Dr. Subodh Verma
Cardiac Surgeon, St. Michael’s Hospital | Canada Research Chair in Cardiovascular Surgery | Professor, University of Toronto
Dr. Subodh Verma shares his perspective on screening, lifestyle changes, and reducing cardiovascular disease risk.
Q1: Heart disease remains one of the leading health concerns for Canadian men. What are some of the most important steps men can take today to reduce their cardiovascular risk?
The single most powerful thing men can do is know their numbers. Blood pressure, LDL cholesterol, blood sugar, Lp(a), C-reactive protein, smoking, physical inactivity, central adiposity, stress, and sleep duration and quality quietly drive most heart attacks, and you can’t manage what you don’t measure. Beyond that, the fundamentals matter enormously: don’t smoke or vape, stay physically active, and pay attention to waist circumference rather than just weight on a scale. Diet counts too—favour vegetables, whole grains, fish, and healthy fats over ultra-processed foods. Finally, know your family history. If your father or brother had early heart disease, your starting risk is higher, and that should prompt earlier, more aggressive prevention. Consistent, modest improvements across several risk factors add up to a dramatically lower lifetime risk. Slow and steady.
Q2: Many cardiovascular conditions develop silently over time. What warning signs should men be aware of, and when should they speak with a healthcare professional?
Classic chest pressure or tightness with exertion deserves urgent attention, but heart disease often whispers before it shouts. Be alert to unusual shortness of breath, unexpected fatigue, or discomfort radiating to the jaw, arm, or back. A noticeable drop in your exercise tolerance, or becoming suddenly winded by stairs you used to climb easily, is also important. Watch out for palpitations or episodes of lightheadedness. One sign men overlook: erectile dysfunction can be an early marker of blood-vessel disease, sometimes years before a cardiac event. As a rule, anything new, persistent, or worsening warrants a conversation with your doctor. And for sudden, severe chest pain, breathlessness, or fainting, don’t wait or drive yourself—call 911. Acting early saves heart muscle and can prevent death.
Q3: What roles do regular screenings and preventative care play in improving long-term heart health outcomes?
Screening lets us intervene while problems are still silent and fully modifiable. Cardiovascular risk assessment should generally begin around age 40, or earlier if you have a family history, diabetes, kidney disease, or other risk factors, and in some cases if you are part of a high-risk ethnic group, such as South Asian. A few simple checks—blood pressure, a lipid panel, Lp(a), CRP, UACR, and blood-sugar testing—combined with risk calculators give us a remarkably good picture of your future risk. The value is in the timing. Treating high blood pressure or cholesterol can be incredibly important in reducing long-term risk. Managing stress and sleep hygiene is equally imperative. Think of screening not as looking for disease, but as buying decades of healthy years.
Q4: How do lifestyle factors such as diet, exercise, sleep, and stress influence heart health, and which changes can have the greatest impact?
These four pillars are deeply interconnected, and their effects compound. A Mediterranean-style diet—rich in plants, fish, nuts, and olive oil—consistently lowers cardiac risk. Aim for at least 150 minutes of moderate activity weekly; movement improves blood pressure, cholesterol, and blood sugar simultaneously. Sleep is underrated: seven to nine quality hours support cardiovascular repair, and untreated sleep apnea is a genuine risk factor worth investigating if you snore heavily or wake unrefreshed. Chronic stress raises blood pressure and drives unhealthy habits, so managing it matters too. If I had to rank impact, not smoking and controlling blood pressure and cholesterol carry the greatest weight. But lifestyle is the foundation that makes everything else work. The good news is these changes reinforce one another: improve one, and the others tend to follow.
Q5: If there was one message you could share with Canadian men about taking a proactive approach to their health, what would it be?
Don’t wait for your body to send a warning you can’t ignore. Too many men treat their health as something to address ‘later,’ and in cardiology, later is sometimes too late. Strength isn’t powering through symptoms—it’s having the wisdom to check your numbers, ask questions, and act before a crisis forces your hand. A few small, consistent decisions made years in advance are far more powerful than any treatment I can offer in an operating room. Take charge early. Your future self, and your family, will thank you. The heart beats selflessly almost 100,000 times a day, and we need to take good care of it.