How the Heart Grows Old

Many of us have questions about the effects of time and age on the heart. Is heart disease inevitable? Why is the heart more vulnerable when exposed to what used to be everyday occurrences? Does age eventually cause the heart to just “give out?”

To begin, we must remember that the heart is a muscle, and like all muscles, undergoes change with age. Not all changes in the older heart are certain, but certain changes are inevitable, even in the absence of disease:

• Heart walls thicken
• Heart rate slows, and the “timer” can be irregular with pauses
• Maximum heart rate declines
• The heart does not pump as efficiently
• The heart as a muscle loses strength

These factors mean the pumping power of the heart declines, as does the maximum heart rate (the most times the heart can contract in a minute). When this rate declines, systolic blood pressure rises as the heart works harder to give the body the oxygenated blood it craves.

As the years go by and the heart experiences a significant loss of pump function due to the changes of the heart with age, congestive heart failure can occur.

So why do we sometimes see and treat older people as frail? There is some truth to the perception that an aging heart may be slightly less capable to tolerate increased heart workloads, such as:

Illness: makes it important for the aged population to get flu and pneumonia vaccines. Another risk factor, as a result of serious illness, may be surgical procedures. Dr. John Crawford, a general practitioner physician in Charlotte, NC, says that surgery can be particularly hard on an aging heart.

Infection: can result from a number of causes, from post-surgery trauma to a wound that won’t heal due to diabetes. Infection of the heart could result from valve malfunction and other heart timing issues or a viral or bacterial attack.

Emotional Stress: irregular heartbeat, increased pumping action, increased resting heat rate, and other issues all contribute to the heart’s decreased ability to handle sudden or traumatic stress, and can cause pain (angina) or fainting in the older person.

Injuries:  broken bones, cuts, bruises, etc. can lead to surgery and slow healing, which may put an aging heart on overload.

Extreme Physical Exertion: during strenuous exercise, the older heart cannot squeeze down to the small size achieved by the younger heart at the end of the heartbeat. This may cause shortness of breath and angina. When angina occurs, according to Crawford, it is a sign that an area of the heart muscle is screaming for more blood supply. That blood supply could be blocked due to lifestyle choices we’ll discuss later in this article.

Certain Medications: The management of prescription drugs is complicated by the fact that an individual may be receiving prescriptions from their family doctor, a cardiologist, an orthopedist or any variety of physicians who are treating any variety of ailments at one time for one person. Some medications prescribed for heart disease and high blood pressure may cause fatigue, headache, low libido and other side effects.

Ailments and side effects no longer respond as quickly to treatment, and the body does not adapt as quickly to changes as it and the heart ages. This slow-down is an important aspect in elderly healthcare. However, they should continue to take medication as directed, never stopping on their own until a conversation with a healthcare provider indicates otherwise.

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