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Heart Health at Every Age

Your decade-by-decade guide to a healthy heart.

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The statistics are staggering: More than 2,000 people die of heart disease in this country every day. That’s an average of one death every 40 seconds. And while the risk of heart disease increases with age, it’s never too early to get into healthy habits that help protect this essential organ. In fact, the younger you start, the better off you’ll be. 

“Atherosclerosis, which is a buildup of fats, cholesterol, and other substances in your arteries, accumulates over a lifetime,” says Eugenia Gianos, MD, director of women's heart health at Northwell Health’s Lenox Hill Hospital and director of cardiovascular prevention for Northwell. “Our views as physicians have changed over the last 10 years,” she says. “While historically, doctors have treated hearts later in life after a cardiac event has occurred, we are now able to help patients avoid the disease process altogether, which is obviously the best course of action.”

Here’s what you can do at every age to help keep your heart healthy for life. 

Your 20s

Pay attention to your numbers, particularly if you have risk factors. High blood pressure, cholesterol, and diabetes all increase your risk of heart disease, and all can start at an early age. High blood pressure has no symptoms, so have your blood pressure checked at least once every two years. If it’s over 120/80, your doctor may want to check it more often. You should also have your cholesterol levels tested with a fasting lipoprotein profile. If it’s high, talk to your doctor about a follow-up plan and ways to bring it down. If all is well, repeat at least every four to six years, or more often based on your physician’s recommendations.

If your body mass index is higher than 25 (23 if you’re Asian American) or you have other diabetes risk factors, such as high blood pressure, high cholesterol, a sedentary lifestyle, a family history of diabetes, or a history of polycystic ovary syndrome (PCOS) or heart disease, get screened for diabetes now.

Get moving. The earlier you make exercise a habit, the more likely you’ll stick with it for the long haul. Exercise strengthens your heart, improves circulation, helps with weight control, and lowers your cholesterol, blood sugar levels, and blood pressure, says Dr. Gianos. The American Heart Association recommends at least 30 minutes of moderate-intensity aerobic activity—that’s fast walking, jogging, biking, or dancing—at least five days per week, and muscle-strengthening exercises at least twice a week.

Your 30s

Don’t smoke. Full stop. Quit smoking and you can lower your risk of heart disease as much as, or more than, you would if you took aspirin, statins, beta blockers, or ACE inhibitors. “Smoking just one cigarette can have negative effects on the heart. It's simple. Don’t smoke. If you smoke, use all available resources to stop. It is doable!” says Dr. Gianos.

Share any pregnancy problems with your doc. Research has found that a history of gestational diabetes or preeclampsia can raise your risk of having diabetes or high blood pressure later in life. If you experienced either during a pregnancy, discuss it with your physician.

Make sure you floss. Studies show that gum disease may increase your chances of developing heart disease by nearly 50%. Brush twice a day, floss once a day, and see your dentist every six months.

Your 40s

Check your stress levels. Taking care of your career, young kids, aging parents, and all the other responsibilities common at this stage leave little time for relaxation. But don’t let stress get the best of you—it may lead to poor health choices like eating junk food, skipping exercise, or skimping on sleep, all of which can increase your risk for heart disease. Add to that the fact that acute stress sets off the fight-or-flight response, causing your body to release adrenaline, a hormone that triggers your heart to race and your blood pressure to rise.

Learning mechanisms to help you cope with stress is essential. It’s not always easy, but try to leave some time for yourself in your schedule. Simply going out for a walk during lunch or after work can help you relax.

Test your blood glucose levels. If you haven’t already, get tested for type 2 diabetes at age 45. If your levels are normal, retest at least every three years.

Ask about a coronary artery calcium (CAC) score. This test uses CT scan to help your doctor visualize and measure any calcium-containing plaque in the arteries. “For patients who have strong family histories of heart disease or risk factors like borderline cholesterol levels, this gives us a better picture to decide where to go with treatment,” says Dr. Gianos.

Your 50s

Eat like the Greek. “Cardiometabolic changes happen in women due to the hormonal changes after menopause. So re-examining your diet is a really good idea,” says Dr. Gianos. Consider going Greek. Research has found that a Mediterranean diet can slash your risk of heart disease by almost 30%. Make sure your menu includes plenty of plant-based foods, whole grains, beans and other legumes, nuts, healthy fats, and moderate amounts of fish, lean poultry, and dairy products.

Start a gratitude habit. It’s easy to focus on the negative, particularly as the aches and pains of aging begin to take hold. Spend a little time each day to record or share with family three things you’re thankful for. Research from the University of Illinois found that grateful people lead healthier lifestyles. 

Get enough ZZZs. One large study found that those who slept fewer than six hours a night were twice as likely as those sleeping six to eight hours to experience a stroke or heart attack and 60% more likely to have congestive heart failure. Yes, getting more sleep is easier said than done. Read this for some real-world sleep solutions.

Get assessed again. This is especially important for women around menopause. “Your cholesterol profile, sugar levels, and other issues can change, all of which may put you at a different risk level for heart disease,” says Dr. Gianos. Your doctor may change strategies for preventive therapies post-menopause.

Your 60s

Reset your social life. Many people isolate themselves as they get older. But it’s essential to stay connected to friends and family. Having strong social ties has been linked to a longer life. And research shows that a lack of social relationships is associated with a higher risk of heart disease and stroke. Loneliness can be stressful and lead to physical inactivity and poor coping mechanisms like drinking and smoking. Some ways to get involved: Invite neighbors over for a game of cards, sign up for a yoga class, take Spanish lessons, or volunteer at a local soup kitchen.

Ask your doctor about a test for C-reactive protein (CRP) or a coronary artery calcium (CAC) score. CRP is a marker of inflammation in the blood and there’s a link between inflammation and heart disease, says Dr. Gianos. But keep in mind that this marker is also elevated in other inflammatory diseases such as lupus, rheumatoid arthritis, and psoriasis. A CAC helps doctors predict cardiovascular events. “These tests can be valuable at times when we’re on the fence about whether or not there is an issue that requires treatment.”

Your 70s and beyond

Keep even closer tabs on your risk factors. As you age your risk for a heart attack goes up, so it’s crucial to continue to track your numbers, including your weight, cholesterol, blood pressure, and fasting blood sugars. Visit your doctor regularly to make sure you remain on the right path to continued heart health.

Be able to spot the symptoms. The average age for a woman to have her first heart attack is about 70. The key to surviving is getting help in time. If you experience any of the following, call 911 immediately.

  • Chest pain or discomfort (heart attack pain often strikes in the center of the chest and lasts for more than a few minutes. It may even go away and come back, and can be described as uncomfortable pressure, squeezing, or fullness)
  • Pain or discomfort in other areas of the body (usually one or both arms, the back, neck, jaw, or stomach)
  • Shortness of breath
  • Breaking out in a cold sweat, nausea, or lightheadedness

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Published July 23rd, 2019
A young woman with dark curly hair is using mobile phone. Female is smiling while holding smart phone. She is lying on sofa at home.

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