Senior Heart Health: Ailments, Care, and Prevention
February is American Heart Month, and those of us who care for seniors use it as an opportunity to raise awareness about one of the leading ailments in the elderly: cardiovascular disease.
Heart health for seniors takes on increasing importance as the cardiovascular system ages. Older people deal with more arrhythmia (irregular heartbeat), blood clots, thickening walls of the heart and blood vessels, and less efficient blood flow through the body. These problems often start quietly in middle age and accelerate as we get into our 60s, 70s, and 80s.
While aging is itself a risk factor for heart disease, some risk factors are within our control. The following covers essential information to discuss with your elderly loved one and their healthcare providers.
Cardiovascular Disease in the Elderly
The term “cardiovascular” reminds us that we are talking about ailments of both the heart and all the vessels that work with it—arteries, veins, and capillaries. While individuals of any age can suffer from cardiovascular disease, it becomes more common as we get older. Common heart problems in elderly patients include, but are not limited to:
High blood pressure: Also known as hypertension, this very common condition increases the risk of many other cardiovascular problems, including stroke and heart attack. What’s difficult about hypertension is that, day to day, it’s not that noticeable. This can lead to ignoring its very real risks. Contributing factors to high blood pressure are diets high in saturated fat and sodium, chronic stress, obesity, lack of exercise, poor sleep (including with apnea), using tobacco or alcohol, and certain health conditions like kidney disease.
Coronary artery disease (CAD): When there is damage to the arteries from high blood pressure, high cholesterol, diabetes, and other conditions, plaque can build up in the arteries, blocking normal blood flow. This plaque buildup is also called atherosclerosis and is made up of cholesterol, other fats, and calcium. CAD is the leading cause of angina (chest pain) as well as heart attacks.
Arrhythmia: This is experienced as an irregular heartbeat and is caused by damage to the heart’s electrical system. Contributing factors are age itself (due to tissue damage and deterioration), hypertension, diabetes, thyroid disease, and sleep apnea. Arrhythmia can also result from dehydration or electrolyte imbalance (from missing nutrients like potassium), and it can be a side effect of some medications. Arrhythmia increases the risk of stroke and heart failure.
Myocardial degeneration: This is when heart tissue thickens and weakens, leading to reduced blood flow throughout the body. In an individual, this can look like shortness of breath—even when sitting down—fatigue, and edema (swelling in parts of the body, often legs or feet, because of pooling blood and other fluids). Causes include certain infections, nutritional deficiency, drinking alcohol, stress, and sometimes genetics.
Arteriosclerosis: This is similar to myocardial degeneration, but for the blood vessels instead of the heart.
Congestive heart failure: This is a chronic condition that happens when a damaged heart cannot pump adequate blood through the body. Fluid builds up in the lungs and/or legs and arms. Heart failure is often the result of chronic cardiovascular disease/damage, or it can begin after a heart attack. It is more common in those over 75 years of age.
Aneurysm: Aneurysms happen suddenly and are frequently fatal. They occur when part of a weakened artery widens abnormally and then bursts. Prevention of an aneurysm is focused on general blood vessel health, as well as medical screening.
Heart attack: Medically known as a myocardial infarction, a heart attack happens when a blockage (usually a blood clot triggered by plaque buildup) stops blood from flowing normally to the heart. When this happens, heart tissue quickly begins to die. Signs of a heart attack include shortness of breath, nausea or vomiting, extreme fatigue, dizziness, a cold sweat, and intense chest pain. Different symptoms are more common in women vs. men.
Stroke: This is similar to a heart attack, but affecting the brain instead. In addition to a clot, it can be caused by brain bleeding (hemorrhage). Signs of a stroke include severe headache, vision problems, confusion, difficulty speaking, and sudden numbness. It is common to lose control over one half of the body.
Other common conditions include varicose veins, deep vein thrombosis, and aortic stenosis.
Preventive Care for Heart Disease
Much of senior heart disease prevention is focused on keeping the heart and blood vessels strong and clear. This means preventing the strain caused by hypertension, safely exercising the cardiovascular system, and making lifestyle choices that promote healthy arteries.
First, be sure your loved one visits their doctor regularly. Blood tests can assess cholesterol levels and catch problems early, including high blood sugar or other diseases that impact cardiovascular health. Their medical office will take their blood pressure, but this is something you can also do at home. You can also monitor pulse; a normal heart rate for an elderly individual is 60-100 beats per minute when they are at rest, with an average in the 70s. If resting heart rate falls outside this window, bring it up with their doctor.
If your loved one is prescribed medications to manage cholesterol or hypertension, make a plan to ensure they take it exactly as prescribed. Encourage them to speak up about side effects or changes they notice, and don’t be shy about bringing issues promptly to their doctor.
The most important lifestyle change your loved one can make for their cardiovascular health is to quit smoking, since it severely damages bodily tissue. Beyond this, avoiding alcohol and adopting a heart healthy diet are effective ways to preserve the health of their heart and blood vessels. Speak to a doctor or registered dietician about foods to emphasize and foods to avoid. Also find out the healthy target weight range for your loved one and get assistance with diet planning to help them stay within it.
Stress is hard on the whole body, so managing it becomes crucial. Help your loved one find enjoyable activities for relieving stress, whether that is chair yoga or playing a musical instrument. Facilitate their social life; this may mean helping them with rides or with technology to stay in touch with friends and family. If their stress is intense and possibly diagnosable as a mental health disorder, help them find resources such as a counselor or support group.
Exercise is important at every age, but seniors may not be able to safely do all the activities they once did. Talk to their doctor or an occupational therapist about simple, appropriate exercises to maintain flexibility and balance, increase blood flow, and strengthen muscles. This is important for cardiovascular health, but has the side benefit of helping to prevent falls.
Check in with your senior loved one about any cardiovascular symptoms they may be experiencing—shortness of breath, easy tiredness, chest pain, pain in arms or legs, dizziness, or trouble sleeping. Encourage them to see their doctor regularly and to make lifestyle choices that help prevent heart disease in old age.
If you need support in caring for your elderly loved one, our VetAssist mission is to make home care easily and quickly accessible for those who qualify through the VA Pension with Aid and Attendance benefit. Veterans Home Care can help you determine whether you or your loved one will be eligible to receive the benefit, which can cover some or all of the cost of home care, and we make it easy to apply. Chat with us via our website, or call us at (888) 314-6075.
