At What Age Should I Be Concerned About the Risks of Heart Failure?
Key takeaways:
The risk for heart failure increases as you age.
Aging also increases the risk for health conditions that can lead to heart failure, such as high blood pressure or heart disease.
Lifestyle changes can help decrease the risk of heart failure.
The heart is a muscle that pumps blood to the rest of the body. Like any muscle, the heart loses strength as we age. Heart failure occurs when the heart loses enough function that it can no longer meet the body’s needs. While there’s not much any of us can do about getting older, there are lots of lifestyle choices that can help keep your heart strong and decrease your risk of developing heart failure in the future.
How common is heart failure?
Heart failure is very common. Over 6 million people in the U.S. have heart failure, and that number is expected to grow in the coming years.
Heart failure also becomes more common as people age. In American adults over the age of 40, 1 in 5 will develop heart failure within their lifetime. In people over the age of 65, heart failure is the most common cause of hospitalization, and cardiovascular diseases like heart failure are the leading cause of death.
So, at what age should I start to worry about heart failure?
There is not a specific age at which you should start thinking about whether you could have heart failure. This is different from other conditions — like breast or prostate cancer — that have specific guidelines for screening. Testing for heart failure is often prompted by the development of symptoms. But people with conditions that put them at higher risk for heart failure may start screening at the time these conditions are diagnosed, as part of their normal health maintenance.
Whether or not you have specific risk factors for heart failure, it helps to be aware of how and why we all have increased risk for the condition as we age.
Why does the risk of heart failure increase with age?
The heart is part of a larger circulatory system. This includes the heart, the blood vessels throughout the body, and the blood vessels in the lungs. Aging can increase the risk of problems with any part of this system, which in turn increases the risk of heart failure. Here, we explain what these problems look like, why they occur with aging, and what factors other than age can cause them.
Problems with the heart
The heart is made of muscle that pumps the blood, heart valves that allow the blood to pass through the different chambers, and an electricity system that controls the heartbeat. The breakdown of any of these can lead to heart failure, and aging can increase the risk of many of these problems. Here are some examples:
Heart valve conditions, such as mitral valve prolapse or buildup of calcification, can occur with wear and tear over time. These issues make it harder for the heart muscle to pump the same amount of blood.
Abnormal heart rhythms (also known as arrhythmias) also become more common with age. Atrial fibrillation is one of the most common examples. When the heart isn’t able to beat in its natural rhythm, this can keep it from pumping blood effectively.
Abnormalities of the size and shape of the heart muscle, known as cardiomyopathy, can be related to damage that occurs suddenly (like a heart attack) or over time (like with heavy drinking or use of certain drugs like cocaine or methamphetamine).
Problems with the blood vessels
The heart pumps blood through blood vessels to get to the rest of the body. As we age, those blood vessels become stiffer, a condition called atherosclerosis.
In men, this typically starts around age 45, and in women, around age 55. This requires the heart to work harder to get the blood moving, the same way it is harder to pump water through clogged pipes. This extra workload on the heart increases the risk of developing heart failure.
Other conditions like obesity, high blood pressure, high cholesterol, and diabetes can increase the risk of atherosclerosis. Smoking is also an important contributor to atherosclerosis.
Problems with the lungs or breathing
In addition to pumping blood throughout the body, the heart is responsible for moving blood through the lungs to pick up oxygen and drop off carbon dioxide. Similar to stiff blood vessels in the body, lung and breathing problems can also make it harder for the heart to pump blood through the lungs.
Chronic obstructive pulmonary disease (COPD) is an example of such a lung problem. The risk of COPD increases with age, but smoking is the most common cause of COPD.
Obstructive sleep apnea (OSA) is another example of a breathing problem that affects the heart. Just like COPD, the risk of sleep apnea increases with age. Obesity is a significant risk factor as well.
What can I do now to prevent heart failure as I get older?
To some extent, our risk for heart failure increases as we get older no matter what we do. But there are plenty of lifestyle changes that can help to minimize that risk.
Maintain a healthy weight
While there is no one-size-fits-all approach to weight, keeping your weight within a healthy range can help decrease the risk of conditions that can lead to heart failure, such as high blood pressure, high cholesterol, diabetes, and atherosclerosis.
Calculating your body mass index (BMI) is one way to assess if your weight is in a healthy range, though this calculation won’t take into account high muscle percentage or bone density.
There are many different strategies for managing your weight, including a well-balanced diet with plenty of fresh fruits and vegetables, whole grains, and lean protein. Staying active is also important.
Pay attention to existing health conditions
If you already have a health condition that increases your risk of heart failure, like diabetes or high blood pressure, taking the time to regularly check on these conditions is important. This can mean monitoring your blood pressure or blood sugar levels, taking your medications, and keeping up with your regular provider visits.
If there are financial issues, side effects, or scheduling conflicts that make it difficult to take your medication, make sure to mention it with your provider during your visit. They can help find the right medications that are right for your body and lifestyle.
Evaluate substance use
Smoking increases your risk of lung problems and atherosclerosis. If you smoke and want to quit, there are many resources that can help.
Heavy alcohol use can damage heart muscle. While there’s no “safe level” of alcohol, the recommended limits are 1 drink per day for women and 2 drinks per day for men.
Drugs — particularly stimulants like cocaine and methamphetamines — can significantly damage the heart and lead to heart failure. More information on online substance abuse treatment options can be found here. Information on stopping methamphetamine use specifically can be found here.
The bottom line
The risk for heart failure naturally increases as we age. But a lot of that risk comes from other conditions like high blood pressure, diabetes, smoking, poor diet, or inactivity. Small everyday choices, both good and bad, can have magnified effects over time. By doing your best to keep an active lifestyle, maintain a healthy diet, and care for your other health conditions, you can decrease your risk of heart failure as you get older.
Why trust our experts?
References
American Heart Association. (2016). About arrhythmia.
American Heart Association. (2016). Dilated cardiomyopathy (DCM).
American Heart Association. (2017). Understand your risk for heart failure.
American Heart Association. (2017). What causes heart failure?
American Heart Association. (2020). Heart valve problems and causes.
American Heart Association. (2020). What you need to know about how sleep apnea affects your heart.
Centers for Disease Control and Prevention. (2020). Heart failure.
HealthinAging.org. (n.d.). Heart failure.
National Heart, Lung, and Blood Institute. (2022). What is atherosclerosis?
National Institute on Aging. (2018). Heart health and aging.
National Institute on Drug Abuse. (2019). Methamphetamine DrugFacts.
North, B. J., et al. (2012). The intersection between aging and cardiovascular disease. Circulation Research.
