Heart health and aging (2024)

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How does the heart work?

Your heart is a strong muscle that pumps blood to your body. A normal, healthy adult heart is about the size of a clenched fist. Just like an engine turns a car, the heart keeps your body running. The heart has two sides, each with an upper chamber (atrium) and a lower chamber (ventricle). The right side pumps blood to the lungs to pick up oxygen. The left side receives oxygen-rich blood from the lungs and pumps it through arteries throughout the body. An electrical system in the heart controls the heart rate (heart rate or pulse) and coordinates the contraction of the upper and lower chambers of the heart.

How your heart changes with age

People aged 65 and over are much more likely than young people to suffer from itheart attack, to have oneslakor developcoronary artery disease(commonly called heart disease) andheart failure.Heart diseaseis also a leading cause of disability, limiting activity and affecting the quality of life for millions of older people.

Aging can cause changes in the heart and blood vessels. For example, as you get older, your heart can no longer beat as fastfysical activityor times of stress like when you were younger. However, the number of heartbeats per minute (heart rate) at rest does not change significantly with normal aging.

Changes that occur with age can increase a person's riskheart disease. A major cause of heart disease is the build-up of fatty deposits in the walls of the blood vessels over many years. The good news is that you can do things to delay, reduce, or possibly avoid or reverse your risk.

The most common change with aging is increased stiffness of the large arteries, called atherosclerosis (ahr-teer-ee-o-skluh-roh-sis), or atherosclerosis. This causeshigh bloodpressureor hypertension, which becomes more common as we get older.

High blood pressure and other risk factors, including old age, increase the risk of developing atherosclerosis (ath-uh-roh-skluh-roh-sis). Because there are several modifiable risk factors for atherosclerosis, it is not necessarily a normal part of aging. Plaque builds up within the walls of your blood vessels and over time hardens and narrows your blood vessels, restricting the flow of oxygen-rich blood to your organs and other parts of your body. Oxygen and blood nutrients are supplied to the heart muscle through the coronary arteries. Heart disease occurs when plaque builds up in the coronary arteries, reducing blood flow to your heart muscle. Over time, the heart muscle can become weakened and/or damaged, resulting in:heart failure. Heart damage can be caused byheart attack, long-term hypertension anddiabetesand chronically heavyalcohol consumption.

Age can cause other changes in the heart. For example:

• There are age-related changes in the electrical system that can lead tocardiac arrhythmias- a fast, slower or irregular heartbeat - and/or the need for a pacemaker. Valves — the one-way, door-like parts that open and close to regulate blood flow between the chambers of your heart — can become thicker and stiffer. Stiffer valves can restrict blood flow from the heart and leak, causing fluid to build up in the lungs or in the body (legs, feet, and abdomen).
• Your heart chambers may enlarge. The heart wall thickens, so the amount of blood a chamber can hold may decrease despite the increased overall heart size. The heart may fill more slowly. Long-term hypertension is the leading cause of increased heart wall thickness, which can increase the risk of atrial fibrillation, a common heart rhythm problem in older people.
• As people age, they become more sensitive to salt, which can cause a rise in blood pressure and/or swelling of the ankle or foot (edema).

Other factors, such as thyroid disease or chemotherapy, can also weaken the heart muscle. Things beyond your control, such as your family history, can increase your riskheart disease. But leading a heart-healthy lifestyle can help you prevent or delay serious diseases.

What is heart disease?

Heart disease is caused byatherosclerosis(ath-uh-roh-skluh-roh-sis), which is the buildup of fatty deposits or plaques in the walls of the coronary arteries over many years. The coronary arteries surround the outside of the heart and supply blood nutrients and oxygen to the heart muscle. When plaque builds up in the arteries, there is less room for blood to flow normally and deliver oxygen to the heart. If the blood flow to your heart is reduced by plaque buildup or becomes blocked, plaque can suddenly ruptureangina(chest pain or discomfort) or heart attack. When the heart muscle does not get enough oxygen and blood nutrients, the heart muscle cells will die (heart attack) and weaken the heart, making it less able to pump blood to the rest of the body.

Learn more about heart attacks.

Signs of heart disease

Early heart disease often has no symptoms, or the symptoms are barely noticeable. So it is regularconsult your doctorare important.

Contact your doctor immediately if you feel pain, pressure or discomfort in the chest. However, chest pain is a less common sign of heart disease as it progresses, so be aware of other symptoms.Tell your doctorif you have:

• Pain, numbness and/or tingling in the shoulders, arms, neck, jaw or back
• Shortness of breath when you are active, at rest, or while lying flat
• Chest pain during physical activity that gets better with rest
• Stiffness
• Dizziness
• Confusion
• Headache
• Cold sweat
• Nausea/vomiting
• Fatigue etcfatigue
• Swelling in the ankles, feet, legs, abdomen and/or neck
• Decreased ability to exercise or be physically active
• Trouble carrying out your normal activities

Problems witharrhythmiasare much more common in older adults than in younger people. Arrhythmia must be treated. See a doctor if you feel a tingling in your chest or as if your heart is skipping a beat or beating too fast, especially if you are weaker than normal, dizzy, tired, or short of breath when you are active.

