Elena keeps an eye on her husband Frank to make sure he is taking care of his heart. But she was surprised at a recent medical appointment when Dr. Reyes asked about her family's history of heart disease. When Dr. Reyes heard that Elena's mother had died after a heart attack, he told Elena that she too should be following a heart healthy lifestyle. He said older women, as well as older men, can have heart problems. So now, Elena and Frank are both taking steps toward heart health.
Your heart is a strong muscle about the size of the palm of your hand. Just like an engine makes a car go, the heart keeps your body running. The heart pumps oxygen-rich blood through a network of blood vessels called arteries (taking blood away from the heart) and veins (bringing blood back to the heart).
Some changes in the heart and blood vessels are normal as you grow older. But over time, disease can damage your blood vessels and your heart.
A common problem for older people is arteriosclerosis (ahr-teer-ee-o-skluh-roh-sis). This is a stiffening of the arteries that happens, in part, because of growing older. Atherosclerosis (ath-uh-roh-skluh-roh-sis), the buildup of fatty deposits as plaques, is another cause. When plaque builds up along the walls of arteries, there is less space for blood to flow. This makes it harder for blood to get to all the parts of the body that need it, including the heart itself.
Other changes to the heart happen as you age. For example, to help the heart pump blood through stiffer blood vessels, some parts of the heart wall thicken. The size of the four sections of the heart also changes. So do the valves (door-like parts that open and close to control the flow of blood between those sections). The number of heart beats each minute when you are resting (the heart rate) does not change as you age, but the heart can't beat as fast when you are physically active or stressed as it did when you were younger.
There are many different kinds of heart disease. Plaque buildup is often to blame. But there are other causes too. For example, choices you might make every day can lead to damage to artery walls. Do you smoke? Do you drink a lot of alcohol? Are you overweight? Do you spend the day sitting at a desk or in front of the television? Do you avoid doing exercise? Do you have diabetes or high blood pressure that is not under control? Are you under a lot of stress? If you answered yes to one or more of these questions, making changes might help you prevent or delay heart disease. Things you can't control, like your family history, might also increase your risk of heart disease. But even so, leading a heart healthy lifestyle might help you avoid or delay serious illness.
One sign that you are at risk for heart disease is your waist measurement. Extra fat around the middle of your body increases risk. A good way to check that is simply to measure your waist. A man's risk of heart disease is increased if his waist measures more than 40 inches. A woman's risk is increased at 35 inches.
Early heart disease often doesn't have symptoms; that's why regular checkups with a healthcare provider are important. Your doctor will check things like cholesterol, a fat that can add to plaques in your arteries, and your blood pressure. He might also do a blood test for CRP (c-reactive protein). You might also have an ECG or EKG, an electrocardiogram. This is a test that looks at electrical activity in your heart.
Everyone should know the outward warning signs of heart disease.
Chest pain should be taken seriously. Pain in the chest, shoulders, arms, neck, jaw, or back can be a symptom of heart disease. If you have heart disease, you might feel chest pain during physical activity. But, it can have other causes too, so it is important to check with your doctor to learn what is triggering yours.
Heart Attack? Call 9-1-1
Act in time: Learn the warning signs of a heart attack. If you or someone you know might be having a heart attack, call 9-1-1 right away. You need to take an ambulance to the hospital as soon as possible. Do not try to drive yourself, and do not have someone else drive you unless there is no ambulance service where you live.
These warning signs can include crushing chest pain and/or discomfort or pain elsewhere in the upper body, nausea, a cold sweat, fainting or lightheadedness, or shortness of breath.
Other signs of heart disease include a weak or numb feeling on one side of the face or body, dizziness, headache, shortness of breath, tiredness, and swelling in the ankles, feet, legs, stomach, and neck. Some people who have a problem with their heartbeat may report a fluttering in their chest or the feeling that their heart is skipping a beat or beating too hard.
Talk to your doctor if you have any of these signs. Your healthcare provider may want you to see someone who specializes in heart disease. This doctor is called a cardiologist.
There are a lot of steps you can take to keep your heart healthy.
Try to be more physically active. Talk to your doctor about the type of activities that would be best for you. If possible, aim to get at least 30 minutes of moderate-intensity activity on most or all days of the week. Every day is best. It doesn't have to be done all at once—10-minute periods will do. Start by doing activities you enjoy—brisk walking, dancing, bowling, bicycling, or gardening, for example. You might want to join an exercise group or even a gym. See For More Information to learn how to get your free copy of Exercise and Physical Activity: Your Everyday Guide from the National Institute on Aging, written especially for older people.
If you smoke, quit. Smoking adds to the damage to artery walls. It's never too late to get some benefit from quitting smoking.
Follow a heart healthy diet. Choose low-fat foods and those that are low in salt. Eat plenty of fruits, vegetables, and foods high in fiber like those made from whole grains. And if you drink alcohol, men should not have more than two drinks a day and women only one. The National Heart, Lung, and Blood Institute (NHLBI) has information on two eating plans—Therapeutic Lifestyle Changes (TLC) and Dietary Approaches to Stop Hypertension (DASH). See For More Information to learn how to contact NHLBI.
Cholesterol is a type of fat in some foods. Eating fatty foods can raise the cholesterol in your blood. High blood cholesterol levels could add to the plaque in your arteries. Your doctor can check the cholesterol in your blood with a blood test. This will tell you your overall or total cholesterol level as well as the LDLs ("bad" cholesterol), HDLs ("healthy" cholesterol), and triglycerides (another type of fat in the blood that puts you at risk for heart problems).
Keep a healthy weight. Your healthcare provider will probably check your weight and height to learn your BMI (body mass index). A BMI of 25 or higher means you are at greater risk for heart disease as well as diabetes (high blood sugar) and other health conditions. Following a healthy eating plan and being physically active might help you.
The National Heart, Lung, and Blood Institute suggests you ask your doctor the following questions to learn more about your risk for heart disease and what to do about it. Be sure to ask what you can do if you are told you are at increased risk or already have a heart problem.
Here are some helpful resources:
American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
National Heart, Lung, and Blood Institute
Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
National Library of Medicine
For more information about health and aging, including exercise, high blood pressure, stroke, smoking, and diabetes, contact:
To sign up for regular email alerts about new publications and other information from the NIA, go to: www.nia.nih.gov/health.
Visit NIHSeniorHealth (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. Special features make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.
National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
Publication Date: August 2010
Page Last Updated: April 30, 2013