How Does The Heart Work, And How Does It Change As You Age?

Everyone ages with time, and the aging process affects every part of your body, including the heart. The older you get, the higher are your chances of having a heart attack or develop heart disease. It is expected that by the time they reach the 60s, 10% of women and 20% of men develop heart disease. By the age of 80, these numbers grow to 19 percent of women and around 32% of men.¹

Most people think that they can wait for until they are older to start thinking about their heart health. However, if you wait until you are 70 or 80 years old to start taking care of your heart, it could already be too late. This is because by that time, the heart muscles already become stiffer, and neither does it beat as quickly as it once used to when you exercise or do other activities. With age, the arteries that carry blood to from the heart to the rest of the body also become harder, increasing the risk of developing high blood pressure or hypertension.²

In order to understand the effects of aging on the heart, let us look at how aging affects the heart first.

The heart muscle is one of the strongest muscles in the body. It pumps blood to your entire body. A normal healthy adult heart is typically the size of a clenched fist. The heart has two sides, with each side having a top chamber known as the atrium and a bottom chamber called the ventricle. The right side of the heart pumps blood to the lungs to pick up oxygen, while the left side receives blood that is enriched with oxygen from the lungs and then pumps it through the arteries throughout your body.³

You can say that there is a type of electrical system in your heart that controls your heartbeat or heart rate. It also coordinates the contraction of both the heart’s top and bottom chambers.⁴

By the age of 65 and older, people become more susceptible than young people to have a stroke, heart attack, or develop heart failure or coronary heart disease (also known as heart disease). In older people, heart disease can be one of the major causes of disability, restricting your daily activity and even eroding the quality of life in millions of older adults.

Aging has a profound impact on the heart and your blood vessels. As you get older, the heart is unable to beat as fast as it used to during physical activity or during times of stress, as it used to when you were younger. However, there is not much of a change in your heart rate, or the heart beats per minute, at rest with normal aging.

Nevertheless, the many changes that happen as you age are known to increase the risk of heart disease. The most common aging change that happens is the increased stiffness of the large arteries of the body, a condition known as arteriosclerosis, or hardening of your arteries. This increased stiffness of the arteries can cause high blood pressure or hypertension, which is also more common as we continue to age.⁵

High blood pressure, along with advancing age, can increase your risk of heart disease. One of the major causes of heart disease is the accumulation of fatty deposits in the arterial walls over many years.⁶

Advancing age, high blood pressure, along with other risk factors, increase the risk of developing atherosclerosis. Due to the fact that there are many modifiable risk factors for atherosclerosis, it is not really considered to be a normal part of aging. The plaque buildup inside the walls of the arteries, and the hardening and narrowing of the arteries over time, can limit the flow of oxygen-enriched blood to your organs and other parts of the body. The coronary arteries supply oxygen and blood nutrients to the heart muscle. Heart disease begins to develop when the plaque that has accumulated in the coronary arteries begins to reduce the blood flow to the heart muscle. Over a period of time, the heart muscle starts to get weak or becomes damaged, which can result in heart failure. Heart damage can also be caused by long-term hypertension, heart attacks, diabetes, and chronic heavy alcohol use.^7,8

With age, many other heart-related changes can also occur. These include:

The chambers of the heart may increase in size, and the heart wall may thicken. This may cause the amount of blood that the heart chamber can hold to decrease despite the increase in the overall size of your heart. The heart may also fill up more slowly. One of the primary causes of increased thickness of the heart wall is having high blood pressure for a long time. This can also increase the risk of atrial fibrillation, which is a commonly observed heart problem related to the heart rhythm in older adults.^9,10

Age-related changes can occur in the electrical system of the heart that can cause arrhythmias, which is characterized by slow, rapid, or irregular heartbeat. This may cause you to need a pacemaker. This may also impact the heart valves, which are the door-like parts that open and close to allow the heart to control the blood flow between the chambers of the heart. The valves may also become stiffer and thicker, which can restrict the blood flow out of the heart and become leaky. Both of these can lead to fluid buildup in the lung or rest of the body, including the legs, feet, and abdomen.^11,12

With advancing age, people can also start becoming more sensitive to salt. This can cause an increase in your blood pressure and/or even lead to swelling in the ankle or foot, a condition known as edema.¹³

The heart is not able to squeeze as tightly as it used to as you age. Due to the increase in your diastolic blood pressure, the heart also starts to stretch more with each beat, delivering a stronger pump to have a stronger contraction that will allow the heart to pump the excess blood volume. However, due to the increased diastolic pressure, the heart is no longer able to squeeze as tightly as before.

