With age comes change. Crow’s feet, fragile and looser skin, and a receding hairline can all manifest, not to mention bone, joint, and muscle issues that leave us creaky and uncertain of the way we walk.

But arguably the most important change is one out of sight and sometimes tougher to detect: the changes in our hearts.

“The muscle can get thicker with age and stiffer, less able to relax between beats,” Dr. Gina Lundberg, a professor at Emory University School of Medicine and clinical director of the Emory Women’s Heart Center, told The Atlanta Journal-Constitution.

The metabolic changes stand out as well.

“Good cholesterol is declining. The bad cholesterol is going up. The triglycerides are going up. You’re becoming more insulin-resistant or heading toward diabetes,” Lundberg said.

All of these changes predispose one to develop atherosclerosis, which is a buildup of fats and cholesterol on the walls of an artery that can cause narrowing and blockages and cardiovascular problems long term, she said. According to the Mayo Clinic, this occurs when the major blood vessels that supply the heart aren’t able to send enough blood and nutrients to supply the heart muscle, which can cause coronary artery disease.

According to a study published in the American Journal of Nursing, the most common hospital admission is for heart failure. Also, the potential for heart attacks, angina, and congestive heart failure only increases with age, according to a study published in the National Library of Medicine. Race, gender, and age are also factors.

But tackling what is under our control can go a long way.

“I’d say as much as 80% is completely modifiable,” says Avril James Maynard, Piedmont Heart Institute Women’s Heart Program coordinator, Fayette/Newnan.

So how can you achieve that goal? Here are some tips from the experts.

Check blood pressure

Maynard said walking into a pharmacy and using one of those check-your-blood pressure machines doesn’t yield the most spot-on results, “because you wouldn’t be relaxed.” Same with going to the doctor’s office.

So, how often to check?

“I think if you’re over 55 you probably should be checking your blood pressure daily, especially if you have been diagnosed with hypertension or have a familial history,” she said.

She suggested checking right as you wake up in the morning on an empty stomach and before taking medication, logging readings, and bringing your doctor anywhere from a couple of weeks to 30 days of results, especially if you have cardiovascular disease.

Lundberg is equally firm about regular monitoring, although she leans into two to three times a month instead.

Dr. Searle Videlefsky, a cardiologist with Northside Hospital Heart Institute, says buying a machine to measure blood pressure is less extensive than you might think. According to WebMD, many at-home monitors cost less than $100.

Quit smoking

While most insurance plans offer a smoking cessation program, health experts add there’s no one-size-fits-all for snuffing the tobacco habit.

“I’ve had patients who have quit cold turkey and I’ve had patients who have done a weaning process with a patch or Nicorette gum and they’ve also been successful,” Lundberg said. “The most important thing is a motivated patient.”

She said she quizzes those pushing for a cessation program, wanting to know how long they’ve been smoking how much they’re puffing and why they’re lighting up.

Her major recommendations are to stay away from triggers, get rid of the ashtrays, and rearrange the furniture. Stay out of your car if that’s where you frequently light up.

The American Lung Association says other helpful strategies include focusing on your motivators, building confidence in your ability to stop, managing stress, and — something that’s important for those over 55 — realizing that it’s never too late to quit.

Research supported by the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration show that even if you’re 60 and above and have been puffing for decades, stopping improves your health.

Early detection

Lundberg said a coronary artery calcium scan can detect the level of calcified buildup present in the heart arteries.

Healthline reported tests can range from $100 to $400, and many insurance plans don’t cover them. According to Lundberg, it’s “a great thing to do when you’re 50, definitely 55.”

Videlefsky takes a more measured approach. He recommended such a scan only for patients with heart disease risk factors who are not taking good care of themselves, but added anyone can take the test.

He said even if a test detects merely minor blockage it’s a helpful tool to encourage to do lifestyle modification and, if need be, medication.

Manage stress

Experts say taking up a meditation practice and beginning an exercise program are quite effective stress-busters.

“In fact, exercise has been shown to actually decrease your risk of a heart attack,” Videlefsky said.

Maynard supports meditation and breathwork — anything that can help one slow down and be more attentive to the moment, which can include anything from yoga to crocheting and knitting.

Lundberg says studies have shown that people in their 80s realize measurable health benefits if they start a regular walking program, which health educators say is the number one way to get moving. Or if they have a bad knee or hip, pivoting to swimming or water aerobics is sensible.

There’s no shame in starting a walking or another exercise regimen slowly, Maynard said. Instead of meeting that oft-suggested 30-minutes, five-day-a-week walking benchmark right away, take three 10-minute walks, giving yourself time to recover.

Heart-healthy diet

A study published in the Journal of the American Heart Association cited the Southern diet as possibly heightening the risk of sudden cardiac death.

“But things are improving. I think there’s a focus on ‘yes you can have southern cuisine but you can make it a little lighter, a little healthier,” Lundberg said.

She and Videlefsky said the Mediterranean diet is effective at helping keep heart issues at bay. Regardless of age, she said, one should be eating plenty of fruits, vegetables, and whole grains, consuming fish or seafood more than chicken or other poultry, and eating beef very infrequently.

Maynard suggested going 75% to 80% plant-based. Instead of baked chicken with a side of broccoli, plan a meal around broccoli with a side dish of chicken.

Tying directly into that is obesity, one of several lifestyle issues that lead to heart disease. Factors also include smoking and lack of exercise.

Lundberg noted a rise in heart attacks among people in their 50s and 60s compared to two or three decades ago. Studies have also shown a higher incidence of heart disease among older adults with obesity.

“The number one piece of advice I’d give to someone over 55 is (to) stay active,” Lundberg said.

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