If you have signs of heart disease, your doctor may refer you to heart diseasecardiologist, a doctor specialized in the heart.

For more information about heart disease, visitNational Heart, Lung, and Blood Institute.

What can I do to prevent heart disease?

There are many steps you can take to keep your heart healthy.

Try to be morephysically active. Talk to your doctorabout the type of activities that suit you best. If possible, try to get at least 150 minutes of exercise every week. Every day is the best. It doesn't have to be done all at once.

Start with activities you enjoy, such as brisk walking, dancing, bowling, cycling or gardening. Avoid sitting for hours each day.

If you smoke, stop. Smoking is the leading cause of preventable death. Smoking increases damage to the artery walls. It's never too late to take advantagequit smoking. Stopping, even later in life, can reduce the risk of cardiovascular disease.slak, InCancerafter a while.

Follow a heart-healthy diet.Choose foods with low contentsaturated fats,added sugar, Insalty. As we age, we become more sensitive to salt, which can cause swelling in the legs and feet. Eat plenty of fruits, vegetables and fiber-rich foods, such as foods made from whole grains. Get more information abouthealthy dietfrom NIA. You can also find information aboutDietary measures to stop hypertension(DASH) eating plan and the United States Department of AgricultureFood patterns.

Maintain a healthy weight.Balancing the calories you eat and drink with the calories you burn through being physically active can help you maintain a healthy weight. Some ways you can maintain a healthy weight include:limit portion sizeand the creaturephysically active. Read more about how youmaintain a healthy weightof the NIA.

See Tuesdiabetes,high bloodpressureand/or high cholesterol under control.Follow your doctor's advice to manage these conditions and take medications as prescribed.

Don't drink muchalcohol.Men should drink no more than two glasses a day and women only one. One drink equals:

• A 12-ounce can or bottle of regular beer, beer or wine cooler
• An 8 or 9 ounce can or bottle of malt liquor
• A 5-ounce glass of red or white wine
• A 1.5-ounce shot glass of spirits such as gin, rum, tequila, vodka or whiskey

Deal with stress.Learn how to manage stress, relax and cope with problems to improve physical and emotional health. Think of activities likestress management program,meditation,fysical activityand talk to friends or family. To learn more about stress management techniques, visitNational Center for Complementary and Integrative Health.

To learn more about making changes to your heart-healthy lifestyle, visitNational Heart, Lung, and Blood Institute.

The future of research into aging and the heart

Adults aged 65 and over are more likely than young people to suffer from cardiovascular disease, which are problems with the heart, blood vessels or both. Aging can cause changes in the heart and blood vessels that can increase the risk of developing cardiovascular disease.

To understand how aging is related to cardiovascular disease, so that we can ultimately develop treatments for this group of diseases, we must first understand what happens in the healthy but aging heart and blood vessels. This understanding has evolved dramatically over the past thirty years.

Learn more about The Heart Truth®, a national heart disease awareness campaign for women from the National Heart, Lung, and Blood Institute.

Today, researchers understand more than ever what causes your blood vessels and heart to age and how your aging cardiovascular system leads to cardiovascular disease. In addition, they have identified risk factors that increase a person's chance of developing cardiovascular disease. They learn a lot more about howfysical activity,costsand other lifestyle factors influence the “aging rate” of the healthy heart and arteries. The aging of other organ systems, including the muscles, kidneys and lungs, also likely contributes to heart disease. Research is underway to discover how these aging systems interact, which could reveal new targets for treatments.

In the future, interventions or treatments that slow the accelerated aging of the heart and blood vessels in young and middle-aged people who appear healthy will prevent or delay the onset of heart disease.slakand other cardiovascular diseases later in life. Some interventions that we already know slow down the aging of the heart and blood vesselshealthy diet,exercise, reduce stress andquit smoking. The better we understand the changes that take place in cells and molecules during aging, for example, the closer we come to being able to design drugs that target these changes. Gene therapies can also target specific cellular changes and could potentially provide a way to intervene in the aging process. While you wait for these new therapies to be developed, you can still enjoy activities, such as exercise and healthy eating, that can benefit your heart.

For more information about heart health

Million Hearts Initiative
Center for Disease Control and Prevention
Center for Medicare & Medicaid Services
https://millionhearts.hhs.gov

This content is provided by the NIH National Institute on Aging (NIA). NIA investigators and other experts review this content to ensure it is accurate and current.

Contents reviewed: June 1, 2018