What happens to your heart as you get older

As we age, the heart and blood vessels undergo several, often significant, changes.

Make your heart health a priority (Alamy/PA) (Alamy/PA)

As we mature, it’s easy to notice the changes we can see – such as shifts in our skin, muscle tone, or even hair colour – but far less obvious are the changes happening beneath the surface, particularly in the heart.

To mark Heart Health Month this February, we spoke with Dr Anish Bhuva, consultant cardiologist at HCA Healthcare UK The Wellington Hospital, to find out what structural and functional changes the heart can undergo as we get older. He has also shared some practical advice on how to counter some of these effects to help keep your heart healthy and resilient well into later life.

Heart muscle can decrease in size

“Across the whole body, muscles tend to lose their mass over time, and we are becoming more conscious about trying to reverse the speed of that decline,” says Bhuva. “The heart, like any other muscle, also shows that process. There are also small changes in the heart muscle which means it becomes thinner with time as well. That usually doesn’t cause much harm in itself, but it is a process that you can see with ageing.”

Aortic stenosis

“There’s four valves in your heart and all of them open and close with every heartbeat over a person’s lifetime,” says Bhuva. “The purpose of the heart valves is to support efficient blood flow and stop it going backwards.”

But as you get older, your aortic valve can become narrowed which stops it from working properly, a condition called aortic stenosis, according to the British Heart Foundation’s website.

“Over time, like an engine in a car, it does wear and tear,” says Bhuva. “The heart valve can gradually become a bit more degenerated, you can get calcium build-up, and the valve can become much stiffer and thicker, which leads to difficulties opening properly.

“This can start to cause difficulties of blood flowing from the heart to the rest of the body, because it’s blocking the flow.”

Blood vessels and arteries can become stiffer

“A hallmark of ageing is when the aorta and blood vessels become stiffer,” says Bhuva. “When your vessels get stiffer, it increases the risk of stroke and heart disease.”

Heart rate can’t increase as fast during physical activity

“You might find that your heart rate can’t increase as fast as it would when it was younger with physical activity,” says Bhuva. “Most people tolerate that, but for some people that can cause symptoms and problems which can be supported with a pacemaker.”

Wear and tear of the electrical wires within the heart

“With time, you can also get wear and tear of the electrical wires within the heart,” adds the cardiologist. “This usually doesn’t cause any problems, but for some people, it can cause abnormally slow or abnormally fast heart rhythms. People may experience fluttering in their chest, dizziness or blacking out, or can experience no symptoms at all.”

Increased risk of heart attacks

“The most common risk factor for a heart attack is age,” says Bhuva. “Unfortunately, heart attacks become more likely as you get towards middle age and beyond.

“That’s why it’s so important to be proactive and to identify what factors in your life might be accelerating the ageing, degenerative processes in your heart.”

What can we do to combat some of these effects?

Quit smoking

“If you’re worried about family history of heart disease, the first thing to do is to stop smoking,” says Bhuva. “Smoking damages the arteries and enables cholesterol plaque build-up.”

Monitor your blood pressure and cholesterol levels

“Make sure you are monitoring your cholesterol and blood pressure,” advises Bhuva. “Once you get to the age of 40, we recommend a health check by your doctor to check your blood pressure, cholesterol and all the other common risk factors. Older adults should get this checked every year.”

Eat a healthy diet

“Your five-a-day is super important, so make sure you are eating lots of fruit and veg,” says Bhuva. “Try to eat less red meat and more oily fish, as that is really good for cholesterol. Also, try to minimise your consumption of artificial sugars.”

Move your body

“The most beneficial thing you can do is to start moving in whatever way you can,” says Bhuva. “You don’t need to do a marathon every year, just small levels of exercise like walking every day can be really beneficial.

“Exercise can help slow down the ageing process in the cardiovascular system in many, many different ways.”