Understanding Heart Health: What You Need to Know
Heart health can feel overwhelming, especially with all the advice out there about what to watch for as we age. But staying on top of it doesn’t have to be complicated. In this conversation, we dive into the common misconceptions about heart disease, early warning signs to look out for, and practical steps seniors (and their caregivers) can take to maintain a healthy heart. Whether you're curious about risk factors, symptoms, or simple ways to stay proactive, this discussion provides clear, expert-backed insights to help you make informed decisions about your heart health.
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Heart health is tough sometimes for the average person to understand exactly what we're supposed to be looking for, and it changes as we get older. But, generally, I think the misconceptions are that, well, if I feel fine, I'm okay, and I must not have any issues.
And so that's not always the case. We recommend, in our offices, a yearly exam so that the patient can spend time with their doctor discussing how they're feeling. If there's a change in their condition, the doctor can pick up on that quickly and really come to a conclusion that maybe not everything is okay. Just because you're feeling well doesn't mean you don't have some underlying issue.
That's great, that kind of leads to my next question:
How can individuals assess their risk for heart disease? What are some of the things that seniors, or anyone for that matter, but certainly seniors, should be thinking about?
I think the most important thing for seniors to recognize is that if there's a change in how they're feeling from their baseline, that's a signal to go get checked. If all of a sudden they're more tired than usual and there's not a good explanation for that, or they're becoming more short of breath, they don't have to necessarily have chest pain. They can just be experiencing shortness of breath, a change in their condition—maybe their weight has fluctuated, or they have swelling in their feet. Those are times when it's important to make an appointment, go see your doctor, and get checked out.
There are more specific things they can do, like the heart scan. A lot of hospitals offer promotional coronary CT scans that are inexpensive. Some hospitals offer them for $49 as a screening, where you can get your lungs and heart scanned to check for calcium in the arteries. That can sometimes reveal existing coronary artery disease that you didn’t know you had.
The main point I’d like to make is that if there's a change in your baseline, if there's a change in how you feel, it’s worth getting checked. Women, in particular, may not have chest pain. They may not have shortness of breath. They may just say, "I'm more fatigued than normal," and that’s a sign to get your heart checked.
That makes sense, that's great.
What are some of the early warning signs of a heart attack or other cardiac event?
A lot of people think that the typical presentation of a heart attack is someone clutching their chest and collapsing with pain. That isn’t always the case in men or women. Certainly, men may experience more pain as the initial presenting symptom, whereas women may, as I mentioned before, have fatigue and shortness of breath without experiencing pain.
If there’s pain on one side of the chest radiating up into the jaw, profuse sweating, sudden shortness of breath, an inability to catch your breath, or a racing heart, those are all signs of a possible heart attack or another cardiac event, such as an arrhythmia.
But it can also be more subtle. For example, you might be out cutting the grass and suddenly develop chest pressure. You sit down, and it goes away, but when you resume cutting the grass, the pressure returns. Some people think, "Well, I'm okay if I sit down," but that could be a sign of a significant blockage in one of the arteries, so you'll want to get checked out.
A lot of times, people develop these subtle signs weeks before an actual heart attack. The body gives warning signs, so I encourage people not to overlook them and to see a doctor to get checked out.
Those are all great points.
How does aging impact the heart? What should seniors do to maintain cardiovascular health? Are there unique heart health concerns for seniors they should be aware of?
The initial thinking for a lot of people is, "Well, my cholesterol is okay, so I don't have to worry." But there’s much more to cardiac health than just cholesterol. A fasting lipid panel should be done annually, at a minimum, once you’re over 65.
Checking your blood pressure is also crucial. Having a home blood pressure monitor is helpful. The standard in the U.S. has been to keep blood pressure under 130/80, though recent studies suggest 120/80 as a better target. As we age, the systolic (top) number can rise slightly, which is normal, but it's still important to keep an eye on it.
Doctors can also check for inflammation in the body, which plays a role in heart health. The Cleveland Clinic, for example, is conducting research on inflammatory biomarkers—blood tests that detect inflammation, which may indicate a higher risk for coronary events beyond what a regular cholesterol check reveals.
Managing blood sugar is also key. A fasting blood sugar level should be between 70 and 100, and the A1C (a three-month average of blood sugar) should be under 5.7%. The main takeaway is that you shouldn’t just check these things once and assume you're okay. As we age, it's important to monitor them yearly, or even twice a year.
That’s great. When you talk about that, I also think about caregivers.
How can caregivers or family members help seniors manage heart-related conditions and maintenance activities?
As we get older, it becomes more difficult to manage health because we often have multiple doctors prescribing different medications. This can be overwhelming. Caregivers—whether a spouse, an adult child, or another family member—play an important role in ensuring medications are taken correctly and at the right times.
Caregivers can also help monitor for changes in a senior’s condition. A family member might notice that their loved one isn’t moving as well as they did a couple of weeks ago or seems more short of breath, even if the patient doesn’t recognize it. That’s why I find it valuable when a spouse or family member accompanies a patient to appointments. They provide another perspective and can help track changes objectively.
Caregivers don’t need to be doctors or nurses to notice if something is off. They can help ensure appointments are kept and medications are managed properly. When spouses or family members come in with patients, I often take the time to educate them on what to look for at home. If they notice any concerning changes, they can call us, and we can get the patient in for evaluation.