Like your hair and skin, your cardiovascular system also changes as you age. Starting as early as age 20, your heart and blood vessels start to gradually change over time, even in healthy cardiovascular systems. This can include a change in heart rate or rhythm, changes to the shape of the heart, thickening of heart valves and blood vessels, and more.
In a healthy cardiovascular system, the right side of the heart pumps blood to the lungs to receive oxygen and get rid of carbon dioxide, while the left side pumps oxygen-rich blood to the body.
Your arteries flow out of the heart, branching out and getting smaller as they go into your tissues until they become tiny capillaries. Capillaries provide oxygen and nutrients to the tissues, and receive carbon dioxide back from them. That carbon dioxide is then carried into larger and larger veins, which return blood to the heart.
However, your risk of heart problems slowly increases as you get older due to normal, age-related changes to your cardiovascular system, such as:
Age is a predominant risk factor when it comes to risk of heart failure. In the United States, 50% of all heart failure diagnoses and 90% of all heart failure deaths occur in those aged 70 and above. Researchers credit these numbers with a “convergence of declining cardioprotective systems and increasing disease processes.”
What this means is that while cardiovascular changes are a normal part of aging, when combined with risk factors for heart disease that are modifiable, they can increase your risk of heart failure. For example, high blood pressure, cholesterol levels, diabetes, obesity, and smoking are all risk factors for heart disease that you can address to help lower your risk.
You can keep your level of risk low by:
Plus, an older heart may not be able to pump blood as well when you make it work harder, so it’s important to be aware of certain medications, emotional stress, illness, infections, injuries, and physical exertion that can all make your heart work hard.
It’s important to speak to your health care practitioner regarding shortness of breath, fatigue, chest pain, or any other concerning symptoms. To determine the health of your heart, your doctor may perform a physical exam or order lab tests and imaging to investigate the cause for symptoms.
Imaging could include exams to find out how your heart performs under stress, such as an exercise stress test or myocardial perfusion imaging (MPI). Coronary computed tomography angiography (CCTA) may also be appropriate.
CCTA can non-invasively examine the coronary arteries using a combination of X-rays and computer technology to produce comprehensive, detailed images. It’s designed to look for plaque buildup in the arteries supplying the heart muscle (a risk factor for heart disease). Patients with family histories of heart disease may be at risk for developing atherosclerotic plaque buildup, blocking or narrowing these arteries. On CT, these can be identified even before symptoms of chest pain develop.
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Strait, J.B., & Lakatta, E.G. (2012) “Aging-associated cardiovascular changes and their relationship to heart failure.” Heart Failure Clinics. Jan. 8(1): 143-64. Accessed May 23, 2022.