Maxy sez : Age and Your Heart

Age can impact heart health — but lifestyle and genetics can provide protection.
By Dr. Arthur Agatston
For both men and women, age is a major risk factor for heart disease. The older you are, the more wear and tear there has been on your artery walls, the longer and harder your heart has had to work, and the more time you've had to accumulate arterial plaque. It's not surprising, then, that four out of every five deaths due to heart disease occur in people over age 65.

Men, on average, show signs of cardiovascular disease about 10 years earlier than women do, and on average, men are 5 years younger when they have their first heart attack. Because men tend to get heart disease earlier than women, many women believe that they are at low risk for heart disease. They are mistaken.

Women do get heart disease, but usually later than men because their female hormones generally offer special protection for the heart while they are premenopausal. However, once a woman reaches menopause, usually in her late forties or early fifties, her estrogen levels sharply decline and her risk of having a heart attack dramatically increases. And by age 65, women are even more likely than men to develop high blood pressure. Notably, a woman who undergoes early menopause is at greater risk for heart disease than her peers who are still menstruating and still cycling estrogen.

Chronological age alone does not tell the whole story. I want to stress that just because you are in your sixties or seventies doesn't mean that your heart health is deteriorating. Recently, I reviewed the heart scan of a 74-year-old male patient who exercised daily and followed a healthy diet. There was absolutely no calcified plaque in his coronary arteries, which meant that his risk of having a heart attack was extremely low. He may have indeed chosen the right parents, but that still doesn't completely account for his good health. Some credit must go to his heart-healthy lifestyle.

That same day, I reviewed the scan of a 58-year-old woman who was overweight and sedentary. Her arteries were loaded with plaque, which put her at much greater risk of having a heart attack than my older male patient. My point is that you can have healthy arteries well into old age if you make the right lifestyle and therapeutic choices and take steps to reduce those risk factors that are within your control.


What is really important is the "physiologic" age of your arteries. Just as we are impressed by the sharp minds of many elderly people, we have also seen that they can have young arteries despite their advanced years. In many non-Western societies, where food is not overprocessed and exercise is part of everyday life, the arteries of the elderly are clean and heart attacks and strokes are rarities.