Heart disease is the number one cause of death globally, according to the World Health Organisation (WHO), accounting for a little under a third of all deaths. In 2016, nearly 10 million deaths were attributable to heart disease, with many more being linked to similar conditions. However, the vast majority of heart disease-related deaths are due to preventable causes, such as smoking, obesity or physical inactivity. Therefore, it is vital to understand what heart disease is and how it can be prevented.
For older people and those who look after them, it is essential to be informed about the effects of age on the heart, the types of heart disease, and the associated symptoms. While some damage to the heart is permanent, the impact of risk factors can be alleviated, with many therapies available to improve heart health in old age.
The heart’s function
On a basic level, most people understand the heart is a pump. Few realise that each day their heart beats more than 100,000 times, reacting to the environment to continually supply the body with oxygen. The heart is composed of four chambers. The chambers on the right pump blood to the lungs for oxygenation. The ones on the left pump the oxygenated blood from the lungs to the rest of the body. The more oxygen our muscles or body needs, the faster the heart pumps. The more resistance the heart faces, the harder it must pump, placing a strain on this vital organ.
Age and the heart
Throughout our lives – and depending on our lifestyle – fat builds up in our arteries, clogging them up. Like a blocked pipe in a water system, this places strain on the pump. As our hearts work harder; blood pressure rises – doctors call this ‘hypertension’. As a result, as you age, your heart becomes less capable, with the maximum heart rate dropping to 145, from a peak of 180 to 200 beats per minute.
Over time, the valves between the chambers can harden. The rhythm of your heart can become faulty due to changes in the electrical system. As your heart pumps against the hardened arteries, the muscle thickens, leading to impaired pumping. The heart itself can even enlarge. All of these are a sign of ageing and heart disease.
These changes are not purely governed by ageing and lifestyle, but also by genetics. People with a family history of poor heart health are more likely to experience problems themselves.
Heart disease: What is it?
The leading cause of heart disease is atherosclerosis: the long-term build-up of fats in the arteries, that leads to them becoming rigid and firm. In early life, these blood vessels are elastic and open to blood flow. However, once they become stiff and blocked, blood cannot flow normally leading to heart strain. If the heart is under constant pressure for long enough, then it will no longer work as a pump: this is called heart failure.
If the blockage occurs in one of the arteries that supply the heart with blood, then the heart will not receive as much oxygen, causing angina. If the heart muscle does not receive any oxygen, then the tissue will die, and a heart attack will occur. Following a heart attack, the heart has an impaired ability to supply the body with oxygen – another cause of heart failure.
What are the signs and symptoms?
High blood pressure or hypertension is one of the leading causes of heart disease; however, people rarely experience any symptoms. Therefore, it is vital to undergo regular check-ups with a doctor. If the blood vessels supplying the heart have become blocked (angina), the following symptoms may develop:
Chest pain will most commonly occur with exercise or exertion, as the heart requires more oxygen than the blood vessel can provide, due to the blockage.
If the above symptoms are severe, with crushing chest pain of sudden-onset, then it could be the sign of a heart attack. Immediately, seek medical services, ideally at a hospital.
Other signs of heart disease include a fluttering heartbeat or rhythm, alongside dizziness and shortness of breath. These symptoms are associated with an arrhythmia or rhythm problem, most commonly atrial fibrillation or AF. While the condition itself is not usually harmful, it can be a cause of other diseases, such as stroke or a clot on the lung. Therefore, it is vital to get tested by a doctor.
What tests will a doctor perform?
To measure the health of a heart, doctors and nurses will do a range of tests. We’ve already discussed measuring blood pressure; however, blood tests such as cholesterol monitor substances that can lead to plaques. Others monitor for heart strain and signs of heart failure.
More complicated tests include:
Electrocardiograms (ECG or EKG) are used to measure the rhythm of the heart by analysing electrical activity. It can show signs of heart attacks, arrhythmias and other conditions.
Chest x-rays are used to see an enlargement of the heart or fluid around the heart. They may also be used in complications of heart conditions, such as blood clots in the lung.
Echocardiograms use sound to see into the heart, examining the valves and seeing how well the heart is pumping. They let the doctor see your heart in action.
How to prevent heart disease?
To paraphrase an old saying: the best time to boost heart health was yesterday, the second-best time is today. No matter whether you or your loved one already have a heart condition or not, everyone can benefit from an improved lifestyle.
Physical activity, such as a brisk walk, gardening, dancing, or bowling, will all keep your heart pumping, improving its strength and resilience. Aim for 150 minutes of physical activity a week.
Eat healthily. A diet low in trans and saturated fats, processed sugars and salt is a fantastic way to give the heart a break. Fill your diet with fruits, vegetables, and plenty of fibre.
Quit smoking. This needs no explanation. Smoking is bad for almost every aspect of a person’s health.
Lower blood pressure and cholesterol. These can be managed through diet; however, many fantastic medications are available to help, such as ACE inhibitors or statins.
Drink less alcohol. Many people enjoy a drink. But moderation is key.
Practice stress reduction. Meditation and physical activity will lower stress, which can place a significant strain on the heart.
Follow these simple tips and look out for the signs and symptoms to maintain a healthy heart well into old age.