance. London: PCUK.
Steinberg, F.M. et al. (2005) ‘Vitamins E and C in prevention of cardiovascular disease in men’, Ann Intern Med, 142(1), pp. 37–42.
USDA and NHLBI (2015) Dietary Guidelines 2015–2020, Washington D.C.: USDA.
Williams, R.S. et al. (2009) ‘Multidimensional integrative medicine intervention reduces CHD risk’, Arch Intern Med, 169(9), pp. 106–112.
Zhang, Y., Lee, A., Patel, A. et al. (2020) ‘eHealth interventions for reducing CVD risk in men’, Preventive Medicine Reports, 19, 101126.