For our Aging Gracefully series, WTOP speaks with different specialists at MedStar Washington Hospital Center about the best ways to maintain your health as you age.
WASHINGTON — There are a lot of misconceptions when it comes to how the heart ages.
“People assume as your heart ages, it becomes weaker and you have problems with this, that and the other, and that’s not necessarily true,” says Dr. Samer Najjar, the director of Heart Failure with MedStar Heart & Vascular Institute at MedStar Washington Hospital Center.
Najjar says because cardiovascular-related diseases are more prevalent in older adults, it’s assumed that these diseases are normal to acquire with age. But really, age and disease are two separate issues.
There are some natural changes that happen to the heart and blood vessels as they age. For starters, an aging individual is unable to obtain as high of a heart rate during exercise as a younger individual.
“That’s why a 70-year-old can’t complete with a 20-year-old … from a heart perspective,” Najjar says.
Blood vessels in the body also become stiffer with age. In a young individual, the aorta is a very compliant vessel. But as a person ages, the blood vessels, which have worked hard for a number of years, undergo structural changes and become stiffer.
When this happens, Najjar explains that the heart has to work harder to pump the blood through the vessel.
“All of the sudden, a couple of things are happening. Number one, the heart has to do more work, and that’s not good for the heart because now it has to generate more force,” he says.
A harder-working heart predisposes an individual to other health issues often seen in old age, such as heart failure.
“Because the heart has to work more for a longer period of time and it may start saying, ‘I’m getting tired out,’” Najjar says.
Another disease that’s a result of stiffening vessels is hypertension, or high blood pressure, which is also common in the older population.
“The most common hypertension is called systolic hypertension; it’s from stiffness. So stiffening of the vessels, which is something you get from aging, leads to hypertension,” Najjar says.
A heart attack, however, is not a natural symptom of an aging heart.
“Developing atherosclerosis is not a normal aging thing,” says Najjar, who adds that diet, lack of exercise and smoking all contribute to this state of plaque build up in the arteries, which can lead to heart attack and stroke. “That’s a disease state of some sort.”
However, Najjar says age makes it easier for heart diseases to manifest.
“Aging lowers your threshold for developing those cardiovascular diseases that we all talk about, given the stimulus that people are receiving.”
For example, a young person who eats a lot of sodium may not see a change in his blood pressure early in life. But at an older age, the same amount of sodium intake will likely have a greater impact.
So how does one keep a healthy heart with age? Najjar says the answer involves some low-tech interventions.
“We know, without a shadow of a doubt, that exercise actually can prevent these things from happening.”
He says a mix of aerobic exercise and light resistance training is the most effective approach. Maintaining a healthy diet and not smoking are also important when it comes to keeping heart disease at bay as you age.
“Salt is a big contributor to these things. Moderating the amount of salt you eat also can have long-term effects,” Najjar says.
Genetics plays an important role in the health of your heart as you age, as well. “And I have no doubt that there’s many other risk factors that we just don’t know about in 2015,” Najjar adds.
Since people go through the aging process at different speeds, Najjar says the best thing to do is to adopt these practices as soon as possible. Smoking, remaining sedentary and eating poorly will only put you on the “fast track” to a declining heart.
Hypertension can be managed with drugs, but there are no screening tests for overall heart health as you age. Najjar says this is mostly because there is no “magic pill” to treat an aging heart and cardiovascular system.
“People don’t need to have screening tests; they need to identify the risk factors and modify them. And then modifying risk factors is something that is available to us, and that’s what we really should focus on.”
