February 4, 2020

It's Never Too Late to Improve Your Heart Health

When we think about heart health, often the focus is on eating a balanced diet and exercising to help keep our blood pressure in check and our cholesterol in a healthy range. But, for many there’s often a gap between what we should be doing and what we actually do. Demanding jobs, busy family schedules and even a belief that we still have time to get back into shape can lead us to a more sedentary life than we realize. The good news is that it’s really never too late to help your heart health, although there are some important things to keep in mind.

Your Heart is a Muscle

It’s important to remember that the heart is also a muscle – and like other muscles in our body, it can lose its flexibility with age.

“Your heart has a complicated job with every beat,” says UW Health cardiologist  Amita Singh, MD. “People focus a lot on the strength of the heart’s pumping function, when it ejects blood to the rest of the body. But as you age, there are changes that can be seen in the stiffness of the heart muscle, which is important for a different reason.”

This stiffness has implications for how efficiently the heart relaxes and allows for filling. When the heart muscle can’t relax normally, the ventricle is less efficient at filling with blood before it pumps. Over time, and uncorrected, this gradual stiffening can cause symptoms of shortness of breath, or even more concerningly, signs of heart failure. While age is a factor in the heart muscle’s ability to do its job, high blood pressure and heart disease can also affect the process.

Physical Activity is a Vital Sign of Heart Health

“As physicians we try to get a sense of our patient’s capacity for being active,” says Singh, explaining that heart health isn’t just about how well the heart functions, but its ability to do the additional work that comes with physical activity. When the heart is asked to do more activity, can it do it? “It is very reassuring if it can,” she adds.

There’s no question that being fit is beneficial for long-term health. But, if someone isn’t active, there is still hope, no matter their age or even their diagnosis.

“When we think about how well patients will do – one of the first things we’re going to ask is, ‘how much activity can you currently do comfortably, and what makes you feel limited,’” Singh says. “The more they can do, the more reassured we feel, regardless of the clinical scenario ahead of them. In some ways your physical activity is like a vital sign of your heart health.”

Start Small and Make it Sustainable

It can be hard admitting we don’t do as much as we should, and we may even feel there’s no point because we’re just too old or too out of shape. But even small changes can have a positive impact.

“I have patients say ‘I don’t do that much,’ or that they’re worried because they are not active” says Singh. “So my advice to them is to start small, with achievable goals. Moderate amounts of activity can absolutely offer cardiovascular benefits.”

She comments that many patients think they have to run a marathon or commit hours to the gym to make a difference, and anything less is not worth it – so they don’t. For many people, a big commitment to physical activity is not sustainable, and a recent small study suggests it’s not even necessary.

Researchers compared two groups of individuals who were middle aged – 45-65 years – and not previously physically active. One group did yoga and strength training at least three days a week – while the other included high intensity exercises at least twice during their sessions, along with two to three days of aerobic activity. The group that included the high intensity exercise saw the greatest benefit as participants lost body fat and their heart health improved. But, Singh notes that while more research is needed, it showed that exercise could make a difference even if started later in life.

“So many people think improving your fitness has to be really drastic, intense, requiring several hours per week and if you can’t achieve that, then it’s not worth it. But it doesn’t have to be that way,” she says. The current recommendations for cardiovascular health are 150 minutes or more per week of moderate intensity exercise, or 75 minutes or more of higher intensity exercise. “From a time investment perspective, if it’s feasible and doable, it can make a difference.”

She acknowledges that it is not easy to go from zero to full activity, or even to stay motivated over time. But gradually, being active can become a habit. “You’re never too old. Being physically active is always a good thing.” 

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