Your exercise capacity will also decrease as the heart ages. The heart becomes less capable of responding as rapidly as it used to chemical messages received from the brain. However, researchers do not know exactly why the heart fails to respond as fast as it used to messages to speed up and when to adjust to any type of increased activity.

The resultant of this is that the body is not able to exercise for as long or as intensely as it used to before. The signs of this can show up as shortness of breath, which is a sign that your oxygen-enriched blood is not moving fast enough throughout the body, and the lungs are trying to take in more oxygen.

There are many other factors like thyroid disease and/or chemotherapy, can also weaken the heart muscle. There are also several factors over which you have no control, including your family history, but these can also increase the risk of heart disease as you age. However, following a heart-healthy lifestyle can help you prevent or delay serious heart-related illness.

Here are some of the risk factors for heart disease as you age that cannot be changed, but some of these are under our control:

• Gender: Studies have shown that men tend to get heart disease nearly ten years earlier than women. Women are likely to remain protected by estrogen until after they reach menopause. After menopause, women’s risk for heart disease begins to match the risk of men.¹⁴
• Family history: As mentioned above, you can’t control your family history. Your risk of developing heart disease is significantly higher if your brother or father were diagnosed with heart disease before the age of 55 or if your sister or mother were diagnosed before the age of 65.¹⁵
• Blood pressure: Having persistent blood pressure over 120/80 mmHg ages our heart faster.¹⁶
• Cholesterol: The higher your cholesterol levels are, the older your heart will be, and the faster it will continue to age.¹⁷
• Smoking: Any smoking increases the risk of stroke and heart attack, even if you only smoke once in a while. Being exposed to secondhand smoke can also be dangerous.^18,19
• Weight: Being obese or overweight puts a lot of strain on your heart, making it age faster than usual.²⁰
• Diabetes: Having prediabetes or diabetes puts you at an increased risk for developing heart problems.²¹

However, it is never too late to reduce your risk factors for heart disease and your heart’s age. Here are some things you can do to help your heart stay young and healthy.

You must make an effort to stop smoking sooner than later. There are many things you can do to protect your heart and your arteries. Avoiding any form of tobacco is one of the best things you can do for your heart health as you age.

Smoking is known to be one of the biggest controllable risk factors for heart disease. If you smoke or use tobacco products in any form, the National Heart, Lung, and Blood Institute (NHLBI), the American Heart Association (AHA), and the Centers for Disease Control and Prevention (CDC) all actively encourage you to quit at the earliest.

Quitting smoking can not only help your heart, but it can also be good for your overall health.^22,23,24

Not matter how long you have been smoking, your heart will get healthier once you quit, but it will not happen overnight. Quitting smoking can be a challenging process. Many people try to quit smoking and fail dozens of times before they finally succeed in quitting for good. Counseling quit smoking programs and medication can help you quit smoking for good. It is always a good idea to reach out to your doctor for help instead of struggling alone.

Research published in the Journal of the American College of Cardiology has linked the presence of excess belly fat to high blood pressure and unhealthy levels of blood lipid.²⁵ If you have excess fat around your middle, it is time to start exercising and following a healthy lifestyle to cut down your belly fat. Eating fewer calories and regular exercising can help you cut down the excess belly fat.

It is important that you take care of any chronic diseases or conditions. The most important thing to do is to manage your blood pressure within the normal range. This will lower the risk of developing heart-related problems.

The same is applicable for diabetes and high cholesterol. Conditions such as thyroid disease and even some medications can weaken your heart over time. If you have any chronic condition, it is important to have regular checkups with your doctor, follow the treatment plan and take your medications as your doctor has prescribed.

It is essential that you maintain a healthy weight. So increase your intake of fruits and vegetables and consume plenty of fiber. At the same time, focus on eating more chicken, fish, and legumes over red meat. While, of course, you don’t need to completely eliminate your favorite foods, but try to limit the intake of trans fats, salt, refined sugar, and saturated fats. You should also cut back on reducing the portions of your favorite foods and prevent snacking between meals.²⁶

Your heart needs exercise to remain in shape.²⁷ Exercise helps increase the heart’s pumping ability and also allows it to deliver oxygen throughout the body. Regular exercise will also help you keep your blood pressure and weight under control. Exercise is also the best way to reduce stress.

If you have a condition or disease that makes it challenging to exercise, you can discuss with your doctor to come up with a modified exercise program that is designed to suit your capabilities.²⁸

Older adults are more likely than younger people to suffer from heart disease. Aging can cause many changes in your heart and blood vessels that increase the risk of developing heart disease. However, following a healthy lifestyle, exercising regularly, eating right, and learning how to manage your stress can help you have a better quality of life and also keep your heart healthy.

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